中药关节腔灌注配合小针刀疗法对激素性股骨头坏死家兔病理组织学变化及TGF-β1表达影响的研究

摘要

目的:通过建立激素性股骨头坏死(SANFH)家兔模型,探讨活骨注射液髋关节注射配合针刀疗法治疗SANFH病程中股骨头局部病理组织学变化及转化生长因子(TGF-β1)表达的变化及意义.方法:选择健康成年雄性新西兰大白兔72只,采用马血清加激素法造模.造模成功后,将造模家兔随机分为模型组、针刀组、灌注组与联合组4组,每组18只.模型组与针刀组家兔双侧髋关节每日给予生理盐水关节腔注射,灌注组与联合组给予等量活骨注射液双髋关节注射治疗.各组2、5、8周各处死6只,取双侧股骨头,HE染色检测股骨头病理改变,免疫组化法检测TGF-β1蛋白表达,RT-PCT法检测TGF-β1 mRNA表达变化.结果:联合组在SANFH治疗的过程中对股骨头病理组织学及TGF-β1的表达有影响(P＜0.05),具有统计学意义.结论:活骨注射液髋关节注射配合针刀治疗SANFH,在治疗2周后可使股骨头病理组织学发生改变,并促进TGF-β1的表达上调,其中8周达到疗效最佳.%Objective:To explore the changes of local histopathology and TGF-β1 in SANFH rabbits with Huogu injection combined with acupotomy.Methods:72 healthy New Zealand white rabbits were modeled with horse serum and hormone.After successful modeling,they were randomly divided into the model group (n =18),the acupotomy group(n =18),the injection group (n =18),and the combination group (n =18).The rabbits in the model group and the acupotomy group were treated with saline injection into both hip joints.The injection group and the combination group were given the same amount of Huogu injection into both hip joints.Six rabbits were killed to take out the bilateral femoral heads each time at week 2,week 5,and week 8,HE staining was used to detect the pathological changes of the femoral heads.The expression of TGF-β1 protein was detected by immunohistochemistry.The expression of TGF-β1 mRNA was detected by RT-PCT.Results:The combination group had a significant effect on the histopathology and the expression of TGF-β1 in the process of SANFH (P ＜ 0.05).Conclusion:The treatment of Huogu injection into hip joint combined with acupotomy therapy can improve the histopathology of the femoral heads and promote the up-regulation of TGF-β1 in the treatment of SANFH after two weeks of modeling,and the best effect happened after eight weeks.