陈元膏摩法对阳虚寒凝型膝骨性关节炎模型兔关节软骨细胞凋亡、基质金属蛋白酶及血清炎性因子的影响  

Traditional Chinese Medicine Clinical Characteristics of Drug-resistant Bacteria Infection:A Retrospective Analysis of 295 Cases

作　　者：古来撒尔·艾克拜尔 刘俊昌[1,2] 王忆葑 买合热衣·亚迪 何静 卢旭昇 张晓婷[1] 郭蕾 AIKEBAIER Gulaisaer;LIU Junchang;WANG Yifeng;YADI Maihereyi;HE Jing;LU Xusheng;ZHANG Xiaoting;GUO Lei(Xinjiang Medical University,Urumqi,830017;Xinjiang Medical University Affiliated Hospital of Traditional Chinese Medicine;Branch of Urumqi First People's Hospital;Hami Central Hospital Affiliated to Xinjiang Medical University;Yili Friendship Hospital)

机构地区：[1]新疆医科大学,新疆维吾尔自治区乌鲁木齐市830017 [2]新疆医科大学附属中医医院 [3]新疆维吾尔自治区乌鲁木齐市第一人民医院分院 [4]新疆医科大学附属哈密市中心医院 [5]新疆维吾尔自治区伊犁州友谊医院

出　　处：《中医杂志》2022年第22期2154-2161,共8页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81760897)。

摘　　要：目的 探讨陈元膏摩法治疗阳虚寒凝型膝骨性关节炎(KOA)的效用及可能作用机制。方法 60只新西兰大白兔随机分为正常组、模型组、手法组、陈元膏组、陈元膏摩法组及扶他林组,每组10只。模型组和各干预组采用高分子绷带屈曲位固定+薄荷油、气候箱法建立兔阳虚寒凝型KOA模型。造模8周后,正常组和模型组不作干预;手法组给予单纯推拿手法;陈元膏组涂抹陈元膏剂;陈元膏摩法组在陈元膏组基础上行推拿手法治疗;扶他林组涂抹扶他林软膏,每日1次,连续6周。最后一次干预后次日进行取材,HE染色观察软骨、滑膜组织病理学变化并将切片进行病理学Mankin软骨组织学评分;ELISA法检测血清中炎性因子白细胞介素1β (IL-1β)、白细胞介素6 (IL-6)、白细胞介素10 (IL-10)、肿瘤坏死因子α (TNF-α)水平;Western Blot法检测B淋巴细胞瘤2 (Bcl-2)、B淋巴细胞瘤2相关X蛋白质(Bax)水平;免疫组化法及qRT-PCR法测定关节软骨组织中金属蛋白酶抑制剂1 (TIMP-1)、基质金属蛋白酶13 (MMP-13)、基质金属蛋白酶3 (MMP-3)蛋白及mRNA表达水平。结果 病理结果显示,正常组兔关节软骨细胞排列有序,基质均匀一致,滑膜组织结构正常,滑膜细胞排列整齐。模型组软骨基质失去均质性,部分区域软骨细胞崩解、消失、排列紊乱,滑膜细胞增大,层数增加,间质纤维组织增生伴部分玻璃样变性,较多慢性炎性细胞浸润。手法组、陈元膏组、陈元膏摩法组软骨细胞损伤均有不同程度改善,且陈元膏组及陈元膏摩法组改善程度优于手法组。与正常组比较,模型组兔关节软骨组织Mankin评分升高,血清IL-1β、TNF-α、IL-6水平升高,软骨组织Bcl-2蛋白表达及Bcl-2/Bax值降低,Bax、MMP-13蛋白表达升高,MMP-3、MMP-13 mRNA表达升高,TIMP-1 mRNA表达降低(P<0.05)。与模型组比较,陈元膏摩法组兔关节软骨组织Mankin评分降低;各干预组血清IL-1β水平及Objective To summarize and analyze the distribution characteristics of traditional Chinese medicine(TCM) syndrome elements in patients with drug-resistant bacteria infection.Methods Patients admitted to the wards of Beijing Hospital of Traditional Chinese Medicine,Capital Medical University who had any drug sensitivity test results of sputum,urine,blood and secretion culture showing the drug-resistant bacteria was Pseudomonas aeruginosa,Acinetobacter baumannii,Klebsiella pneumoniae or Escherichia coli were included.The general condition of the patient and the information related to the four examinations of TCM were retrospectively collected,including gender,age,case source,diagnosis,infection site,drug-resistant bacteria,drug-resistant degree,symptoms,tongue and pulse manifestation.The distribution of disease nature-related TCM syndrome elements among different drugresistant bacteria were analyzed,and the category of deficiency and excess was differentiated.Cluster analysis was used to analyze the distribution of different combinations of syndrome elements,and association rules were used to analyze the cluster of core syndrome elements;the complex network of syndrome elements was visualized.Results A total of 295 patients with drug-resistant bacterial infections were included,most of whom were 75~89 years old(115 cases,39.0%),and mainly diagnosed as urinary tract infection(138 cases,45.2%)and bacterial pneumonia(117 cases,38.4%).The drug-resistant bacteria ranked from high to low was Escherichia coli(168 cases,56.9%),Klebsiella pneumoniae(58 cases,19.7%),Pseudomonas aeruginosa(44 cases,14.9%)and Acinetobacter baumannii(25 cases,8.5%).Multidrug-resistant(MDR)strains accounted for 94.6%of the total patients(279 cases),while extensively drug-resistant(XDR)strains accounted for 5.4%(16 cases).A total of 10 syndrome elements were extracted including qi deficiency,blood deficiency,yang deficiency,yin deficiency,cold,heat,dampness,phlegm,rheum,and blood stasis,of which dampness,phlegm and rheum were distributed signific

关 键 词：膝骨性关节炎 阳虚寒凝 陈元膏 推拿疗法 炎性因子 基质金属蛋白酶 细胞凋亡 

分 类 号：R244.1[医药卫生—针灸推拿学]