丹渗注射液关节内注射预防关节粘连的实验研究(英文)

Prophylactic effects of intra-articular injection of salvia miltiorrhiza on joint adhesions in rabbit knee joints

[目的]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]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,搜刮髌上囊前壁,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组注丹渗注射液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)。[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,这可能与丹参通过多种途径减少组织的胶原含量和/或降低组织损伤修复的病理反应有关。

[ Objective ] To investigate the prophylactic effects of intra - articular injection of salvia mihiorrhiza on joint adhesion. [ Methods] Twenty-four Japanese male rabbits were randomly divided into 3 groups. All right hind knees were made in this way ： the auterior 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 mihiorrhiza 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 there was no significant difference （P 〉 0.05 ）compared to group B and group C. The scoring of joint adhesions in group B or C was smaller than that in group A （P 〈 0.01 ）, and there was no significant difference （P 〉 0. 05 ） compared to group B and group C. The scoring of histological changed of the synovial membrane in group B or C was smaller than that in group A （P 〈 0. 01 ）, and there was no significant difference（ P 〉 0. 05 ）compared to group B and group C. Total collagens content of the synovial membrane in group B or C was smaller than that in group A （ P 〈0. 01 ）, while that of group C was less than in group B（P 〈0. 01 ）. [ Conclusion] Similarly to sodium hyaluronate, salvia miltiorrhiza can effectively prevent joint adhesions.