电针联合康复运动训练对膝骨关节炎患者血液流变学和TLR4/MyD88/NF-kB信号通路的影响  

Effect of electroacupuncture combined with rehabilitation exercise training on hemorheolo⁃gy and TLR4/MyD88/NF⁃κB signaling pathway in patients with knee osteoarthritis

作　　者：陆海红 孟庆芳 冷珊珊 谭长龙 LU Haihong;MENG Qingfang;LENG Shanshan;TAN Changong(Department of Bone and Joint Rehabilitation,Qingdao Navy Special Service Nursing Center,Qingdao,Shandong,China,266071;Department of Orthopedics,971 Hospital of PLA Navy,Qingdao,Shandong,China,266071)

机构地区：[1]海军青岛特勤疗养中心骨关节康复科,山东青岛266071 [2]中国人民解放军海军第九七一医院骨科,山东青岛266071

出　　处：《分子诊断与治疗杂志》2023年第11期1855-1858,1863,共5页Journal of Molecular Diagnostics and Therapy

基　　金：国家卫生健康委“十四五”规划全国重点课题(YYWS3011)。

摘　　要：目的 探讨电针联合康复运动训练对膝骨关节炎(KOA)患者血液流变学和外周血单核细胞Toll样受体4/髓样分化因子88/核转录因子-kB(TLR4/MyD88/NF-κB)信号通路的影响。方法 收集2021年1月至2022年8月在海军青岛特勤疗养中心接受诊治的86例KOA患者。采用随机数字表将患者分为对照组(接受康复运动训练,43例)和研究组(对照组基础上联合电针治疗,43例)。观察两组各项量表评分、膝关节屈曲活动度(ROM)、肌力、血液流变学指标和TLR4/MyD88/NF-kB信号通路相关指标。结果 与对照组相比,研究组治疗1个月后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、全血黏度(高切)、疼痛视觉模拟评分法(VAS)评分、TLR4 mRNA、全血黏度(低切)、MyD88 mRNA、血浆黏度、NF-kB mRNA、红细胞聚集指数降低,膝关节屈曲活动度(ROM)、肌力、Lysholm膝关节功能评分升高,差异有统计学意义(t=24.746、11.024、9.562、12.183、7.495、8.707、11.102、10.416、20.677、-4.918、-2.351、-9.474,P<0.05)。结论 电针联合康复运动训练治疗KOA患者可改善血液流变学和调节外周血单核细胞TLR4/MyD88/NF-kB信号通路。Objective To explore the effect of electroacupuncture combined with rehabilitation exercise training on hemorheology and toll like receptor 4/myeloid differentiation factor 88/nuclear transcription factor-κB(TLR4/MyD88/NF-κB)signaling pathway of peripheral blood mononuclear cells in patients with knee osteoarthritis(KOA).Methods 86 patients with KOA who received treatment in Navy Qingdao Special Service Rehabilitation Center from January 2021 to August 2022 were collected.Using a random number table,patients were divided into the control group(43 patients received rehabilitation exercise training)and the study group(43 patients received combined electroacupuncture treatment on the basis of the control group).The scores of various scales,knee flexion range of motion(ROM),muscle strength,hemorheology indicators and TLR4/MyD88/NF-κB signaling pathway related indicators in the two groups were observed.Results Compared with the control group,the study group received the western ontario and memaster universities osteoarthritis index(WOMAC)score,whole blood viscosity(high shear),pain visual analogue scale(VAS)score,TLR4 mRNA,whole blood viscosity(low shear),MyD88 mRNA,plasma viscosity,NF-κB mRNA and red blood cell aggregation index after 1 month of treatment decreased,while knee flexion activity(ROM),muscle strength,and Lysholm knee function score increased(t=24.746,11.024,9.562,12.183,7.495,8.707,11.102,10.416,20.677,-4.918,-2.351,-9.474,P<0.05).Conclusion Treatment of electroacupuncture combine with rehabilitation exercise training in patients with KOA could improve hemorheology and modulate the TLR4/MyD88/NF-κB signaling pathway in peripheral blood monocytes.

关 键 词：血液流变学 Toll样受体4 髓样分化因子88 核转录因子-ΚB 

分 类 号：R684.3[医药卫生—骨科学]