超短波和被动运动对兔膝关节骨性关节炎的作用  

The effects of ultrashortwave therapy and passive motion on osteoarthritis of the knee joint in the rabbits

作　　者：孔瑛[1] 邹琳[1] 伍刚 张长杰[1] 

机构地区：[1]中南大学湘雅二医院康复医学科,长沙410011 [2]长沙民政学院康复医学系

出　　处：《中华物理医学与康复杂志》2008年第9期579-583,共5页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的观察超短波和被动运动对兔膝关节骨性关节炎的治疗作用。方法取健康雄性家兔20只，采用左膝关节伸直位制动4周的方法制作实验性膝关节骨性关节炎（OA）模型，共20个膝关节。造模成功后，随机分为对照组（不接受任何治疗）、超短波组（接受超短波治疗）、被动运动组（接受被动运动治疗）、综合组（接受超短波和被动运动治疗），各组均治疗4周。分别比较每组治疗前、后OA侧膝关节被动关节活动度（PROM）。于治疗4周末处死所有兔，肉眼观察OA侧膝关节软骨形态学大体变化，取股骨内侧髁软骨进行甲苯胺蓝染色、HE染色及免疫组化染色，观察蛋白多糖染色情况，分别进行组织形态学评分及诱导型一氧化氮合酶（iNOS）的阳性细胞分数比较。结果①被动关节活动度：治疗前各组组间比较，差异无统计学意义（P〉0．05）。治疗后对照组与超短波组组间比较，差异无统计学意义（P〉0．05）；对照组、被动运动组及综合组组间比较，差异有统计学意义（P〈0．05）。治疗前、后PROM改变值最大的为综合组，其次为被动运动组，对照组、超短波组两组改变值较小。②组织学评分（Mankin评分）：对照组、超短波组、被动运动组、综合组组间比较，差异均有统计学意义（P〈0．05），评分最高的是对照组，其后依次为超短波组、被动运动组、综合组。③iNOS表达：对照组、超短波组、被动运动组及综合组组间比较，差异有统计学意义（P〈0．05），评分最高的是对照组，其后依次为超短波组、被动运动组、综合组。结论超短波、被动运动及综合治疗均可减轻和延缓骨性关节炎关节软骨退变；超短波加被动运动治疗的效果优于单纯被动运动治疗和单纯超短波治疗。Objective To investigate the effects of ultrashortwave therapy and passive motion on experimental osteoarthritis caused by immobilization of the joint. Methods Twenty healthy male rabbits had their left knee joints fixed in extension for 4 weeks. They were randomly divided into 4 groups ： a control group which did not receive any treatment, an ultrashortwave therapy group, a passive motion group, and an ultrashortwave therapy plus passive motion group, and treated accordingly for 4 weeks. The range of motion of the joint before and after treatment was compared in every group. At the end of the 4th week, all the rabbits were sacrificed, and the cartilage at the condylus medialis femoris was sampled and observed with toluidine blue staining, haematoxylin-eosin staining. Its gross ap- pearance was noted and it was also analyzed using immunohistochemical techniques. Results （1）Passive range of motion （ PROM）,： there were no significant differences among the 4 groups before the treatment. Ultrashortwave therapy per se did not yield significant therapeutic effects in terms of PROM as compared to the controls, However, passive motion alone and in conjunction with ultrashortwave therapy brought about significant improvement of PROM when compared against the control group. The most significant change was seen in the integrated group, followed by the passive motion group. （2）The histological scoring system ： Mankin＇s scoring system showed significant differences a- mong all 4 groups. The highest value was the control group, which was followed by the ultrashortwave therapy group, the passive motion group and the integrated group. （3）The positive expression rate of inducible nitric oxide synthase： there were significant differences among all 4 groups. The control group had the highest values, followed by the ultrashortwave treated group, the passive motion treated group and the integrated group. Conclusions Ultrashortwave therapy, passive motion therapy and integrated therapy combining ultrashortwav

关 键 词：骨性关节炎 关节软骨 被动运动 超短波 诱导型一氧化氮合酶 

分 类 号：R684.3[医药卫生—骨科学] R745.12[医药卫生—外科学]