| 摘要: |
| 目的：探讨温针灸对膝骨关节炎（knee osteoarthritis， KOA）模型兔股四头肌生物力学特征及软骨退化的影响。方法：将18只健康普通级新西兰兔按随机数字表法分为空白组、模型组、温针灸组，每组各6只。空白组正常饲养，模型组和温针灸组采用膝关节腔内注入0.5 mL浓度为4%的木瓜蛋白酶溶液建立兔KOA动物模型。造模成功后，温针灸组选取犊鼻、内膝眼、阳陵泉3个穴位对模型兔进行温针灸干预，每日1次，连续2周。采用改良版膝骨关节炎严重程度（lequesne severity index for knee osteoarthritis，Lequesne MG）指数对兔膝骨关节炎严重程度进行评估，采用数字化弹性触诊仪对兔右侧关节股四头肌的肌肉物理特性进行检测，采用酶联免疫吸附法（Enzyme-Linked Immunosorbent Assay，ELISA）检测血清肿瘤坏死因子-α（tumor necrosis factor-alpha，TNF-α）、白细胞介素-1β（interleukin-1 beta，IL-1β）、基质金属蛋白酶-3（matrix metalloproteinase-3，MMP-3）水平，采用苏木精-伊红染色（Hematoxylin and Eosin Staining，HE）观察软骨组织病理形态，并进行关节软骨组织学评分（Mankin’s评分）。结果：与空白组相比，模型组Lequesne MG指数评分、Mankin’s评分及血清TNF-α、IL-1β、MMP-3水平均显著升高，股直肌（rectus femoris，RF）、股内侧肌（vastus medialis，VM）、股外侧肌（vastus lateralis，VL）的自然振动频率（natural oscillation frequency，F）、动态刚度（dynamic stiffness，S）、对数衰减率（logarithmic decrement，D）均明显升高，差异均有统计学意义（P<0.01）；病理形态学显示，模型组关节面有软骨缺损、骨赘多、滑液浑浊。与模型组相比，温针灸组Lequesne MG指数评分、Mankin’s评分及血清TNF-α、IL-1β、MMP-3水平均降低，RF、VM、VL的F、S、D值均降低，差异均有统计学意义（P<0.01）；病理形态学显示，温针灸组关节软骨基本正常，软骨表面偶有浅表层磨损。结论：温针灸可有效改善膝骨关节炎模型兔膝关节功能，降低局部炎症因子水平，减轻关节软骨病理损伤，并调节股四头肌生物力学异常状态。 |
| 关键词: 膝骨关节炎 软骨退化 温针灸 生物力学 肌肉物理特性 |
| DOI： |
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| Effect of warming acupuncture-moxibustion on the biomechanical characteristics of the quadriceps femoris and cartilage degeneration in rabbits with knee osteoarthritis |
| WU Qixiang,ZHANG Yu,ZENG Min,PENG Kezhi |
| (Guizhou University of Traditional Chinese Medicine, Guiyang 550025, Guizhou, China) |
| Abstract: |
| Objective: To investigate the effect of warming acupuncture-moxibustion on the biomechanical characteristics of the quadriceps femoris and cartilage degeneration in a rabbit model of knee osteoarthritis （KOA）. Methods: A total of 18 healthy New Zealand rabbits were divided into blank group, model group, and warming acupuncture-moxibustion group using a random number table, with 6 rabbits in each group. The rabbits in the blank group were fed normally, and those in the model group and the warming acupuncture-moxibustion group were injected with 0.5 mL of 4% papain solution into the knee joint cavity to establish an animal model of KOA. After successful modeling, the rabbits in the warming acupuncture-moxibustion group were given warming acupuncture-moxibustion at Dubi, Neixiyan, and Yanglingquan points, once a day for 2 consecutive weeks. The modified Lequesne severity index for knee osteoarthritis （Lequesne MG） was used to assess the severity of KOA; a digital elastic palpation instrument was used to measure the physical properties of the quadriceps femoris in the right joint of the rabbits; ELISA was used to measure the serum levels of tumor necrosis factor-α （TNF-α）, interleukin-1β （IL-1β）, and matrix metalloproteinase-3 （MMP-3）; HE staining was used to observe the pathology of cartilage tissue, and the histological score of articular cartilage （Mankin’s score） was determined. Results: Compared with the blank group, the model group had significant increases in Lequesne MG score, Mankin’s score, and the serum levels of TNF-α, IL-1β, and MMP-3, as well as significant increases in the natural oscillation frequency （F）, dynamic stiffness （S）, and logarithmic decrement （D） of the rectus femoris （RF）, the vastus medialis （VM）, and the vastus lateralis （VL） （P<0.01）, and pathological morphology showed that the model group had cartilage defects on the articular surface, with multiple osteophytes and turbid synovial fluid. Compared with the model group, the warming acupuncture-moxibustion group had significant reductions in Lequesne MG score, Mankin’s score, and the serum levels of TNF-α, IL-1β, and MMP-3, as well as significant reductions in the F, S, and D values of the RF, the VM, and the VL （P<0.01）, and pathological morphology showed that the warming acupuncture-moxibustion group had basically normal articular cartilage, with occasional superficial wear on the cartilage surface. Conclusion:
Warming acupuncture-moxibustion can effectively improve knee joint function, reduce the levels of local inflammatory factors, alleviate the pathological injury of articular cartilage, and regulate biomechanical abnormalities of the quadriceps femoris in rabbits with KOA. |
| Key words: knee osteoarthritis cartilage degeneration warming acupuncture-moxibustion biomechanics physical properties of muscle |
