经筋微创松解术治疗膝骨关节炎对TLR4/MyD88/NF-κB信号转导通路的影响  

Effects of channel-sinew micro-invasive release for the treatment of knee osteoarthritis on the TLR4/MyD88/NF-κB signal transduction pathway

作　　者：韦嵩[1] 申茜茸 李晓昊[1] 陈志煌[1] 侯春福[1] WEI Song;SHEN Xi-rong;LI Xiao-hao;CHEN Zhi-huang;HOU Chun-fu(Department of Traditional Chinese Medicine,Guangzhou General Hospital of Guangzhou Military Command,Guangzhou 510010,China)

机构地区：[1]广州军区广州总医院中医科,广州510010

出　　处：《中华中医药杂志》2018年第10期4637-4641,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81573883);广东省科技计划项目(No.2015B020233011)~~

摘　　要：目的:探讨经筋微创松解技术治疗膝骨关节炎的作用机制。方法:选取24只清洁级健康6月龄新西兰兔,6只为空白组,其余18只统一采用1.6%木瓜蛋白酶造模,空白组予以等剂量0.9%氯化钠溶液膝关节腔内注射;6周后,将18只新西兰兔等分为3组,分别为经筋微创组、电针组、造模组,治疗4周。光镜观察各组兔软骨HE染色病理切片结果;荧光定量PCR和Western blot分别检测各组软骨TLR4、MyD88、NF-κB基因和蛋白表达变化。结果:造模组膝关节软骨表面粗糙,软骨层厚薄不均;经筋微创组膝关节软骨表面轻度破坏;电针组膝关节软骨表面欠光滑,表层轻度破坏。与造模组比较,空白组、电针组、经筋微创组软骨TLR4、MyD88、NF-κB mRNA及蛋白表达均显著下调(P﹤0.05);与电针组比较,经筋微创组(除MyD88)mRNA及蛋白表达均显著下调(P﹤0.05)。结论:经筋微创松解疗法可能通过调控TLR4信号转导通路,抑制下游MyD88、NF-κB表达,阻断炎性细胞因子的分泌,改善关节疼痛、活动功能障碍等症状。Objective： To explore the mechanism of channel-sinew micro-invasive release for the treatment of knee osteoarthritis. Methods： A total of 24 6-month healthy clean New Zealand rabbits were selected, and 6 rabbits were used as the blank control group, the remaining 18 were treated with 1.6% papain for modeling, and the blank control group were injected isodose 0.9% normal saline in the left knee joint. After 6 weeks, the 18 rabbits were randomly divided into 3 groups, including channel-sinew micro-invasive group, electro-acupuncture group and model group, each group was treated for 4 weeks. The HE staining pathological sections of rabbit cartilage were observed by light microscopy. The expression changes of gene and protein of TLR4, MyD88, NF-κB were detected by fluorescence quantitative PCR and Western blot. Results： In the model group, the surface of the knee cartilage was rough, the thickness of the cartilage layer was uneven. In channel-sinew micro-invasive group, the surface of cartilage was slightly damaged. In electro-acupuncture group, the surface of the articular cartilage was not smooth and was slightly damaged. Compared with the model group, the mRNA and protein expressions of TLR4, MyD88 and NF-rB in blank group, electro-acupuncture group and channel-sinew micro-invasive group were down-regulated （P〈0.05）. Compared with the electro-acupuncture group, the mRNA and protein expressions in channel-sinew micro-invasive group （except MyD88） was down-regulated （P〈0.05）. Conclusion： Channel-sinew micro-invasive release therapy can improve the symptoms of joint pain, motor dysfunction through the regulation of TLR4 signal transduction pathway, the inhibition of the expression of MyD88 and NF-κB and the interdict of secretion of inflammatory cytokines.

关 键 词：经筋松解 膝骨性关节炎 TLR4/MYD88/NF-κB信号转导通路 作用机制 

分 类 号：R684.3[医药卫生—骨科学]