郑氏芪藤软坚散外敷治疗创伤性膝关节僵硬的实验研究  

An experimental study of external application of Zheng's Qiteng Ruanjian San in the treatment of post-traumatic knee joint stiffness

作　　者：廖莹莹 张鑫[1] 任凯 刘辉[1] 陈科 温呈洪[2] 税晓平 LIAO Yingying;ZHANG Xin;REN Kai;LIU Hui;CHEN Ke;WEN Chenghong;SHUI Xiaoping(Sichuan Province Orthopedic Hospital,Chengdu 610041,Sichuan,China;Affiliated Sport Hospital of Chengdu Sport University,Chengdu 610041,Sichuan,China;Mianyang Orthopedics Hospital,Mianyang 621000,Sichuan,China)

机构地区：[1]四川省骨科医院,四川成都610041 [2]成都体育学院附属体育医院,四川成都610041 [3]绵阳市骨科医院,四川绵阳621000

出　　处：《中医正骨》2023年第2期1-9,21,共10页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：四川省中医药管理局科学技术研究专项课题(2020JC0098);四川省区域中医(专科)诊疗中心建设项目(川中医药函〔2018〕20号)。

摘　　要：目的:观察郑氏芪藤软坚散外敷治疗创伤性膝关节僵硬的疗效,并探讨其可能的作用机制。方法:从66只8周龄SPF级雄性SD大鼠中随机选取18只纳入空白组,剩余48只建立右侧创伤性膝关节屈曲型僵硬模型,将造模成功的41只大鼠随机纳入模型组(20只)和软坚散组(21只)。空白组和模型组大鼠常规喂养,不予干预;软坚散组大鼠造模成功后采用郑氏芪藤软坚散外敷,每天1次,连续治疗4周。分别于药物干预开始前、药物干预开始后2周、药物干预结束后,从各组随机选取部分大鼠,分别进行右侧膝关节活动度测量、膝关节囊厚度测量、膝关节囊组织病理学观察及成纤维细胞计数(HE染色)、膝关节囊中转化生长因子β1(transforming growth factorβ1,TGF-β1)水平测定(免疫组织化学法)。结果:①膝关节活动度。在3个时间点,3组大鼠的膝关节活动度总体比较,差异均有统计学意义(122.43°±4.54°,64.78°±2.68°,65.13°±4.52°,F=530.817,P=0.000;124.50°±5.01°,82.83°±6.05°,88.67°±8.62°,F=67.404,P=0.000;122.33°±4.08°,92.50°±2.74°,107.13°±7.41°,F=44.886,P=0.000)。在3个时间点,空白组的膝关节活动度均大于模型组和软坚散组(P=0.000,P=0.000;P=0.000,P=0.000;P=0.000,P=0.000);药物干预开始前、药物干预开始后2周时,模型组和软坚散组的膝关节活动度比较,组间差异均无统计学意义(P=0.857,P=0.154);药物干预结束后,软坚散组的膝关节活动度大于模型组(P=0.000)。②膝关节囊厚度。在3个时间点,3组大鼠的膝关节囊厚度总体比较,差异均有统计学意义[(0.256±0.020)mm,(0.533±0.024)mm,(0.528±0.012)mm,F=412.282,P=0.000;(0.254±0.036)mm,(0.531±0.018)mm,(0.523±0.019)mm,F=125.803,P=0.000;(0.257±0.028)mm,(0.527±0.017)mm,(0.521±0.014)mm,F=211.708,P=0.000]。在3个时间点,空白组的膝关节囊厚度均小于模型组(P=0.000,P=0.000,P=0.000);药物干预开始前和药物干预结束后,软坚散组的膝关节囊厚度均Objective:To observe the ffect and underlying mechanism of extemal application of Zheng’s Qiteng Ruanjan San in the treatment of post-traumatic knee joint stiffness.Methods:Sixty-six 8-week-old male SD rats of SPF grade were enrolled and randomly divid-ed intoa blank group(n=18)and an experimental group(n=48).The right post-traumatic knee joint stifness model of flexion type was in-duced in 48 rats of the experimental group.Forty-one successful model rats were randomly divided into a model group(n=20)and a Qiteng Ruanjian San group(n=21).Rats in the blank group and the model group were fed routinely without intervention,while those in the Qiteng Ruanjian San group received external application of Qiteng Ruanjian San,once a day for 4 weeks after modeling.Some rats were randomly selected from each group before drug intervention,at 2 weeks of drug intervention,and after drug intervention for the measurement of right knee joint range of motion and knee capsule thickness,histopathological observation of knee capsule,fibroblast count(HE staining),and the determination of transforming growth factorβ1(TGF-B1)level in the knee capsule(immunohistochemistry).Results:①Knee joint range of motion.There were statistically significant differences in the overall knee joint range of motion among the blank group,the model group,and the Qiteng Ruanjian San group at three time points(122.43°±4.54°vs 64.78°±2.68°vs 65.13°±4.52°,F=530.817,P=0.000;124.50°±5.01°vs 82.83°±6.05°vs 88.67°±8.62°,F=67.404,P=0.000;122.33°±4.08°vs 92.50°±2.74°vs 107.13°±7.41°,F=44.886,P=0.000).At the three time points,the knee joint range of motion in the blank group was greater than those in the model group and the Qiteng Ruanjian San group(P=0.000,P=0.000;P=0.000,P=0.000;P=0.000,P=0.000).There was no sig-nificant difference in the knee joint range of motion between the model group and the Qiteng Ruanjian San group before drug intervention and at 2 weeks of drug intervention(P=0.857,P=0.154),and the knee joint range of motion in

关 键 词：膝关节 关节僵硬 创伤和损伤 郑氏芪藤软坚散 动物实验 

分 类 号：R285.5[医药卫生—中药学]