小针刀对膝关节骨性关节炎模型兔的实验研究

摘要

目的:观察小针刀对兔膝骨性关节炎模型组织形态及其关节软骨MMP-9及COX-2的变化.方法:将30只新西兰兔随机分为假手术组、模型组、针刀组,各10只.其中模型组及针刀组接受KOA模型制作,假手术组及模型组不接受任何干预措施,针刀组在造模第2天起利用针刀以纵疏、横剥法为手法对膝关节内外侧副韧带及髌尖下正中点进行松解,每周1次,共治疗4周,每周每只兔子右膝关节内注射丹参注射液0.6mL,连用4周(增加丹参注射液的使用).治疗结束后光镜下观察3组兔膝关组织形态变化,并用Western blotting法关节软骨MMP-9及COX-2浓度变化.结果:1)HE染色后模型组、针刀组新西兰兔膝关节均有不同程度的水肿、增生,其中针刀组较模型组改善;此外模型组膝关节软骨还可见一定程度退行性改变.2)与假手术组比较,模型组及针刀组兔膝关节软骨MMP-9及COX-2浓度均升高,其中模型组升高的趋势更明显(P＜0.05),针刀干预后针刀组上述两指标水平较模型组下降(P＜0.05).3)使用Pearson法进行MMP-9、COX-2浓度变化的相关性分析,结果发现两者呈正相关关系,结论:针刀松解术可明显改善膝关节骨性关节炎模型兔软骨退变,其机制可能与降低MMP-9及COX-2有关.%Objective:To observe acupotomy on the morphology of knee osteoarthritis rabbits model and the changes of MMP-9 and COX-2 in the articular cartilage.Methods:Thirty New Zealand rabbits were randomly divided into a sham-operate group,a model group and an acupotomy group,10 models in each.The model group and the acupotomy group were made into KOA model,while the sham-operate group and then model group didn't accept any interventions.The acupotomy group released the lateral collateral ligament and the patellar ligament on the second day of molding by acupotomy with vertical and horizontal strip method,once a week,for 4 weeks' treatment.After the treatment,knee histomorphology changes under light microscope of the three groups of rabbits were observed,and concentration changes of articular cartilage MMP-9 and COX-2 were tested by Western blotting.Results:1) After HE dyeing,the model group,the acupotomy group of New Zealand rabbits' knees all have different degrees of edema and hyperplasia,and the improvements in the acupotomy group was better than that in the model group;a certain degree degenerative changes were also visible in the knee joint cartilage of the model group.2) Compared with the sham-operate group,MMP-9 and COX-2 concentration of articular cartilage increased in both of the model group and the acupotomy group,but the increasing trend of the model group was more obvious (P ＜ 0.05).After acupotomy intervention,the above two index levels in the acupotomy group dropped more than those in the model group (P ＜ 0.05).3) Using Pearson method to analyze MMP-9 and COX-2 correlation,the results showed that MMP-9 levels was positively correlated with COX-2 (P ＜ 0.05).Conclusion:Acupotomy can improve cartilage degeneration of the knee osteoarthritis of model rabbits obviously,and the mechanism maybe related to the reduction of MMP-9 and COX-2.