温针灸对膝骨关节炎兔损伤前交叉韧带修复及相关因子的影响  

Effect of warm-needling moxibustion on anterior cruciate ligament injury repair and related growth factors in rabbits with knee osteoarthritis

作　　者：李春[1] 张艳玲[1] 刘娣[1] 王明磊[1] 王铎 刘君伟 武永利[1,3] Li Chun;Zhang Yanlin;Liu Di;Wang Minglei;Wang Duo;Liu Junwei;Wu Yongli(General Hospital of Ningxia Medical University,Yinchuan 750004,Ningxia Hui Autonomous Region,China;Lingwu Traditional Chinese Medicine Hospital,Lingwu 751600,Ningxia Hui Autonomous Region,China;Key Laboratory of Ningxia Ethomedicine Modernization,Ministry of Education,Ningxia Medical University,Yinchuan 750004,Ningxia Hui Autonomous Region,China)

机构地区：[1]宁夏医科大学总医院,宁夏回族自治区银川市750004 [2]灵武市中医院,宁夏回族自治区灵武市751600 [3]宁夏少数民族医药现代化教育部重点实验室,宁夏回族自治区银川市750004

出　　处：《中国组织工程研究》2024年第23期3621-3626,共6页Chinese Journal of Tissue Engineering Research

基　　金：宁夏自然科学基金资助项目(2021AAC03347),项目负责人:李春;国家自然科学基金资助项目(82160939),项目负责人:武永利;宁夏医科大学校级科研项目(XM2020158),项目负责人:刘娣。

摘　　要：背景:温针灸可有效治疗膝骨关节炎。前交叉韧带的退变、损伤、断裂可影响膝关节局部稳定性,进而诱发膝骨关节炎的形成,温针灸是否可修复损伤前交叉韧带及其作用机制,目前尚不清楚。目的:观察温针灸对膝骨关节炎兔前交叉韧带形态学及相关生长因子类胰岛素样生长因子1、转化生长因子β表达的变化,明确温针灸修复前交叉韧带的作用机制。方法:将30只新西兰兔采用随机数字表法分为空白组、模型组、温针灸组3组,每组10只。模型组和温针灸组兔采用石膏管型固定法制备膝骨关节炎兔模型。造模成功后,模型组每日于兔固定架固定15 min;温针灸组选取“鹤顶”“内膝眼”“外膝眼”行温针灸治疗,每日1次,7日为1个疗程,共治疗2个疗程;空白组不予干预。治疗结束后MRI观察前交叉韧带影像学改变,并进行MRI分级统计;透射电镜、苏木精-伊红染色观察其形态学变化;RT-PCR、Western blot检测组织类胰岛素样生长因子1、转化生长因子βmRNA及蛋白的表达。结果与结论:①MRI检查:与空白组比较,模型组前交叉韧带增粗、水肿、部分撕裂,分级评估差异有统计学意义(P<0.05);与模型组比较,温针灸组韧带增粗略轻,轻度水肿,无撕裂,分级评估差异有统计学意义(P<0.05)。②大体观察:模型组前交叉韧带表面光泽变淡,边侧有絮状被膜覆盖,有明显组织坏死;温针灸组韧带表面光泽,韧带呈正常螺旋走形。③苏木精-伊红染色:模型组前交叉韧带内明显组织坏死,大量新生毛细血管,成纤维细胞及胶原纤维排列松散;温针灸组韧带内有少量组织坏死,偶见新生血管,细胞及胶原纤维排列疏松、欠规则。④透射电镜观察:模型组前交叉韧带纤维排列紊乱,粗细不均,分布不均,成纤维细胞较多且形态不规则;温针灸组纤维基本呈纵向排列,纤维粗细、分布不均,少量椭圆形的纤维细胞存在。⑤RTBACKGROUND:Warm-needling moxibustion can effectively treat knee osteoarthritis.Degeneration,injury and fracture of the anterior cruciate ligament can affect the local stability of the knee joint,and then induce the formation of knee osteoarthritis.Whether warm-needling moxibustion can repair the injured cruciate ligament and the mechanism of action are still unclear.OBJECTIVE:To observe the effects of warm-needling moxibustion on the morphology of the anterior cruciate ligament and the expression of insulin growth factor-1 and transforming growth factor-βin rabbits with knee osteoarthritis and to clarify the mechanism of anterior cruciate ligament repair by warmneedling moxibustion.METHODS:Thirty New Zealand rabbits were randomly divided into blank group,model group and warm-needling moxibustion group,with 10 rabbits in each group.Knee osteoarthritis model was established by plaster cast immobilization.The blank group was not intervened.Rabbits in the model group rabbits were fixed in a rabbit holder for 15 minutes every day.The warm-needling moxibustion group was treated with warm acupuncture,once a day,7 days as a course of treatment,a total of two courses.After treatment,the imaging changes of the anterior cruciate ligament were observed by MRI and MRI grading statistics were performed.Morphological changes of the anterior cruciate ligament were observed by transmission electron microscope and hematoxylin-eosin staining.mRNA and protein expressions of insulin growth factor-1 and transforming growth factor-βwere detected by RT-PCR and western blot,respectively.RESULTS AND CONCLUSION:MRI examination:Compared with the blank control group,the anterior cruciate ligament in the model group was thickened,edematous,and partially torn,and the difference in grading statistics was statistically significant(P<0.05).Compared with the model group,the anterior cruciate ligament in the warm-needling moxibustion group was slightly thickened,with mild edema and no tearing,and the difference in grading statistics was statistic

关 键 词：膝骨关节炎 温针灸 前交叉韧带 超微结构 生长因子 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R446