针刀、电针和圆利针对膝骨关节炎模型兔股直肌Bcl-2、Bax、Caspase-3蛋白表达的影响  

Effects of Acupotomy,Electroacupuncture or Round-sharp Acupuncture Needle Interventions on Expression of Bcl-2,Bax,Caspase-3 Proteins of Rectus Femoris in Rabbits with Knee Ostarthritis

作　　者：黄怡然[1] 金英利[1] 李娜[1] 雷林丹[1] 余飞[1] 李玉波[1] 陶琳[1] 张茜[1] 郭长青[1] 

机构地区：[1]北京中医药大学针灸推拿学院,北京100029

出　　处：《针刺研究》2014年第2期100-105,123,共7页Acupuncture Research

基　　金：国家自然科学基金项目(No.81173333)

摘　　要：目的:从细胞凋亡角度探讨不同干预方法对制动致关节损伤的治疗机制。方法:6月龄新西兰兔随机分为正常组、模型组、针刀组、电针组和圆利针组,每组9只,用改良的Videman左后肢伸直位固定制动法建立兔膝关节损伤模型。电针组电针左侧"阳陵泉"-"阴陵泉""内膝眼"-"外膝眼",每次20min,隔日1次,每周3次,共3周;针刀组从兔左侧内、外侧副韧带及髌韧带的中点前缘进针,刀口线与韧带方向平行,分别松解5次,每周1次,共3次;圆利针进针点与针刀组一致,分别松解5次,每周1次,共3次。分别于造模后4、8和12周各时间窗评定各组兔双侧膝关节被动活动范围。采用Western blot法检测各组兔患肢股直肌B淋巴细胞瘤-2(Bcl-2)、Bcl-2相关的X蛋白(Bax)、天冬氨酸特异性半胱氨酸蛋白酶-3(Caspase-3)蛋白表达水平。结果:造模后4周出现稳定的实验性膝骨关节炎兔模型。造模后4、8、12周时,与正常组比较,模型组兔患侧膝关节被动活动度明显降低(P<0.01);治疗结束后,与模型组相比,针刀组、电针组和圆利针组兔患侧膝关节被动活动度显著提高(P<0.01)。各组患肢股直肌Bcl-2蛋白表达的变化差异无统计学意义(P>0.05)。模型组患肢股直肌Bax、Caspase-3蛋白表达较正常组明显升高(P<0.05),Bcl-2/Bax比值明显降低(P<0.05);针刀组、圆利针组Bax、Caspase-3蛋白表达较模型组明显降低(P<0.05),Bcl-2/Bax比值明显升高(P<0.05);电针组上述各指标的变化与模型组相比,差异无统计学意义(P>0.05)。结论:针刀、圆利针和电针干预膝骨关节炎兔均有治疗效果,针刀和圆利针可通过下调Bax、Caspase-3蛋白表达,升高Bcl-2/Bax比值抑制膝骨关节炎兔股直肌细胞凋亡,从而发挥治疗作用,这与电针治疗关节损伤的机制存在差异。Objective To observe the effect of acupotomy, electroacupuncture （EA） or round-sharp acupuncture needle intervention on the expression of Bcl-2,Bax and Caspase-3 proteins in the rectus femoris in rabbits with knee ostarthritis （KOA）, so as to explore their mechanisms underlying improvement of braking-induced joint damage from the cellular apoptosis. Methods Forty-five New Zealand rabbits were equally and randomized into control group, model group, acupotomy （AP） group, EA group and round-sharp acupuncture needle （RSAN） group （n = 9 in each group）. The knee-joint injury model was established by fixing the left knee joint in extention position with plaster bandage. EA （2 Hz/100 Hz, 3 mA, 20 min each time） was applied to the left ＂Yanglingquan＂ （GB 34）- ＂Yinlingquan＂ （SP 9） and left ＂Neixiyan＂（EX-LE 4）-＂Waixiyan＂（ST 35） for rabbits in the EA group. The EA treatment was given once daily, 3 times a week, 3 weeks in total. For rabbits of the AP group, a needle-knife was held to insert into the front edge of the midpoint, the starting point and the stopping point of the left medial collateral ligamen, la- teral collateral ligament and the patellar ligament of the knee to make a loosening manipulation for 5 times in a session of treat- ment, once a week, 3 times altogether. For rabbits of the RSAN group, a round-sharp needle was performed in the same way tothe needle-knife including the stimulation point, the manipulation method and treatment sessions. At the end of the experiment, the left rectus femoris was taken out for detecting the expression of Bcl-2,Bax and Caspase-3 proteins with Western blot. Results In comparison with the control group, the passive range of motion （PROM） level was significantly decreased 4, 8 and 12 weeks after modeling （P〈0.01）, and the expression levels of Bax and Caspase-3 proteins in the rectus femoris were considerably up- regulated in the model group （P〈0.05）, while the ratio of Bcl-2/Bax was notably down-regulated �

关 键 词：针刀 电针 圆利针 膝骨关节炎 股直肌 细胞凋亡 Bcl-2 Bax Caspase-3 

分 类 号：R245.31[医药卫生—针灸推拿学]