CAJ | 학술논문

目的：研究电针配合穴位注射骨瓜提取物治疗日本大耳白兔类风湿关节炎镇痛消炎作用机制。方法：日本大耳白兔40只，随机分为模型组、电针组、骨瓜提取物组及联合治疗组，4组大鼠均经右膝关节腔内多点注射小牛软骨Ⅱ型胶原加福氏完全佐剂0．1 ml制备类风湿性关节炎动物模型，造模成功后电针组取血海、足三里、阳陵泉3穴为主穴电针刺激30 min；骨瓜提取物组肌注骨瓜提取物注射液；联合治疗组取足三里、血海、阳陵泉3穴为主穴电针刺激30 min后穴位注射骨瓜提取物；模型组注射生理盐水。以上各组均治疗14天，并于治疗前后14天测定关节滑膜BMPs及MMP－1阳性表达率，测关节积液前列腺素E2（PGE2）、透明质酸（HA）、白细胞介素－8（IL－8），并计算膝关节肿胀百分率。结果：经14天治疗，联合治疗组关节滑膜BMPs及关节积液中HA分泌增高，PGE2、IL－18、MMP－1细胞阳性表达率及肿胀百分率明显降低，与治疗前及电针组、骨瓜提取物组比较，P＜0．05，差异均有统计学意义。结论：电针配合穴位注射骨瓜提取物能有效治疗日本大耳白兔类风湿性关节炎，其作用机制可能为电针刺激经络激发经气，促进关节局部血液循环及病变组织新陈代谢，提高关节滑膜BMPs分化及关节积液中HA分泌，抑制IL－1β、PGE2等炎性因子合成，提高病变部位痛阈，减轻关节疼痛而起到协同治疗作用。
목적：연구전침배합혈위주사골과제취물치료일본대이백토류풍습관절염진통소염작용궤제。방법：일본대이백토40지，수궤분위모형조、전침조、골과제취물조급연합치료조，4조대서균경우슬관절강내다점주사소우연골Ⅱ형효원가복씨완전좌제0．1 ml제비류풍습성관절염동물모형，조모성공후전침조취혈해、족삼리、양릉천3혈위주혈전침자격30 min；골과제취물조기주골과제취물주사액；연합치료조취족삼리、혈해、양릉천3혈위주혈전침자격30 min후혈위주사골과제취물；모형조주사생리염수。이상각조균치료14천，병우치료전후14천측정관절활막BMPs급MMP－1양성표체솔，측관절적액전렬선소E2（PGE2）、투명질산（HA）、백세포개소－8（IL－8），병계산슬관절종창백분솔。결과：경14천치료，연합치료조관절활막BMPs급관절적액중HA분비증고，PGE2、IL－18、MMP－1세포양성표체솔급종창백분솔명현강저，여치료전급전침조、골과제취물조비교，P＜0．05，차이균유통계학의의。결론：전침배합혈위주사골과제취물능유효치료일본대이백토류풍습성관절염，기작용궤제가능위전침자격경락격발경기，촉진관절국부혈액순배급병변조직신진대사，제고관절활막BMPs분화급관절적액중HA분비，억제IL－1β、PGE2등염성인자합성，제고병변부위통역，감경관절동통이기도협동치료작용。
Objective:To study the analgesic and anti-inflammatory mechanism of electroacupuncture com-bined with acupoint injection of bone melon extract for the treatment of rheumatoid arthritis of Japanese big ear rabbits.Methods:40 white rabbits were randomly divided into a model group,an electro acupuncture group,a bone melon extract group and a combined treatment group.In four groups rats were treated by the right knee joint cavity of multi point injection of bovine type II collagen with Freund's complete adjuvant 0.1 mL prepara-tion in animal models with rheumatoid arthritis.After the success of modeling of electro acupuncture group, Zu-sanli , Xuehai and Yanglingquan were electroacupunctured for 30 min;the bone and melon extract group was in-jected with bone melon extract injection and in the combined treatment group, Zusanli, Xuehai and Yan-glingquan were electroacupunctured for 30 min and then received acupoint injection of bone melon extract,and the model group was injected with physiological saline.All groups were treated for 14 days( D) .Determine the synovial joint BMPs and MMP-1 positive expression rate before and after treatment and measure joint effusion of prostaglandin E2(PGE2), hyaluronic acid (HA), interleukin-8 (IL-8), and calculate the percentage of knee joint swelling.Results:After 14d treatment, in the combined treatment group the joint effusion synovial BMPs secretion of HA was increased and PGE2,IL-18,MMP-1 positive cells rate and swelling percentages were decreased significantly, compared with those before treatment and those in the acupuncture group, bone and melon extract group,P<0.05,and the difference had a statistical significance.Conclusion:Electro acu-puncture combined with acupoint injection of bone melon extract can be effective in the treatment of rheumatoid arthritis of Japanese big ear rabbits, and its mechanism may be through main and collateral channels and elec-troacupuncture stimulation, promoting the joint local blood circulation and superseding diseased tissues with the new.It can increase HA secretion of synovial BMPs differentiation and joint effusion, inhibit IL-1 beta, PGE2 and other inflammatory cytokines synthesis,raise the pain threshold and reduce joint pain.Therefore,it has a synergistically therapeutic effect.