内热针抑制成骨细胞凋亡延缓兔激素性股骨头缺血性坏死  

Internal heat acupuncture inhibits osteoblast apoptosis and delays steroid-induced avascular necrosis of the femoral head in rabbits

作　　者：田心保 马良辰 田富宝 刘园园 许建峰[3] 林瑞珠[1] 朱宁[1] Tian Xinbao;Ma Liangchen;Tian Fubao;Liu Yuanyuan;Xu Jianfeng;Lin Ruizhu;Zhu Ning(Department of Rehabilitation Medicine,Ningxia Medical University General Hospital,Yinchuan 750004,Ningxia Hui Autonomous Region,China;Department of Geriatrics and Special Needs Medicine,Ningxia Medical University General Hospital,Yinchuan 750004,Ningxia Hui Autonomous Region,China;Department of Traditional Chinese Medicine Orthopedics,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康复医学科,宁夏回族自治区银川市750004 [2]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 [3]宁夏医科大学总医院中医骨伤科,宁夏回族自治区银川市750004

出　　处：《中国组织工程研究》2025年第29期6161-6166,共6页Chinese Journal of Tissue Engineering Research

基　　金：中央引导地方科技发展专项(2021FRD05017),项目负责人:许建峰;宁夏科技厅重点研发计划项目(2022BEG03134),项目负责人:林瑞珠;宁夏医科大学校级课题(XM2023049),项目负责人:田心保;宁夏医科大学总医院“新入职硕士培养”项目,项目负责人:田心保。

摘　　要：背景:激素性股骨头缺血性坏死是一种骨科常见的进展性、致残性和高发病率的非创伤性股骨头坏死,但确切的发病机制尚不清楚。激素性股骨头缺血性坏死的内热针治疗表现出良好的临床疗效,但其具体作用机制尚不明确。目的:探究内热针对兔激素性股骨头缺血性坏死股骨头组织中成骨细胞凋亡及Bcl-2和Bax表达的影响。方法:将24只新西兰兔随机分为空白组、模型组和内热针组(n=8),后两组采用大肠杆菌内毒素联合甲泼尼龙琥珀酸钠的方法建立兔激素性股骨头缺血性坏死模型。造模4周后内热针组实验兔进行臀部内热针干预,每周1次,20 min/次;其余两组不予干预。进行为期4周的治疗后取材,采用TUNEL法和苏木精-伊红染色分别观察各组兔股骨头组织成骨细胞凋亡情况及组织形态学变化;采用免疫组化和Western Blot检测股骨头组织中Bcl-2和Bax的蛋白表达情况。结果与结论:①空白组中骨髓腔内造血细胞丰富,骨小梁结构清晰有序,脂肪细胞少,空骨陷窝少见;模型组中骨髓腔内脂肪细胞数量明显增加,并伴有增生、部分骨细胞脂肪变性和更多的空骨陷窝;内热针干预后,脂肪细胞和中空骨陷窝数量少于模型组,但比空白组明显;②与空白组相比,模型组股骨头组织中成骨细胞凋亡明显增加,Bax表达水平明显升高(P<0.001),Bcl-2表达明显下降(P<0.001);内热针干预后,成骨细胞凋亡明显降低,Bax表达水平明显下降(P<0.001),Bcl-2表达明显升高(P<0.001);③结果表明,内热针可通过抑制股骨头组织中成骨细胞凋亡,延缓兔激素性股骨头缺血性坏死。BACKGROUND:Steroid-induced avascular necrosis of the femoral head is a common progressive,crippling and high incidence of non-traumatic osteonecrosis of the femoral head,but its exact pathogenesis is not clear.Internal heat acupuncture therapy has a good clinical effect in the treatment of steroid-induced avascular necrosis of the femoral head,but its specific mechanism is not clear.OBJECTIVE:To investigate the effect of internal heat acupuncture on osteoblast apoptosis and expression of Bcl-2-associated X protein(Bax)and B lymphocytoma-2(Bcl-2)in steroid-induced avascular necrosis of the femoral head in rabbits.METHODS:Totally 24 male New Zealand rabbits were randomly divided into blank group,model group,and internal heat acupuncture group(n=8).The rabbit model of steroid-induced avascular necrosis of the femoral head was made in the last two groups by methylprednisolone sodium succinate combined with Escherichia coli endotoxin.After successful model establishment for 4 weeks,the rabbits in the internal heat acupuncture group received internal heat acupuncture intervention on the buttocks of rabbits,once a week for 20 minutes each time,while the other two groups did not receive any intervention.After 4 weeks of treatment,samples were harvested.Morphological changes of femoral head and osteoblast apoptosis were observed by hematoxylin-eosin staining and TUNEL assay.Protein expression of Bcl-2 and Bax in rabbit femoral head tissue was detected by immunohistochemistry and western blot assay.RESULTS AND CONCLUSION:(1)In the blank group,there were abundant hematopoietic cells in the bone marrow cavity,clear and orderly trabecular structure,few adipocytes and few empty bone lacunae.In the model group,the number of adipocytes in the bone marrow cavity increased significantly,accompanied by hyperplasia,steatosis of some osteocytes and more empty bone lacunae.After the intervention of internal heat acupuncture,the number of adipocytes and hollow bone lacunae was less than that in the model group,but more obvious than tha

关 键 词：内热针 激素性股骨头缺血性坏死 成骨细胞凋亡 BCL-2 BAX 工程化组织构建 

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