不同参数的静态渐进性牵伸治疗大鼠膝关节僵硬的效果及机制研究  

Efficacy and mechanism of static progressive stretch with different parameters in treatment of stiff knee in rats

作　　者：陈科 张鑫[1] 任凯 刘辉[1] 廖莹莹 温呈洪[2] 税晓平[3,4] Chen Ke;Zhang Xin;Ren Kai;Liu Hui;Liao Yingying;Wen Chenghong;Shui Xiaoping(Department of Rehabilitation,Sichuan Orthopedic Hospital,Chengdu 610041,China;Department of Sports Injury,Affiliated Hospital of Chengdu University of Physical Education,Chengdu 610041,China;College of Acupuncture and Tuina,Sichuan College of Traditional Chinese Medicine,Mianyang 621000,Sichuan,China;Department of Orthopedic Rehabilitation,Mianyang Orthopaedics Hospital,Mianyang 621000,Sichuan,China)

机构地区：[1]四川省骨科医院康复科,成都610041 [2]成都体育学院附属医院运动性伤病科,成都610041 [3]四川中医药高等专科学校针灸推拿学院,四川绵阳621000 [4]绵阳市骨科医院骨伤康复部,四川绵阳621000

出　　处：《中华创伤骨科杂志》2024年第3期255-261,共7页Chinese Journal of Orthopaedic Trauma

基　　金：四川省中医药管理局中医药基础研究课题(2020JC0098);四川省科学技术厅科技计划项目(2021YFS0067);国家中医康复中心建设项目。

摘　　要：目的探讨不同参数的静态渐进性牵伸(SPS)治疗大鼠膝关节僵硬的效果及其治疗机制。方法取56只8周龄雄性SD大鼠,分为手术组(48只)和空白组(8只,正常饲养大鼠,不做任何处理)。手术组大鼠通过克氏针固定膝关节4周,建立右膝关节屈曲僵硬模型。42只造模成功的大鼠再随机分为6组(n=7):模型组大鼠造模成功后即处死大鼠并取材;自然恢复组大鼠造模成功后不给予任何治疗;T1组大鼠SPS治疗时长为20 min,1次/d;T2组大鼠SPS治疗时长为30 min,1次/d;T3组大鼠SPS治疗时长为20 min,1次/2 d;T4组大鼠SPS治疗时长为30 min,1次/2 d。16 d后检测并比较各组大鼠膝关节活动度、肌成纤维细胞计数及关节囊转化生长因子β1(TGF-β1)阳性占比。结果自然恢复组和4个SPS治疗组大鼠膝关节活动度均较治疗前显著增加,4个SPS治疗组大鼠膝关节活动度改善显著优于自然恢复组大鼠,差异均有统计学意义(P<0.05);其中T2组大鼠膝关节活动度(112.29°±1.89°)改善最明显。T2组大鼠肌成纤维细胞计数为(23.72±10.75)个/HP,显著少于T3组[(55.72±33.56)个/HP]、T4组大鼠[(50.72±33.34)个/HP],差异均有统计学意义(P<0.05)。4个SPS治疗组大鼠关节囊TGF-β1阳性占比显著低于模型组大鼠,T2组大鼠(0.51%±0.38%)又显著低于T3组、T4组大鼠,差异均有统计学意义(P<0.05)。结论SPS治疗大鼠膝关节僵硬效果显著,可减少关节内TGF-β1的表达,抑制肌成纤维细胞过度增殖,减轻僵硬关节的病变程度。治疗时长为30 min、频率为1次/d的疗效最佳。Objective To investigate the efficacy and mechanism of static progressive stretch(SPS)with different parameters in the treatment of stiff knee in rats.Methods Fifty-six male 8-week SD rats were randomly divided into an operation group(n=48)and a blank group(n=8,normal feeding rats without any treatment).The knee joints of the rats in the operation group were fixed with Kirschner wire for 4 weeks to create models of right knee flexion stiffness.The 42 rats with successful modeling were randomly divided into 6 groups(n=7):the model group was executed and sampled after successful modeling,the spontaneous recovery group was not given any treatment after successful modeling,group T1 was given SPS treatment for 20 min once per day,group T2 was given SPS treatment for 30 min once per day,group T3 was given SPS treatment for 20 min once every 2 days,and group T4 was given SPS treatment for 30 min once every 2 days.After 16 days,the range of knee motion,number of myofibroblasts,and positive proportion of transforming growth factor-β1(TGF-β1)in the joint capsule were detected and compared between groups.Results The ranges of knee motion in the spontaneous recovery group and the 4 SPS treatment groups were significantly greater than those before treatment(P<0.05),and the improvements in the range of knee motion in the 4 SPS treatment groups were significantly greater than that in the spontaneous recovery group(P<0.05).The range of knee motion in group T2(112.29°±1.89°)was improved the most significantly.The number of myofibroblasts was(23.72±10.75)/HP,which was significantly smaller than that in T3 group[(55.72±33.56)/HP]or in T4 group[(50.72±33.34)/HP](P<0.05).The positive proportions of TGF-β1 in the joint capsule in the 4 SPS treatment groups were significantly lower than that in the model group,and the positive proportion of TGF-β1 in the joint capsule in group T2(0.51%±0.38%)was significantly lower than those in group T3 and T4(P<0.05).Conclusions As SPS treatment can reduce the expression of TGF-β1 in the

关 键 词：膝关节 关节挛缩 纤维化 僵硬 大鼠 静态渐进性牵伸 

分 类 号：R684[医药卫生—骨科学]