针刀松解法治疗髌骨半脱位的相关分子机制实验研究  

Molecular Mechanism of Acupotomy Loose Therapy in Treating Subluxation of Patella

作　　者：宋寒冰[1] 李远峰[1] 刘家兴 王革强 任树军[1] 徐英杰[1] 姜益常[1] SONG Hanbing;LI Yuanfeng;LIU Jiaxing;WANG Geqiang;REN Shujun;XU Yingjie;JIANG Yichang(The First Affiliated Hospital of Chinese Medicine, Harbin 150040, China)

机构地区：[1]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040

出　　处：《针灸临床杂志》2021年第6期74-78,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：黑龙江自然科学基金,编号:H2017052;2011年教育部“春晖计划”合作科研项目,编号:Z2010050;黑龙江省普通本科高等学校青年创新人才培养计划,编号:UNPYSCP-2017228;黑龙江中医药大学“优秀创新人才支持计划”科研项目,编号:2018RCQ07;黑龙江省中医药学会青年中医药科技创新项目,编号:ZHY19-033。

摘　　要：目的:应用针刀松解法治疗大兔髌骨半脱位,观察治疗后的效果以及对髌股关节软骨相关作用分子含量的影响,来验证针刀松解法对髌骨半脱位的治疗作用机制,为针刀治疗髌骨半脱位提供理论基础。方法:造模采用手术方法制作髌骨半脱位模型,将体质量及月龄相当的实验用大兔共48只随机平均分为4组:假手术组、模型组、阳性对照组和治疗组。每组12只大兔(6只雌性、6只雄性)。治疗组采用针刀松解法治疗;阳性对照组应用中医经络理论进行电针针刺治疗;模型组造模成功后常规饲养,不做任何治疗;假手术组采用未造模大兔常规饲养。结果:与模型组比较,治疗组和阳性对照组改良Lequesne MG评分显著降低,而髌股指数显著升高,且差异具有统计学意义(P<0.05);通过ELISA法检测,可见治疗组较阳性对照组及模型组IL-1、TFN-α及MMP-3含量均呈显著降低,比较差异具有统计学意义(P<0.01);通过免疫组化染色观察,模型组MMP-3、TNF-α及IL-1镜下呈棕黄色异染颗粒,而治疗组和阳性对照组棕黄色异染颗粒明显减少,治疗组黄色异染颗粒最少,治疗组与模型组和阳性对照组比较差异具有统计学意义(P<0.01)或P<0.05。结论:应用针刀松解法治疗髌骨半脱位效果明显,针刀松解法可以改善髌骨半脱位髌骨软骨破坏,其作用机制可能与IL-1、TNF-α和MMP-3等炎性因子有关。Objective:To observe the effect of the acupotomy loose therapy in treating subluxation of patella in rabbits and its influence to the contents of molecules related to patellofemoral cartilage,to verify the therapeutic mechanism of acupotomy loose therapy on subluxation of patella,thus to provide theoretical basis for the treatment of the disease.Methods:A total of 48 rabbits were randomly divided into the sham group,the model group,the positive control group and the treatment group.The subluxation of patella model was made by operation.The treatment group was treated by acupotomy loose therapy and the positive control group was treated with electro-acupuncture with TCM meridian theory.Results:Compared to the model group,the improved Lequesne MG scores decreased significantly in the treatment group and the positive control group,whereas the patellofemoral indexes increased significantly(P<0.05).The levels of IL-1,TFN-αand MMP-3 were significantly lowered in the treatment group than those in the positive control group(P<0.05),the model group and the sham group(P<0.01).In terms of the immunohistochemical staining,MMP-3,TNF-αand IL-1 were stained with brown-yellow metachromatic particles in the model group,whereas those in the treatment group and the positive control group were significantly decreased;those in the treatment group were the least compared to and the positive control group and the sham group(P<0.05,P<0.01).Conclusion:Acupotomy loose therapy is effective in the treatment of subluxation of patella.It can improve the destruction of patellar cartilage in subluxation of patella,which may be related to the inflammatory factors of IL-1,TNF-αand MMP-3.

关 键 词：针刀松解法 髌骨半脱位 髌股指数 分子机制 

分 类 号：R246.2[医药卫生—针灸推拿学]