电针联合推拿对骨关节炎大鼠模型的保护软骨损伤并减轻膝骨关节炎疼痛作用研究  

Protection Cartilage Injury and Alleviate Knee Osteoarthritis Pain of Electroacupuncture Combined with Massage in Osteoarthritis Rat Model

作　　者：刘杨 薛小娜[2] 吕亚楠 国生[1] 魏培栋[1] LIU Yang;XUE Xiaona;LYU Yanan;GUO Sheng;WEI Peidong(Department of Massage and Physiotherapy,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Department of Pediatrics,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Department of Social Work,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东方医院推拿理疗科,北京100078 [2]北京中医药大学东方医院儿科,北京100078 [3]北京中医药大学东直门医院社会工作部,北京100700

出　　处：《世界科学技术-中医药现代化》2025年第1期292-300,共9页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：北京中医药大学基本科研业务费青年教师项目(2019-JYB-JS-118):振腹推拿治疗餐后不适综合征(PDS)的临床疗效观察,负责人:刘杨。

摘　　要：目的探究电针联合推拿对膝骨关节炎大鼠软骨损伤的保护作用及分子作用机制。方法本研究选择SD大鼠各50只,按照奇偶数方法将大鼠分为对照组、模型组、电针组、推拿组、电针+推拿组各10只。对照组不做造模处理,其余各组大鼠均在关节腔内注射木瓜蛋白酶构建右侧膝骨关节炎(Knee osteoarthritis,KOA)模型,电针及推拿干预2周;采用改良Le-quesne MG量表评估大鼠行为学表现;分别于干预前后统计大鼠压痛值、热痛阈值;8周后处死大鼠,取腹主动脉血,ELISA法检测各组大鼠血清疼痛介质(K^(+))、5-羟色胺(5-hydroxytryptamine,5-HT)、多巴胺(dopamine,DA)含量;取大鼠右侧膝关节进行HE染色Mankin评分、TUNEL软骨细胞凋亡分析,甲苯胺蓝染色观察软骨基质多聚糖变化;Westernblot检测各组大鼠膝关节组织内软骨基质因子Ⅱ型胶原(CollagenⅡ)、C端肽(C-terminalpeptide,CTXⅡ)、Ⅱ型胶原C前肽(C-precursor peptide,CPⅡ)、凋亡相关蛋白Bax、Bcl-2、Cleaved-caspase-3、YAP、p-YAP浓度表达。结果KOA模型建立后,大鼠Lequesne MG评分显著提升(P<0.05);与模型组相比,电针组、推拿组大鼠Lequesne MG评分显著降低(P<0.05);二者联合可显著降低Lequesne MG评分(P<0.05);与对照组相比,模型组疼痛阈值(TWL、MWT)显著下调,血清疼痛因子(K^(+)、DA、5-HT)水平显著上调(P<0.05);与模型组相比,电针组、推拿组疼痛阈值(TWL、MWT)显著上调,血清疼痛因子(K^(+)、DA、5-HT)水平显著下调(P<0.05);二者联合体现出最高疼痛阈值(TWL、MWT)及最低血清疼痛因子(K^(+)、DA、5-HT)水平。模型组大鼠关节软骨裂隙明显,软骨基质染色度、着色面积均下降,Markin评分、细胞凋亡能力显著提升(P<0.05);与模型组相比,电针组、推拿组大鼠软骨层排列度、软骨基质染色度、着色面积均显著提升,Markin评分、细胞凋亡率均显著降低(P<0.05);联合可以进一步降低Markin评分及软骨细胞凋亡程Objective The protective effect and molecular mechanism of electroacupuncture combined with massage on cartilage damage in knee Osteoarthritis rats were explored.Methods 50 SD rats were selected and divided into a control group,a model group,an electroacupuncture group,a massage group,and an electroacupuncture+massage group of 10 rats each using an odd even number method.The rats in the control group were not treated with modeling,and the rats in the other groups were injected with Papain into the articular cavity to build the right knee Osteoarthritis(KOA)model.The massage and electroacupuncture groups were intervened with electroacupuncture and massage for 2 weeks.The improved Le-quesne MG scale was used to evaluate the behavioral performance of rats.The pressure pain value and heat pain threshold of rats before and after intervention were calculated.After eight weeks,the rats were euthanized and abdominal aortic blood was collected.The serum levels of pain mediators(K^(+)),5-hydroxytryptamine(5-HT),and dopamine(DA)were measured by ELISA in each group of rats.The right knee joint of rats was taken for HE staining Mankin score,TUNEL chondrocyte apoptosis analysis.Toluidine blue staining was used to observe the changes of cartilage matrix polysaccharide;Western blot was used to detect the concentration and expression of cartilage matrix factor typeⅡcollagen(CollagenⅡ),C-terminal peptide(CTXⅡ),typeⅡcollagen C-precursor peptide(CPⅡ),apoptosis related proteins Bax,Bcl-2,Cleared caspase-3,YAP,p-YAP in the knee joint tissues of rats in each group.Results After the establishment of the KOA model,the Lequesne MG score of rats increased significantly(P<0.05).Compared with the model group,the Lequesne MG scores of rats in the electroacupuncture group and massage group decreased significantly(P<0.05).The combination of the two can further reduce the Lequesne MG score significantly(P<0.05).Compared with the control group,the pain threshold(TWL,MWT)of the model group was downregulated significantly,and the levels o

关 键 词：膝骨关节炎 电针 推拿 软骨损伤 膝关节疼痛 Hippo-YAP信号通路 

分 类 号：R245.97[医药卫生—针灸推拿学]