电针对膝关节骨关节炎大鼠滑膜炎性反应期自发痛及后期触诱发痛的影响  

Effect of electroacupuncture on spontaneous pain during the synovial inflammatory response stage and allodynia at the later stage in rats with knee osteoarthritis

作　　者：陈蔚 李恒聪 万红叶 刘一寒 景向红[1] 张晓宁[1] 何伟[1] CHEN Wei;LI Heng-cong;WAN Hong-ye;LIU Yi-han;JING Xiang-hong;ZHANG Xiao-ning;HE Wei(Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院针灸研究所,北京100700

出　　处：《中国针灸》2022年第12期1385-1393,共9页Chinese Acupuncture & Moxibustion

基　　金：国家重点研发计划项目:2019YFC1709002;北京市自然科学基金项目:7222289;中国中医科学院科技创新工程项目:CI2021A03404。

摘　　要：目的:观察电针干预对膝关节骨关节炎(KOA)模型大鼠痛行为、滑膜炎性反应和隐神经脱髓鞘的影响,探讨电针干预改善触诱发痛的效应机制。方法:将84只成年雄性SD大鼠随机分为对照组、模型组和电针组,每组28只。模型组、电针组均于右侧膝关节腔注射单碘乙酸钠(MIA)建立KOA模型。电针组分别在造模后第5、7、9天针刺右侧“足三里”“阳陵泉”,并连接电针,予疏密波(2 Hz/15 Hz),电流强度1 mA,每次30 min,每日1次,共干预3次。造模后第9天,观察各组大鼠患肢承重率;HE染色、Masson染色法观察大鼠滑膜组织形态;流式细胞术观察大鼠滑膜免疫细胞数量;MSD多因子法检测大鼠滑膜炎性细胞因子含量。造模后第14天,观察各组大鼠足底机械缩足反射阈值;使用透射电镜观察大鼠隐神经超微结构。结果:造模后第9天,与对照组比较,模型组大鼠患肢承重率降低(P<0.01),患肢滑膜组织增生、炎性细胞浸润、滑膜纤维化,膝关节滑膜组织CD11b^(+)细胞、M1型巨噬细胞(CD11b^(+)CD86^(+))数量增加(P<0.01),滑膜肿瘤坏死因子α(TNF-α)、白介素(IL)-6、IL-1β、IL-10、IL-13含量升高(P<0.01,P<0.05);与模型组比较,电针组大鼠患肢承重率升高(P<0.05),滑膜组织增生、炎性细胞浸润、滑膜纤维化程度减轻,膝关节滑膜组织CD11b^(+)细胞、M1型巨噬细胞(CD11b^(+)CD86^(+))数量减少(P<0.01),TNF-α、IL-6含量降低(P<0.05)。造模后第14天,与对照组比较,模型组大鼠足底机械缩足反射阈值降低(P<0.01);与模型组比较,电针组大鼠足底机械缩足反射阈值升高(P<0.05)。模型组大鼠隐神经出现明显的髓鞘结构破坏,髓鞘板层崩解松散、挤压轴索或板层增厚并出现裂隙;与模型组比较,电针组大鼠隐神经损伤情况明显减轻。结论:电针干预可以减轻KOA模型大鼠滑膜炎性反应及患肢隐神经损伤,从而缓解炎性反应期自发痛和后期触诱发痛。Objective To observe the effect of electroacupuncture(EA)on pain behavior,synovial inflammatory response and demyelination of saphenous nerve in the rats modeled with knee osteoarthritis(KOA)and explore the effect mechanism of EA for reliving allodynia.Methods Eighty-four male SD rats were randomly divided into a control group,a model group and an EA group,28 rats in each one.Intra-articular injection of sodium monoiodoacetate(MIA)was administered in right knee joint of each rat in the model group and the EA group to establish the KOA model.In the EA group,separately,on day 5,7 and 9 after modeling,EA was applied at"Zusanli"(ST 36)and"Yanglingquan"(GB 34)on the right side,with disperse-dense wave(2 Hz/15 Hz),1 mA in current intensity,for 30 min in one intervention,once a day,and 3 interventions were required.On the 9th day after modeling,the weight-bearing rate was calculated for the affected limbs of the rats in each group,the synovial morphological changes were observed using HE and Masson staining,flow cytometry was adopted to detect the synovial immunocyte counts,and MSD multi-spot assay was used to detected the synovial inflammatory cytokine content.On the 14th day after modeling,the hind-paw mechanical withdrawal threshold was observed in each group and the ultrastructure of the saphenous nerve was observed under transmission electron microscopy.Results On the 9th day after modeling,compared with the control group,the weight-bearing rate of the affected limb was reduced(P<0.01),the synovial hyperplasia,inflammatory cell infiltration and synovial fibrosis occurred in the affected limb;the counts of synovial CD11b^(+)cells and M1 macrophages(CD11b^(+)CD86^(+))were increased(P<0.01),the contents of tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-1β,IL-10 and IL-13 in the synovial tissue were elevated(P<0.01,P<0.05)for the rats of the model group.Compared with the model group,the weight-bearing rate of the affected limb was increased(P<0.05),the synovial hyperplasia,inflammatory cell infiltration and syn

关 键 词：膝关节骨关节炎 滑膜炎 电针 肿瘤坏死因子α(TNF-α) 白介素6(IL-6) 隐神经 

分 类 号：R245.97[医药卫生—针灸推拿学]