不同艾灸距离对Ⅱ型胶原诱导型关节炎疗效的影响  

Therapeutic efficacy of moxibustion at different distances on type Ⅱ collagen-induced arthritis

作　　者：王洋[1] 吴心雨 孙志岭[1] 张永怡[1] 薛莲[1] 秦雪[1] 

机构地区：[1]南京中医药大学护理学院,江苏省南京市210023

出　　处：《中国组织工程研究》2017年第8期1241-1245,共5页Chinese Journal of Tissue Engineering Research

基　　金：江苏省"青蓝工程"资助项目(2014);江苏省普通高校学术学位研究生科研创新计划项目(KYLX16_1164);江苏省高等学校大学生创新创业训练计划重点项目(201610315015Z);江苏省优势学科二期项目南京中医药大学护理学一级学科指令性课题(YSHL2016-014)~~

摘　　要：背景:有研究表明艾灸能够改善类风湿关节炎的关节症状、降低炎症反应,但艾灸操作缺乏标准。艾灸距离成为影响艾灸疗效的因素之一。目的:对比不同艾灸距离治疗类风湿关节炎的疗效差异,探索最佳灸距。方法:将40只雄性SD大鼠随机分出8只作为对照组,其他32只均造模处理。建立Ⅱ型胶原诱导型关节炎模型大鼠,分别按不同艾灸距离1,2,3 cm灸"肾俞(BL23)"及"足三里(ST36)"穴,每日灸1次,每个穴位10 min,每个疗程为6 d,各疗程间休息1 d,总共干预3个疗程,同时设置模型组。结果与结论:(1)一般情况及炎性反应情况:模型组大鼠除体质量外,足趾容积、关节炎评分、血清白细胞介素1β、肿瘤坏死因子α水平较对照组显著升高(P<0.01),艾灸干预后上述各指标艾灸各组较模型组均明显降低(P<0.01),并且艾灸1,2 cm组优于艾灸3 cm组(P<0.01);(2)踝关节组织学变化:模型组可见关节腔变窄、关节腔内可见炎细胞及血管翳形成,艾灸1,2,3 cm组可见中度炎细胞浸润,血管翳较少;(3)结果说明,艾灸在改善关节功能、调节免疫方面具有一定作用,可下调白细胞介素1β、肿瘤坏死因子α的水平,减轻滑膜增生。艾灸距离为1或2 cm时,可提高艾灸的效果。BACKGROUND： Moxibustion can improve the symptoms of rheumatoid arthritis and reduce inflammation, but there are no uniform operation standards. The moxibustion distance becomes one of factor influencing the therapeutic efficacy. OBJECTIVE： To compare the effects of different moxibustion distances on rheumatoid arthritis, and to explore the optimal distance. METHODS： The 8 of 40 male Sprague-Dawley rats were randomly selected as controls. The other 32 were used to make animal modes of collagen type II-induced ankle arthritis, and then given moxibustion at Shenshu （BL23） and Zusanli （ST36） at an interval of 1,2 and 3 cm, respectively, once daily, 10 minutes at each point, 6 days per course for three courses, with a course interval of 1 day. Model rats with no treatment acted as model group. RESULTS AND CONCLUSION： Compared with the control group, the toe volume, arthritis index and serum levels of interleukin-113 and tumor necrosis factor-a except the body mass were significantly increased in the model group （P 〈 0.01 ）. After moxibustion treatment, these indexes were significantly decreased in the three treatment groups （P 〈 0.01）, especially in the 1 and 2 cm groups （P 〈 0.01）. Narrowed articular cavity, intra-articular inflammation and pannus formation were observed in the model group, while only moderate inflammatory cell infiltration and few pannus formation were found in the 1 2, 3 cm groups. These results indicate that moxibustion improves joint functions and regulates immune reaction by downregulating the levels of interleukin-I β and tumor necrosis factor-a, as well as reducing synovial hyperplasia. In addition, the optimal distance for moxibustion is 1 or 2 cm, which is a momentous proposition to improve therapeutic efficacy.

关 键 词：组织工程 关节炎 实验性 关节炎 类风湿 大鼠 骨组织工程 艾灸 距离 胶原诱导型关节炎 类风湿关节炎 细胞因子 白细胞介素1Β 肿瘤坏死因子α 关节炎指数 

分 类 号：R318[医药卫生—生物医学工程]