模拟按压手法对兔膝骨关节炎治疗作用的实验研究  

Experimental study of imitate-pressing Tuina on knee osteoarthritis in rabbits

作　　者：朱鸿飞[1] 刘益杰[1] 冯伟[1] 褚立希[1] 杨松滨[1] 宁长青[1] 

机构地区：[1]上海中医药大学康复医学院,上海201203

出　　处：《上海中医药杂志》2012年第9期72-75,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81173357);上海市自然科学基金资助项目(09ZR1432000);上海市浦江人才计划资助项目(10PJ1409300);上海高校创新团队(第二期)建设项目[沪教委科(2009)26];上海市浦东新区卫生系统重点学科群建设项目(PWZxkq2011-01)

摘　　要：目的探讨推拿手法对兔膝骨关节炎的治疗作用及机制。方法将36只健康新西兰大白兔随机分为6组,每组6只,即正常组、模型组和治疗组(根据治疗手法不同再分成4组);除正常组外,其余30只实验兔采用髌韧带缺损术建立膝骨关节炎模型,8周后对治疗组实验免进行治疗,隔天治疗1次,连续治疗6周;对照组不做任何治疗。6周后,检测各组实验兔血清中TNF-α、MMP-13水平,膝关节软骨标本经HE、番红O及甲苯胺蓝染色后光镜下观察病理组织学改变,并用免疫组化检测软骨细胞整合素α1β1的表达。结果①组织形态学:治疗组与模型组比较,软骨细胞簇集和基质失染现象有减轻趋势,但未达到正常组水平;②各治疗组与模型组比较,Mankin评分及血清TNF-α、MMP-13水平差异有统计学意义(P<0.05),治疗组组间差异无统计学意义(P>0.05);③治疗组与模型组整合素α1β1表达无明显差异,但均较正常组表达高。结论软骨组织形态学及血清学检测显示,按压手法通过改变关节内应力环境,调节TNF-α、MMP-13和整合素α1β1的表达来抑制软骨细胞的凋亡,刺激软骨的组织与再生,促进软骨细胞外基质的代谢,从而起到抑制关节软骨退变的作用。Objective To explore the mechanism and efficacy of Tuina on knee osteoarthritis in rabbits. Methods Thirty-slx rabbits went randomized into six groups： normal group, model group and treatment groups （4 different treatment groups were divided based on different manipulations） , six rabbits in each group. Except for normal group, the other 30 rabbits were modeled by patellar ligament defect. The rabbits in treatment groups were treated at）er 8 weeks, every other day for 6 weeks eonlinuously. Rabbits were not treated in control group. After 6 weeks, the levels of TNF-α and MMP-13 were detected in the setalm; the changes of pathological histology was observed by light microscope alter Hematoxylin and eosin staining, safranin O staining and toluidine bluc staining; the expression of inte- grin-α1 β1 was detected by the immunohistoehemistry. Results （1）Histomorphology： compared with model group, the ehoudrocyte clustering and failure staining of matrix in treatment group were relieved, but didn＇t reach the normal level; （2）compared treatment groups with model group, there were signifieam differenees in Mankin score, TNF-α level and MMP-13 level （ P 〈 0.05 ）, but without significant difference between the treatment groups （ P 〉 0.05 ） ; （3）the results of imnluno- hlstochemistry staining showed that compared treatment groups with model group, no significant difference was found in expression of integrin-α1β1 , and the expression of integrin-α1β1 in treatment groups was higher than that in normal group. Conclusion The results of histomorphology showed that imitate-pressing Tuina can inhibit the apoptosis, stimulate regeneration and promote the metabolism of extracellular matrix in chondroeyte by changing the innerstress of joints, regulating expression of TNF-α, MMP-13 and integrin-α1 β1, hence to inhibit the degeneration of articular cartilage.

关 键 词：膝骨关节炎 动物实验 推拿手法 力学刺激 

分 类 号：R274[医药卫生—中医骨伤科学]