内热针干预膝骨性关节炎兔软骨下骨Ⅰ型胶原、基质金属蛋白酶3和骨桥蛋白的表达  

Effect of internal heat-type acupuncture needle therapy on the expression of type Ⅰ collagen, matrix metalloproteinase-3 and osteopontin in the subchondral bone of rabbit knee osteoarthritis model

作　　者：朱仕强 许建峰[1,2] 黑晓燕[1] 陈耘东 田心保 张金晨 林瑞珠 Zhu Shiqiang;Xu Jianfeng;Hei Xiaoyan;Chen Yundong;Tian Xinbao;Zhang Jinchen;Lin Ruizhu(Ningxia Medical University,Yinchuan 750004,Ningxia Hui Autonomous Region,China;Department of Traditional Chinese Medicine for Orthopedics,Yinchuan 750004,Ningxia Hui Autonomous Region,China;Department of Rehabilitation Medicine,General Hospital of Ningxia Medical University,Yinchuan 750004,Ningxia Hui Autonomous Region,China)

机构地区：[1]宁夏医科大学,宁夏回族自治区银川市750004 [2]宁夏医科大学总医院中医骨伤科,宁夏回族自治区银川市750004 [3]宁夏医科大学总医院康复医学科,宁夏回族自治区银川市750004

出　　处：《中国组织工程研究》2021年第17期2636-2642,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学地区基金(81860893),项目负责人:林瑞珠。

摘　　要：背景:内热针疗法是在温针灸疗法基础上,经过现代工艺改良升级的物理治疗方法,兼具针刺效应和热效应,在临床上治疗膝骨性关节炎疗效显著,但对其具体机作用制缺乏了解。目的:探讨内热针作用于兔膝骨性关节炎,对软骨下骨中Ⅰ型胶原、基质金属蛋白酶3、骨桥蛋白表达的影响及其可能的作用机制。方法:30只无特定病原体的新西兰兔采用随机数字表法,分为空白组、模型组和治疗组,每组各10只。模型组和治疗组采用经典Hulth方法选取兔左后肢膝关节进行兔膝骨性关节炎造模。治疗组选取兔左后肢膝关节进行内热针疗法干预,每周1次,每次20 min;空白组和模型组不给予任何治疗。干预4周进行实验兔左后膝关节取材,使用改良版Lequesne MG量表对各组实验兔干预前后进行行为学评价;采用甲苯胺蓝染色观察各组实验兔膝关节软骨下骨组织形态学变化;分别采用蛋白免疫印迹法和实时荧光定量PCR检测3组软骨下骨中Ⅰ型胶原、基质金属蛋白酶3、骨桥蛋白的蛋白及mRNA表达。动物实验方案通过宁夏医科大学总医院医学科研伦理审查委员会批准(批准号:2018064)。结果与结论:①与空白组相比,模型组和治疗组兔的行为学评分显著升高(P <0.05);与模型组相比,治疗组兔的行为学评分显著降低(P <0.05),且干预前后差值更大(P<0.05);②与空白组相比,模型组软骨下骨的骨小梁面积百分数、骨小梁厚度、骨小梁数目明显降低(P<0.05),骨小梁弥散度明显升高(P <0.05);Ⅰ型胶原蛋白及其mRNA表达水平显著降低(P <0.001),基质金属蛋白酶3、骨桥蛋白的蛋白及其mRNA表达水平显著升高(P <0.001);与模型组相比,治疗组软骨下骨的骨小梁面积百分数,骨小梁数目明显升高(P <0.05),骨小梁弥散度明显降低(P <0.05);Ⅰ型胶原蛋白及其mRNA表达水平显著升高(P <0.05),基质金属蛋白酶3、骨桥蛋白的蛋白及其mRNA表BACKGROUND: Internal heat-type acupuncture needle therapy is an updated physical therapy method based on warm-needle moxibustion therapy with a dual effect of acupuncture and thermal therapy. It has significant clinical effect in the treatment of knee osteoarthritis, but there is no full understanding of its specific mechanism.OBJECTIVE: To explore the effect of internal heat-type acupuncture needle on the expression of type Ⅰ collagen, matrix metalloproteinases-3, and osteopontin in the subchondral bone of a rabbit knee osteoarthritis model as well as the possible mechanism of action. METHODS: A total of 30 New Zealand rabbits(specific-pathogen-free level) were divided into a blank group, a model group and a treatment group by a random digital table, with 10 rabbits in each group. A model of knee osteoarthritis was made in the left hind leg of the rabbit by Hulth’s method. The treatment group was given internal heat-type acupuncture needle on the left hind limb knee joint, once a week, for 20 minutes once. The blank group and the model group received no intervention. Knee joint sampling was performed after behavioral evaluation using the modified Lequesne MG scale after 4 weeks of intervention. Toluidine blue staining was used to observe the morphological changes of subchondral bone tissue of rabbits in each group. Western blot and real-time quantitative PCR were used to detect the expressions of type Ⅰ collagen, matrix metalloproteinases-3, and osteopontin protein and mRNA in the subchondral bone of the rabbits. The animal experiment protocol was approved by the Medical Research Ethics Review Committee of the General Hospital of Ningxia Medical University(approval No. 2018064).RESULTS AND CONCLUSION: Compared with the blank group, behavioral scores were significantly increased in the model group and treatment group(P < 0.05). Compared with the model group, behavioral scores were significantly decreased in the treatment group(P < 0.05), and the difference between the two groups was significantly enlarged a

关 键 词：内热针 膝骨性关节炎 软骨下骨 骨代谢 骨重塑 

分 类 号：R446[医药卫生—诊断学] R496[医药卫生—临床医学]