艾灸与刮痧治疗膝关节骨关节炎的穴区效应研究  

Effect of moxibustion and scraping on bioactive substances changes of acupoints in knee osteoarthritis rats

作　　者：陈帅 张改月 王莹莹[2] 陈虹[3] 张豪斌 颜雪华 杨金生[4] CHEN Shuai;ZHANG Gai-yue;WANG Ying-ying;CHEN Hong;ZHANG Hao-bin;YAN Xue-hua;YANG Jin-sheng(School of Acupuncture-Moxibustion and Tuina,Shaanxi University of Chinese Medicine,Xianyang 712046,Shannxi Province;Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences,Beijing 100700;The Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,Shannxi Province;Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700)

机构地区：[1]陕西中医药大学针灸推拿学院,陕西咸阳712046 [2]中国中医科学院针灸研究所,北京100700 [3]陕西中医药大学第二附属医院,陕西咸阳712000 [4]中国中医科学院中医基础理论研究所,北京100700

出　　处：《针刺研究》2023年第4期359-365,共7页Acupuncture Research

基　　金：国家自然科学基金项目(No.82074563)。

摘　　要：目的:通过观察艾灸、刮痧单用与联用对膝关节骨关节炎(KOA)大鼠“阳陵泉”“血海”穴区生物活性物质的影响,探讨其穴区效应的关系及差异性,为临床治疗提供实验依据。方法:SD大鼠按随机数字表法分为空白组、模型组、艾灸组、刮痧组、艾灸+刮痧组,每组8只。空白组大鼠予右膝关节注射50䦛Euclid SymbolmApL 0.9%氯化钠溶液,其他组大鼠予右膝关节注射50䦛Euclid SymbolmApL碘乙酸钠。造模后14 d,艾灸组于右侧“阳陵泉”“血海”给予艾灸,每穴10 min;刮痧组以平补平泻的手法刮拭上述穴区;艾灸+刮痧组用上述方法先刮痧再艾灸。以上干预措施均隔日1次,共7次。检测大鼠机械缩足反射阈值(PWT)和热缩腿反射潜伏期(TWL);用HE染色法观察大鼠膝关节病理变化;用ELISA法和Western blot法分别检测大鼠右侧“阳陵泉”“血海”穴区皮肤组织5-羟色胺(5-HT)含量及P物质(SP)、降钙素基因相关肽(CGRP)蛋白表达水平。结果:与空白组比较,模型组大鼠PWT降低(P<0.001),TWL缩短(P<0.001),右侧“阳陵泉”“血海”穴区皮肤组织5-HT含量及SP、CGRP蛋白相对表达量升高(P<0.001,P<0.01);干预后与模型组比较,艾灸组、刮痧组和艾灸+刮痧组大鼠PWT升高(P<0.01),TWL延长(P<0.01),右侧“阳陵泉”“血海”穴区皮肤组织5-HT含量及SP、CGRP蛋白相对表达量降低(P<0.01,P<0.001,P<0.05);与艾灸组、刮痧组比较,艾灸+刮痧组大鼠PWT升高(P<0.01),TWL延长(P<0.05),右侧“阳陵泉”“血海”穴区皮肤组织5-HT含量及SP蛋白相对表达量降低(P<0.05,P<0.01)。HE染色结果显示,模型组大鼠软骨组织损伤明显,软骨细胞明显减少,损伤区由不等量纤维组织替代,少量新生毛细血管形成;艾灸组、刮痧组和艾灸+刮痧组软骨细胞增多。结论:艾灸和刮痧可能通过降低“阳陵泉”“血海”穴区5-HT含量及SP、CGRP蛋白表达水平,改变穴区微理化环境,调节穴区的“�Objective To compare the effects of moxibustion and scraping of“Yanglingquan”(GB34)and“Xuehai”(SP10)area on changes of bioactive substances in the region of acupoints in rats with knee osteoarthritis(KOA).Methods SD rats were randomly divided into blank,model,moxibustion,scraping,and moxibustion+scraping(combination)groups,with 8 rats in each group.The KOA model was established by injecting 50Euclid SymbolmApL 0.9%sodium chloride solution into the right knee cavity.Fourteen days after modeling,GB34 and SP10 on the right limb were stimulated by moxibustion(10 min)or scraping(till regional flush)once every other day for 7 times.The mechanical paw withdrawal threshold(PWT)and thermal withdrawal latency(TWL)were tested by Von Frey and hot stabbing instrument,separately.The pathological changes of the right knee joint were observed by HE staining.The serotonin(5-HT)contents of skin tissues in the region of acupoint GB34 and SP10 were detected by ELISA.The expression levels of substance P(SP)and calcitonin gene-related peptide(CGRP)in GB34 and SP10 region skin tissues were detected by Western blot.Results Compared with the blank group,the PWT and TWL of the rats in the model group were significantly decreased(P<0.001),while the contents of 5-HT and the expression levels of SP and CGRP in GB34 and SP10 region skin tissues were significantly increased(P<0.001,P<0.01).Following intervention and in comparison the with the model group,the TWL and PWT of rats in the three treatment groups were significantly increased(P<0.01),the content of 5-HT and the expression levels of SP and CGRP in GB34 and SP10 region skin tissues were significantly decreased(P<0.01,P<0.001,P<0.05).Except for the expression levels of CGRP,the above indexes of the combination group were significantly superior to those of the moxibustion and scraping groups(P<0.05,P<0.01).Findings of HE staining showed severe damaged cartilage,few chondrocytes on the surface,with subchondral neovascularization in the model group,which was relatively milder in

关 键 词：膝关节骨关节炎 艾灸 刮痧 P物质 降钙素基因相关肽 5-羟色胺 

分 类 号：R246.2[医药卫生—针灸推拿学]