丹参注射液关节内注射预防关节粘连的实验研究

The Prophylactic Effects of Intraarticular Injection of Salvia Miltiorrhiza on Jiont Adhesions in Rabbit Knee Joints

目的为探讨预防性关节内注射丹参注射液对关节粘连的影响。方法将24只日本雄性大耳白兔随机分为3组,每组8只,分别为盐水对照组(A组)、玻璃酸钠对照组(B组)、丹参治疗组(C组)。手术切开右后膝关节,搔刮髌上囊前壁,切除大部分髌上囊后壁滑膜和髌下脂肪垫,术毕用长腿管形石膏固定右后肢膝关节于伸直位。每只动物采用的药物品种及剂量分别是:A组注生理盐水0.3ml、B组注玻璃酸钠0.3ml、C组注丹参注射液0.3ml,共4次。4周后空气栓塞处死动物,行关节活动度测量、关节腔行大体观察、髌上囊滑膜组织的组织学观察和总胶原含量检测。结果关节活动度B、C组大于A组(P<0.01),B、C组之间差异无显著性(P>0.05);关节粘连计分B、C组均于小A组(P<0.01),B、C组之间差异无显著性(P>0.05);髌上囊前壁滑膜病变组织学计分B、C组均小于A组(P<0.01),B、C组之间差异无显著性(P>0.05);髌上囊前壁滑膜组织总胶原含量B、C组小于A组(P<0.01),C组小于B组(P<0.01)。结论丹参注射液关节内注射能有效预防关节粘连,且与玻璃酸钠的效果类似。

Objective To investigate the prophylactic effects of repeated intraarticular injection of Salvia miltiorrhiza on joint adhesion.Methods 24 Japanese rabbits were divided randomly into 3 groups.All right hind knees were made like this:the anterior wall of suprapatellar bursae was scraped,the posterior wall of suprapatellar bursae and the infrapatellar fat pad were cut off.Each knee was injected with physiological saline 0.3 ml for group A,sodium hyaluronate injection 0.3 ml for group B,and Salvia miltiorrhiza injection 0.3 ml for group C.All right hind knees were immobilized in the extension position with a long leg plaster cast for 4 weeks,and injected weekly.Results After 4 weeks,the joint movement range in group B or C was larger than that in group A(P<0.01),and between group B and group C there had no significant difference(P>0.05).The scoring of joint adhesions in group B or C was smaller than that in group A(P<0.01),between group B and group C there had no significant difference(P>0.05).The scoring of histological change of the synovial membrane in group B or C was smaller than that in group A(P<0.01),and there had no significant difference between group Band group C(P>0.05).Total collagens content of the synovial membrane in group B or C was less than that in group A(P<0.01),while that of group C was less than of group B(P<0.01).Conclusion Similar to sodium hyaluronate,salvia miltiorrhiza can effectively prevent joint adhesions.