基于金属蛋白酶抑制因子与基质金属蛋白酶之间的平衡探讨针刀对兔膝骨关节炎模型软骨基质降解的影响  

Effect of acupotomy on the cartilage matrix degradation in knee osteoarthristis rabbit model of knee osteoarthristis based on tissue inhibitor of metalloproteinase and matrix metalloproteinases balance

作　　者：张良志 李阳阳 刘洪[1] 张泽升 陈斌[1] 谢梓毅 刘晶 修忠标[1] ZHANG Liangzhi;LI Yangyang;LIU Hong;ZHANG Zesheng;CHEN Bin;XIE Ziyi;LIU Jing;XIU Zhongbiao(The Second Department of Orthopedics-traumatology,the People’s Hospital Affiliated of Fujian University of Traditional Chinese Medicine,Fujian Province,Fuzhou350004,China;College of Traditional Chinese Medicine,Fujian University of Traditional Chinese Medicine,Fujian Province,Fuzhou350122,China;Department of Orthopedics-traumatology,Rehabilitation Hospital Affiliated to Fujian University of TraditionalChinese Medicine,Fujian Province,Fuzhou350003,China)

机构地区：[1]福建中医药大学附属人民医院骨伤二科,福建福州350004 [2]福建中医药大学中医学院,福建福州350122 [3]福建中医药大学附属康复医院骨伤科,福建福州350003

出　　处：《中国医药导报》2023年第28期14-19,65,共7页China Medical Herald

基　　金：福建省中青年教师教育科研项目(JAT200225);福建省自然科学基金项目(2022J01354)。

摘　　要：目的基于金属蛋白酶抑制因子(TIMP)与基质金属蛋白酶(MMP)之间的平衡探讨针刀对兔膝骨关节炎(KOA)模型软骨基质降解的影响。方法采用随机数字表法将24只6月龄,体重(2.0±0.5)kg的健康雄性新西兰兔按照随机数字表法分为空白组、模型组和针刀组,各8只。KOA兔模型采用改良Videman法即左后肢伸直位石膏固定6周制备而成。针刀组利用针刀松解筋结病灶点,1次/周,共进行4次治疗;空白组与模型组做相同的抓取,但不采取任何干预。干预结束后1周,采用HE染色形态学、番红固绿染色变化观察各组兔软骨组织病理变化;RT-PCR检测软骨细胞CollagenⅡ、水通道蛋白(AQP)3,TIMP1、MMP13表达水平,Western blot检测CollagenⅡ、AQP3、TIMP、MMP13蛋白表达水平。结果与空白组比较,模型组软骨外观凹凸不平,软骨细胞聚集不规则,部分坏死细胞崩解,潮线紊乱,部分断裂;软骨细胞数量显著下降,软骨基质中番红色显著减少,部分有软骨缺损,潮线模糊且不清晰。与模型组比较,针刀组软骨外观更加平滑,结构层次更加清晰分明,细胞趋于整齐排列,潮线较模型组完整;不仅软骨数量增加,软骨基质中番红着色较正常,而且软骨外表相对光滑平整,潮线也相对完整。与空白组比较,模型组软骨组织CollagenⅡm RNA表达下调,AQP3、TIMP1、MMP13 m RNA表达上调(P<0.05);与模型组比较,针刀组软骨组织CollagenⅡm RNA表达上调,AQP3、TIMP1、MMP13 m RNA表达下调(P<0.05)。与空白组比较,模型组软骨组织CollagenⅡ蛋白表达下调,AQP3、TIMP1、MMP13蛋白表达上调(P<0.05);与模型组比较,针刀组软骨组织CollagenⅡ蛋白表达上调AQP3、MMP13蛋白表达下调(P<0.05);针刀组软骨组织TIMP1蛋白与模型组比较,差异无统计学意义(P>0.05)。与空白组比较,模型组行为学评分升高(P<0.05);与模型组比较,针刀组行为学评分下降(P<0.05)。结论针刀治疗通过调节TIMP/MMP的平衡,达�Objective To investigate the effect of acupotomy on cartilage matrix degradation in rabbit model of knee osteoarthristis(KOA)based on the balance between tissue inhibitor of metalloproteinase(TIMP)and matrix metalloproteinases(MMP).Methods Twenty-four healthy male New Zealand rabbits,aged six months and weighing(2.0±0.5)kg were divided into blank group,model group,and acupotomy group by random number table method,with eight rabbits in each group.The KOA rabbit model group was prepared by the modified Videman method,the left hind limb was immobilized with extended plaster for 6 weeks.Acupotomy group was treated four times with acupotomy once a week to loosen tendon nodules.The blank group and model group made the same grab,but does not take any intervention.One week after the intervention,HE staining morphology and saffron solid green staining were used to observe the pathological changes of rabbit cartilage in each group.The expression levels of CollagenⅡ,aquaporins(AQP)3,and MMP13 in chondrocytes were detected by RT-PCR,while the expression levels of CollagenⅡ,AQP3,TIMP1,and MMP13 were detected by Western blot.Results Compared with blank group,the appearance of cartilage in model group was uneven,the chondrocytes gathered irregularly,some necrotic cells disintegrated,the tide line disorganized,and some broke.The number of chondrocytes decreased significantly,the saffron in cartilage matrix decreased significantly,some cartilage defects,and the tide line was blurred and unclear.Compared with the model group,the appearance of cartilage in acupotomy group was smoother,the structure level was clearer,the cells tended to be neatly arranged,and the tide line was more complete than that in the model group.Not only the amount of cartilage increased,the saffranine coloring in the cartilage matrix was normal,but also the appearance of the cartilage was relatively smooth and smooth,and the tide line was relatively complete.Compared with blank group,the expression of CollagenⅡmRNA in cartilage tissues of model group

关 键 词：膝骨关节炎 金属蛋白酶抑制因子与基质金属蛋白酶平衡 针刀 软骨基质 

分 类 号：R244.5[医药卫生—针灸推拿学]