内热针治疗兔激素性股骨头坏死的机制  

Mechanisms underlying internal heat-type acupuncture in the treatment of steroid-induced osteonecrosis of the femoral head in rabbits

作　　者：马良辰 田富宝 徐玉娟 田心保 陶莹 陈梦莹 连佳伟 林瑞珠[3] 朱宁[3] Ma Liangchen;Tian Fubao;Xu Yujuan;Tian Xinbao;Tao Ying;Chen Mengying;Lian Jiawei;Lin Ruizhu;Zhu Ning(Department of Geriatric and Special Need Medicine,Ningxia Medical University General Hospital,Yinchuan 750004,Ningxia Hui Autonomous Region,China;Ningxia Medical University,Yinchuan 750004,Ningxia Hui Autonomous Region,China;Department of Rehabilitation Medicine,Ningxia Medical University General Hospital,Yinchuan 750004,Ningxia Hui Autonomous Region,China)

机构地区：[1]宁夏医科大学总医院老年与特需医学科,宁夏回族自治区银川市750004 [2]宁夏医科大学,宁夏回族自治区银川市750004 [3]宁夏医科大学总医院康复医学科,宁夏回族自治区银川市750004

出　　处：《中国组织工程研究》2024年第27期4353-4359,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金地区科学基金项目(81760904),项目负责人:朱宁;宁夏医科大学总医院“国家自然科学基金项目孵育计划”,项目负责人:朱宁;国家自然科学基金地区科学基金项目(82360987),项目负责人:林瑞珠。

摘　　要：背景:内热针疗法是将针刺疗法和热疗相结合的新型治疗技术,对激素性股骨头坏死有很好的临床效果,但作用机制仍不完全清晰。目的:探讨内热针疗法治疗兔激素性股骨头坏死的可能作用机制。方法:32只新西兰兔采用随机数字表法分为空白组、模型组、内热针组、冲击波组,每组8只。模型组、内热针组、冲击波组采用甲泼尼龙琥珀酸钠联合大肠杆菌内毒素造模。内热针组对兔臀部进行内热针干预,每周1次,每次20 min;冲击波组对兔臀部进行冲击波干预,每周1次,每次2000下;空白组和模型组不给予任何治疗。干预4周后进行实验兔采血及双侧股骨头取材,采用ELISA法检测血清中肿瘤坏死因子α、白细胞介素6水平;苏木精-伊红染色观察各组实验兔股骨头骨组织形态学变化并计算空骨陷窝率;免疫组织化学染色和蛋白免疫印迹法检测骨组织中基质金属蛋白酶2、基质金属蛋白酶9、基质金属蛋白酶组织抑制剂1、基质金属蛋白酶组织抑制剂2的蛋白表达。结果与结论:①与空白组相比,造模兔出现摄食减少、精神萎靡、活动减少等表现;与模型组相比,内热针及冲击波治疗后实验兔的上述表现均明显改善;②与空白组相比,模型组的股骨头组织形态学明显恶化且空骨陷窝率升高(P<0.001);内热针组及冲击波组的股骨头组织形态学较模型组明显改善且空骨陷窝率降低(P<0.001);③与空白组相比,模型组的血清肿瘤坏死因子α、白细胞介素6水平明显升高(P<0.05);与模型组相比,内热针组及冲击波组的血清肿瘤坏死因子α、白细胞介素6水平明显降低(P<0.05);④与空白组相比,模型组实验兔股骨头组织中基质金属蛋白酶2、基质金属蛋白酶9蛋白表达水平明显升高(P<0.001),基质金属蛋白酶组织抑制剂1、基质金属蛋白酶组织抑制剂2的蛋白表达水平明显降低(P<0.001);与模型组相比,内热针组及冲BACKGROUND:Internal heat-type acupuncture therapy is a new treatment technique that combines acupuncture therapy with hyperthermia.It has good clinical effects on steroid-induced osteonecrosis of the femoral head,but the mechanism of action is still not fully clear.OBJECTIVE:To explore the possible mechanism of internal heat-type acupuncture therapy in treating steroid-induced osteonecrosis of the femoral head in rabbits.METHODS:Thirty-two New Zealand rabbits were randomly divided into blank group,model group,internal heat-type acupuncture group and shock wave group using a random number table method,with 8 rabbits in each group.The model group,internal heat-type acupuncture group and shock wave group were modeled using methylprednisolone sodium succinate combined with Escherichia coli endotoxin.The internal heat-type acupuncture group received an internal heat-type acupuncture intervention on the buttocks of rabbits,once a week,for 20 minutes each time.The shock wave group received shock wave intervention on the buttocks of rabbits,once a week,with 2000 beats per session.The blank group and model group were not given any treatment.After 4 weeks of intervention,blood samples and bilateral femoral head samples were collected from experimental rabbits.The levels of tumor necrosis factor-α and interleukin-6 in serum were detected by ELISA;the histomorphology of the femoral head was observed using hematoxylin-eosin staining and the rate of empty lacunae was calculated;the protein expressions of matrix metalloproteinase 2,matrix metalloproteinase 9,matrix metalloproteinase tissue inhibitor 1,and matrix metalloproteinase tissue inhibitor 2 were detected by immunohistochemistry and western blot.RESULTS AND CONCLUSION:Compared with the blank group,the model rabbits showed reduced food intake,mental fatigue,and decreased activity;compared with the model group,the above performance of the experimental rabbits was significantly improved after internal heat-type acupuncture and shock wave treatment.Compared with the blank g

关 键 词：激素性股骨头坏死 内热针 基质金属蛋白酶 基质金属蛋白酶组织抑制剂 肿瘤坏死因子Α 白细胞介素6 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R245