低频电刺激股四头肌和髋外展肌群治疗膝骨关节炎的实验研究  

Low-frequency electrical stimulation of quadriceps femoris and hip abductor muscle group against knee osteoarthritis:an experimental study

作　　者：刘文洁 李辉[1] 张玲玲 陆永莉 海博涵 王文彪[1] LIU Wenjie;LI Hui;ZHANG Lingling;LU Yongli;HAI Bohan;WANG Wenbiao(The First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan,China)

机构地区：[1]新乡医学院第一附属医院,河南卫辉453100

出　　处：《中医正骨》2024年第6期16-22,31,共8页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：河南省医学科技攻关项目(LHGJ20190464)。

摘　　要：目的:观察低频电刺激股四头肌和髋外展肌群治疗膝骨关节炎(knee osteoarthritis, KOA)的疗效,并探讨其可能的作用机制。方法:将40只2月龄SD大鼠随机分为正常对照组、模型组、电刺激股四头肌组、联合电刺激股四头肌组,每组10只。除正常对照组外,其余3组均分别于造模开始后第1天、第4天、第7天在大鼠右膝关节腔内注射0.15 mL的4%木瓜蛋白酶溶液和浓度为0.03 mol·L^(-1)的L-半胱氨酸溶液(2∶1)的混合液。造模成功后,电刺激股四头肌组和联合电刺激股四头肌组分别于大鼠右股四头肌和股四头肌与髋外展肌群(尤其是臀中肌)进行低频电刺激,隔天干预1次,每次20 min,共28 d;模型组和正常对照组不做任何干预。干预结束后第2天,抽取各组大鼠2 mL下腔静脉血,采用酶联免疫吸附法检测大鼠血清中白细胞介素(interleukin, IL)-1β和基质金属蛋白酶(matrix metalloproteinase, MMP)-13的含量;采血后处死大鼠,切取各组大鼠膝关节股骨远端软骨组织,分别进行苏木精-伊红(hematoxylin-eosin, HE)染色、甲苯胺蓝染色和改良番红O-固绿染色,并采用Mankin评分评估关节软骨损伤情况;采用免疫组织化学染色法检测大鼠膝关节软骨组织中MMP-13的表达量。结果:(1)大鼠膝关节软骨组织病理学观察结果。与正常对照组相比,模型组软骨细胞排列紊乱、数量减少,软骨基质减少、染色明显不均,软骨层变薄,潮线模糊不清。电刺激股四头肌组和联合电刺激股四头肌组软骨细胞排列整齐、数目增多,软骨基质染色均一,软骨层增厚,潮线清晰可见,其中联合电刺激股四头肌组表现更为明显。(2)大鼠膝关节软骨Mankin评分结果。正常对照组大鼠膝关节软骨Mankin评分低于模型组、电刺激股四头肌组、联合电刺激股四头肌组(P=0.000,P=0.000,P=0.000),电刺激股四头肌组、联合电刺激股四头肌组大鼠膝关节软骨Mankin评分低于模型组(PObjective:To observe the outcomes of low-frequency electrical stimulation(LFES)of quadriceps femoris(QF)and hip abductor muscle group against knee osteoarthritis(KOA)in rats,and to explore its underlying mechanism.Methods:Forty 2-month-old Sprague-Dawley(SD)rats were randomized into normal control group,model group,QF LFES group and combined QF LFES group,10 ones in each group.All rats but the ones in normal control group were intervened by knee intra-articular injection of a mixture of 4%papain solution and 0.03 mol/L L-cysteine solution in a ratio of 2∶1(0.15 mL)into the right knees on day 1,4 and 7 after the beginning of the modeling for inducing KOA.After successful modeling,the rats in QF LFES group and combined QF LFES group received LFES on the right QF as well as QF and hip abductor muscle group(especially the gluteus medius),respectively,once every other day,20 minutes at a time for consecutive 28 days;while the ones in model group and normal control group were not given any intervention.On day 2 after the end of intervention,the blood(2 mL)was drawn from the inferior vena cava(IVC)of rats in each group,and the serum levels of interleukin(IL)-1βand matrix metalloproteinase(MMP)-13 were detected by using enzyme linked immunosorbent assay(ELISA).After phlebotomizing,the rats were sacrificed,and their distal femoral cartilage tissues were harvested and stained with hematoxylin-eosin(HE),toluidine blue and modified safranin O-fast green(SO-FG)for observing the histopathological changes;meanwhile,the knee articular cartilage injury was evaluated by using Mankin score.Furthermore,the expression level of MMP-13 in the knee cartilage tissues were detected by using immunohistochemical staining.Results:①Compared with that of normal control group,the histopathological changes,manifesting as decreased and disordered arranged chondrocytes,reduced cartilage matrix with obviously uneven staining,thinned cartilage layer,and the unclear tidal line,were observed in the knee cartilage tissues of rats in model group;wh

关 键 词：骨关节炎 膝 电刺激 股四头肌 髋外展肌群 臀中肌 大鼠 白细胞介素IL-1β 基质金属蛋白酶13 动物实验 

分 类 号：R684.3[医药卫生—骨科学]