揉髌手法对实验兔膝关节软骨细胞凋亡及PCNA表达的影响

[摘要] 目的:通过揉髌手法对实验兔膝关节软骨细胞凋亡和PCNA表达影响的研究，探讨手法治疗膝关节骨性关节炎的作用机制。方法:50只新西兰兔随机分为手法组、玻璃酸钠组、模型对照组、假模组、正常组, 每组各10只。前三组采用手术结扎股静脉，臀下静脉、大隐静脉方法造成右下肢骨内高压型模型，假膜组予以手术暴露但不结扎相应血管，正常组不作任何处理。1周后，手法组采用揉髌手法连续治疗5周共17次；玻璃酸钠组每周右膝关节内注射一次，连续5周；其余各组不作任何治疗。造模后12周末处死所有兔子，分别取右膝胫骨平台软骨组织，采用原位末端标记法观察软骨细胞凋亡，免疫组化法观察PCNA表达。结果: 软骨细胞凋亡率手法组为8.67±1.86%，模型对照组为13.57±3.27%，两组比较P<0.01，有统计学意义；PCNA表达率手法组为8.08±1.39%；模型对照组为6.68±0.79%，两组比较P<0.01，有统计学意义。结论:揉髌手法可以降低实验兔膝关节软骨细胞凋亡率及提高增殖细胞核抗原表达率，可能是其治疗膝关节骨性关节炎的作用机制之一。

Effects of RouBin-Mamipulation on Apoptosis of Chondrocyte

Abstract Objective To observe the effect of roubin-mamipulation on apoptosis of chondrocyte, expression of proliferation cell nuclear antigen (PCNA) experimental knee of rabbit and the mechanism of the treatment with osteoarthritis of the knee. Methods 50 Livor New Zealand rabbits were divided into 5 groups randomly: model contrast group, sodium hyaluronate group, mamipulation group (which were involved as high intraosseous pressure experiment model of right leg by ligating the vena femoralis and gluteae inferiors), normal group and sham operation group. (this only cut out the skin ). One week later, the mamipulation group is treated with roubin-manipulation once of two days, ten minutes a time, over after seventeen times. The sodium hyaluronate is injected into the intra-articular of sodium hyaluronate group once a week, to do as this five weeks. Other groups were feeded as usually at the same time. Specimens were harvested after seven weeks. Cartilage sections of right knee-joint were analyzed by immunohistochemistry and transmission electron microscopic. Results Apoptosis cell index and cell proliferation index have significant difference between mamipulation group (AI 8.67±1.86%, PI 8.08±1.39%) and model contrast group (AI 13.57±3.27%, PI 6.68±0.79%) (P<0.01). Conclusions Roubin-mamipulation can decrease the apoptosis of chondrocyte, increase chondrocyte proliferation. It has therapeutically effect to the experimental osteoarthritis.