模拟按压手法对兔膝骨关节炎治疗作用的实验研究

目的探讨推拿手法对兔膝骨关节炎的治疗作用及机制。方法将36只健康新西兰大白兔随机分为6组,每组6只,即正常组、模型组和治疗组(根据治疗手法不同再分成4组);除正常组外,其余30只实验兔采用髌韧带缺损术建立膝骨关节炎模型,8周后对治疗组实验免进行治疗,隔天治疗1次,连续治疗6周;对照组不做任何治疗。6周后,检测各组实验兔血清中TNF-α、MMP-13水平,膝关节软骨标本经HE、番红O及甲苯胺蓝染色后光镜下观察病理组织学改变,并用免疫组化检测软骨细胞整合素α1β1的表达。结果①组织形态学:治疗组与模型组比较,软骨细胞簇集和基质失染现象有减轻趋势,但未达到正常组水平;②各治疗组与模型组比较,Mankin评分及血清TNF-α、MMP-13水平差异有统计学意义(P<0.05),治疗组组间差异无统计学意义(P>0.05);③治疗组与模型组整合素α1β1表达无明显差异,但均较正常组表达高。结论软骨组织形态学及血清学检测显示,按压手法通过改变关节内应力环境,调节TNF-α、MMP-13和整合素α1β1的表达来抑制软骨细胞的凋亡,刺激软骨的组织与再生,促进软骨细胞外基质的代谢,从而起到抑制关节软骨退变的作用。

Experimental study of imitate-pressing Tuina on knee osteoarthritis in rabbits

Objective To explore the mechanism and efficacy of Tuina on knee osteoarthritis in rabbits.Methods Thirty-six rabbits were randomized into six groups: normal group,model group and treatment groups(4 different treatment groups were divided based on different manipulations),six rabbits in each group.Except for normal group,the other 30 rabbits were modeled by patellar ligament defect.The rabbits in treatment groups were treated after 8 weeks,every other day for 6 weeks continuously.Rabbits were not treated in control group.After 6 weeks,the levels of TNF-α and MMP-13 were detected in the serum;the changes of pathological histology was observed by light microscope after Hematoxylin and eosin staining,safranin O staining and toluidine bluc staining;the expression of integrin-α1β1 was detected by the immunohistochemistry.Results ①Histomorphology: compared with model group,the chondrocyte clustering and failure staining of matrix in treatment group were relieved,but didn’t reach the normal level;②compared treatment groups with model group,there were significant differences in Mankin score,TNF-α level and MMP-13 level(P<0.05),but without significant difference between the treatment groups(P>0.05);③the results of immunohistochemistry staining showed that compared treatment groups with model group,no significant difference was found in expression of integrin-α1β1,and the expression of integrin-α1β1 in treatment groups was higher than that in normal group.Conclusion The results of histomorphology showed that imitate-pressing Tuina can inhibit the apoptosis,stimulate regeneration and promote the metabolism of extracellular matrix in chondrocyte by changing the innerstress of joints,regulating expression of TNF-α,MMP-13 and integrin-α1β1,hence to inhibit the degeneration of articular cartilage.