温针灸对虚寒型膝骨关节炎基因表达通路的影响

Effects of warming-needle therapy on gene expression pathways in the patient with knee osteoarthritis of deficiency-cold syndrome

目的:探讨温针灸疗法对虚寒型膝骨关节炎的作用机制。方法:选取8例膝骨关节炎辨证为虚寒证的患者,取关元、气海、足三里等穴进行温针灸治疗,选取其中疗效较好的4例患者作治疗前后的基因芯片比较,以ratio<0.5或ratio>2.0选取差异表达基因,将这些差异表达的基因通过http://www.DAVID2006获得差异表达通路(P<0.5,n>3)。结果:临床基本痊愈2例,显效4例,有效1例,无效1例。对基因芯片结果分析:共获得差异表达基因449条,差异表达通路10条,涉及能量代谢通路2条(氧化磷酸化,ATP合成),细胞信号转导通路4条(胰岛素信号途径,Toll样受体信号途径,JAK-STAT信号途径及MAPK信号途径)及细胞凋亡通路等。结论:温针灸是治疗虚寒型膝骨关节炎的有效疗法;其治疗膝骨关节炎的分子机制可能是通过多种信号转导途径调控多条基因表达实现的。

Objective To explore the mechanism of warming-needle therapy in treatment of knee osteoarthritis of deficiency-cold syndrome. Methods Eight cases of knee osteoarthritis of deficiency-cold syndrome were selected and treated with warming-needle therapy at Guanyuan （CV 4）, Qihai （CV 6）, Zusanli （ST 36）, etc.. The gene expression profiles before and after treatment in 4 cases who showed better therapeutic effect were compared. Taking ratio 〈 0.5 or ratio 〉 2.0 as differentially expression gene and obtaining differentially expression pathway （P〈0.5, n〉3） by http：//www. DAVID 2006. Results Two cases were clinically cured, 4 cases were markedly effective, 1 case was effective and 1 case was ineffective. With help of the microarray, 449 differentially expression genes, and 10 differentially expression pathways were obtained including 2 energy metabolism pathways （oxidative phosphorylation, ATP synthetase）, 4 cell signal transduction pathways （insulin signal pathway, Toll-like receptor signal pathway, JAK-STAT signal pathway, and MAPK signal pathway） and cell apoptosis pathway. Conclusion Warming-needle therapy is an effective therapy for knee osteoarthritis with deficiency-cold syndrome , which is possibly involved in the control and regulation of many gene expression by various signal transduction pathways.