穴位贴敷联合透明质酸钠对兔膝骨关节炎相关因子表达的影响
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摘要
目的观察穴位贴敷联合透明质酸钠对实验性日本大耳白兔膝骨关节炎的一氧化氮(NO)、软骨寡聚基质蛋白(COMP)、基质金属蛋白酶-1(MMP-1)、基质金属蛋白酶抑制剂-1(TIMP-1)表达的影响。方法将40只日本大耳白兔随机分为对照组、贴敷组、透明质酸钠组、穴位贴敷联合透明质酸钠治疗组(联合治疗组)四组,四组均使用外固定支具造模6周。造模成功后,贴敷组以足三里、膝眼、肾腧穴为主穴敷贴;透明质酸钠组予膝骨关节注射透明质酸钠;联合治疗组在膝骨关节内注射透明质酸钠后,以足三里、膝眼、肾腧穴为主穴敷贴,均治疗4周后分别采集血液与关节液,检测NO、COMP、MMP-1、TIMP-1的指标。结果治疗4周后,联合治疗组NO、COMP、MMP-1阳性表达率水平均低于对照组、贴敷组、透明质酸钠组(<0.05,<0.01),联合治疗组TIMP-1阳性表达率水平高于对照组、贴敷组、透明质酸钠组(<0.05,<0.01)。结论穴位贴敷联合透明质酸钠关节内注射,能明显抑制兔膝关节软骨的NO、COMP、MMP-1的产生,增加TIMP-1阳性表达率,减缓膝关节软骨的退变,对软骨起保护效应。
Objective To observe the effects of acupoint application combined with articular cavity injection of sodium hyaluronate on NO,COMP,MMP-1 and TIMP-1 in knee osteoarthritis(KOA)rabbits. Methods 40 Japanese big ear white rabbits were randomly divided into model group,acupoint application group,sodium hyaluronate group,combined treatment group. All groups received external fixation. After 6 weeks of immobilization,the models of KOA were started to establish.After the models successfully established,acupoint application group was treated with acupoint application at Zusanli,Xiyan,Shenshu; sodium hyaluronate group was treated with articular cavity injection of sodium hyaluronate; combined treatment group was treated with acupoint application combined with articular cavity injection of sodium hyaluronate. The treatment lasted for4 weeks. The blood and synovial fluid were selected to detect the levels of NO and COMP,and the animal articular cartilages were gotten to detect the positive expression rate of MMP-1 and TIMP-1 cartilage cells at the end of treatment.Results After4 weeks of treatment,the levels of NO and COMP,the positive rate of expression of MMP-1 cell rate in combined treatment group were significantly lower than the other groups( <0.05,<0.01).Conclusion Acupoint application combined with articular cavity injection of sodium hyaluronate can obviously inhibit the production of NO,COMP and MMP-1 in the cartilage of the knee of rabbit,increase the positive expression rate of TIMP-1,slow down the degeneration of the cartilage of the knee joint and protect the cartilage.
Objective To observe the effects of acupoint application combined with articular cavity injection of sodium hyaluronate on NO,COMP,MMP-1 and TIMP-1 in knee osteoarthritis(KOA)rabbits. Methods 40 Japanese big ear white rabbits were randomly divided into model group,acupoint application group,sodium hyaluronate group,combined treatment group. All groups received external fixation. After 6 weeks of immobilization,the models of KOA were started to establish.After the models successfully established,acupoint application group was treated with acupoint application at Zusanli,Xiyan,Shenshu; sodium hyaluronate group was treated with articular cavity injection of sodium hyaluronate; combined treatment group was treated with acupoint application combined with articular cavity injection of sodium hyaluronate. The treatment lasted for4 weeks. The blood and synovial fluid were selected to detect the levels of NO and COMP,and the animal articular cartilages were gotten to detect the positive expression rate of MMP-1 and TIMP-1 cartilage cells at the end of treatment.Results After4 weeks of treatment,the levels of NO and COMP,the positive rate of expression of MMP-1 cell rate in combined treatment group were significantly lower than the other groups( <0.05,<0.01).Conclusion Acupoint application combined with articular cavity injection of sodium hyaluronate can obviously inhibit the production of NO,COMP and MMP-1 in the cartilage of the knee of rabbit,increase the positive expression rate of TIMP-1,slow down the degeneration of the cartilage of the knee joint and protect the cartilage.
引文
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[7]李强,旷秋和,董小艳.新火针对家兔膝骨性关节炎基质金属蛋白酶-1、金属蛋白酶抑制剂-1影响的实验研究[J].湖北中医杂志,2015,37(7):20-22.
[8]唐娅琴,程丽琼,华爱军.穴位贴敷配合中药薰洗治疗痛风性关节炎疗效观察[J].上海针灸杂志,2013(23):896
[9]王乐,李陆虎,陈仕强,等.温针灸加关节腔注射玻璃酸钠治疗膝关节骨性关节炎的临床研究[J].陕西中医药大学学报,2016,39(4):54-56.
[10]陈子平,陈鹏典,庄礼兴.穴位贴敷配合电针治疗退行性膝关节炎的临床观察[J].针灸临床杂志,2014,30(5):28-30.
[11]龚志贤,卢敏,罗凌威,等.跌打通痹膏对兔膝骨关节软骨细胞MMP-1,MMP-3,MMP-13及COL-Ⅱ的m RNA表达的影响[J].中国中医骨伤科杂志,2016,24(9):1-5.
[2]李登晓,徐璇,朱洁,等.滑膜炎胶囊对兔膝骨性关节炎组织病理学及NO、SOD、COMP等的影响[J].上海中医药杂志,2014,48(4):86-90.
[3]徐英杰,尹羽薇,董清平.中药超微粉对骨性关节炎兔关节软骨中MMP-1和TIMP-1表达的影响及意义[J].慢性病学杂志,2014,15(6):434-437.
[4]郑洁,王瑞辉,寇久社.青藤碱关节腔注射对膝骨关节炎兔软骨和滑膜组织形态学及基质金属蛋白酶-13和软骨寡聚基质蛋白的影响[J].中国中医药信息杂志,2016,23(1):74-77.
[5]姚丽,赵婧,周强,等.祛痰化瘀利湿方对大鼠膝骨关节炎滑膜组织和血清IL-1,MMP-1及COMP,CTX-Ⅱ的影响[J].中国中医骨伤科杂志,2015,23(11):5-14.
[6]朱太味,赵延朋,谢艳.桃仁膝康丸对膝骨关节炎大鼠血清SOD、MDA、NO的影响[J].风湿病与关节炎,2012,1(1):36-40.
[7]李强,旷秋和,董小艳.新火针对家兔膝骨性关节炎基质金属蛋白酶-1、金属蛋白酶抑制剂-1影响的实验研究[J].湖北中医杂志,2015,37(7):20-22.
[8]唐娅琴,程丽琼,华爱军.穴位贴敷配合中药薰洗治疗痛风性关节炎疗效观察[J].上海针灸杂志,2013(23):896
[9]王乐,李陆虎,陈仕强,等.温针灸加关节腔注射玻璃酸钠治疗膝关节骨性关节炎的临床研究[J].陕西中医药大学学报,2016,39(4):54-56.
[10]陈子平,陈鹏典,庄礼兴.穴位贴敷配合电针治疗退行性膝关节炎的临床观察[J].针灸临床杂志,2014,30(5):28-30.
[11]龚志贤,卢敏,罗凌威,等.跌打通痹膏对兔膝骨关节软骨细胞MMP-1,MMP-3,MMP-13及COL-Ⅱ的m RNA表达的影响[J].中国中医骨伤科杂志,2016,24(9):1-5.