“舒筋”手法对膝关节骨性关节炎家兔关节液白介素1β和5-羟色胺的影响研究  

Effects of Massage with "Relaxing Tendons" Technique on the Interleukin-1β and 5-hydroxytryptamine Levels in the Joint Fluid of a Rabbit Knee Osteoarthritis Model

作　　者：吴佳航 张弛[2] 董思佳[1] 尹浩 WU Jia-hang;ZHANG Chi;DONG Si-jia;YIN Hao(Chengdu University of TCM,Chengdu 610075,China;Orthopedics of Chinese Medicine Teaching-research Section,Chengdu University of TCM,Chengdu 611137,China;Ziyang Hospital of Traditional Chinese Medicine,Ziyang 641300,China)

机构地区：[1]成都中医药大学,四川省成都市610075 [2]成都中医药大学中医骨伤科教研室,四川省成都市611137 [3]四川省资阳市中医院,641300

出　　处：《中国全科医学》2018年第6期688-693,共6页Chinese General Practice

基　　金：四川省科技厅项目(2016KZ0030);四川省教育厅重点项目(15ZA0096);成都市科技局项目(2016-HM01-00417-SF)

摘　　要：目的观察"舒筋"手法对家兔膝关节骨性关节炎模型关节软骨病理改变及关节液中白介素1β、5-羟色胺的影响。方法 2015年8—12月选取50只家兔,按随机数字表法分为空白组12只和造模组38只,采用木瓜蛋白酶注射法造模,造模结束1周后,随机抽取2只造模组家兔检验造模成功与否,将造模成功的36只家兔按随机数字表法分为模型组、玻璃酸钠组和手法组,每组12只。空白组和模型组均常规饲养,未行治疗;玻璃酸钠组右膝关节腔注射玻璃酸钠注射液0.2 ml,1次/周,共注射5次。手法组对右膝关节行"舒筋"手法治疗,12 min/次,隔日1次。每组分别于第8周末、第12周末各处死6只家兔,采用改良Lequesne MG的膝关节级别评估方法评估膝关节,Mankin's评分标准对关节软骨组织变化情况进行评分,ELISA法测定关节液中白介素1β、5-羟色胺。结果第8、12周末,模型组、玻璃酸钠组、手法组改良Lequesne MG评分、关节软骨大体评分、Mankin's评分与空白组比较,差异有统计学意义(P<0.05);第8、12周末,玻璃酸钠组、手法组改良Lequesne MG评分、关节软骨大体评分、Mankin's评分低于模型组(P<0.05)。第8、12周末,模型组、玻璃酸钠组、手法组白介素1β、5-羟色胺与空白组比较,差异有统计学意义(P<0.05);第8、12周末,玻璃酸钠组、手法组白介素1β、5-羟色胺低于模型组(P<0.05)。第8周末玻璃酸钠组、手法组改良Lequesne MG评分、关节软骨大体评分、Mankin's评分高于第12周末(P<0.05)。第8周末玻璃酸钠组、手法组白介素1β、5-羟色胺高于第12周末(P<0.05)。结论 "舒筋"手法可明显抑制家兔膝关节骨性关节炎模型关节软骨的退变,抑制炎性因子白介素1β、5-羟色胺表达。Objective To investigate the effects of the massage with"relaxing tendons"technique on the pathological changes of articular cartilage and the expression of interleukin-1β(IL-1β)and 5-hydroxytryptamine(5-HT)in the joint fluid of a rabbit knee osteoarthritis model.Methods We conducted this study between August and December 2015.Fifty rabbits were divided into blank group(n=12)and modeling group(n=38)based on the random number table.Papain injection was used to establish the model.One week after modeling,from the modeling group,2 randomly selected rabbits were sacrificed and examination results showed that the modeling was successful.The remaining 36 rabbits were randomized into model subgroup,sodium hyaluronate subgroup,and manipulation subgroup with 12 in each.The blank group and model subgroup received no interventions except conventional feeding.Rabbits in the sodium hyaluronate subgroup received injection of Sodium hyaluronate 0.2 ml in the right knee joint cavity,once a week,5 times in total.And those in the manipulation subgroup received 12-min right knee massage with"relaxing tendons"technique,once every other day.At the end of 8th and 12th weeks of intervention,from each group,6 rabbits were selected and sacrificed for pathological examination.The severity for osteoarthritis was assessed by modified Lequesne Index.Osteoarthritic cartilage was evaluated by Mankin score.The expression levels of IL-1βand 5-HT in the joint fluid were measured by ELISA.Results At the end of 8th and 12th weeks of intervention,the modified Lequesne knee score,gross score of articular cartilage erosion and Mankin's score differed significantly between the blank group and 3 subgroups(P<0.05);the model subgroup had substantially lower modified Lequesne knee score,gross score of articular cartilage erosion and Mankin's score compared with other 2 subgroups(P<0.05);significant differences in the expression levels of IL-1βand 5-HT in the joint fluid were found between the blank group and 3 subgroups(P<0.05);the model subgroup demon

关 键 词：骨关节炎 膝 舒筋整复手法 白细胞介素1Β 血清素 兔 

分 类 号：R684.3[医药卫生—骨科学]