急性肌肉软组织损伤后不同冷疗方式处理的组织学变化

Histological changes in muscle tissues with acute injury following cryotherapy

背景:冷疗处理急性软组织损伤已在临床广泛应用。目的:观察不同冷疗方式对急性软组织损伤大鼠的组织学改变及治疗效果。方法:将新生Wistar大鼠随机分成正常组、模型组、间断冷敷组及持续冷敷组,后3组建立急性软组织损伤动物模型。间断冷敷组用4℃生物冰袋间断冷敷于损伤部位,持续冷敷组用4℃生物冰袋持续冷敷,模型组不予以处理。冷敷48h后观察各组损伤部位大体形态改变,采用损伤症候指数评估损伤程度。结果与结论:与模型组比较,间断冷敷组及持续冷敷组损伤症候指数与组织学评分较低,白细胞介素1β的阳性表达率降低,转化生长因子β1的阳性表达率表达率升高(P<0.05)。与间断冷敷组比较,持续冷敷组损伤症候指数与组织学评分较低(P<0.05),白细胞介素1β的阳性表达率降低(P<0.05),转化生长因子β1的阳性表达率表达率升高(P<0.05)。结果证实,冷疗处理治疗急性期软组织损伤的机制与降低白细胞介素1β及提高转化生长因子β1表达有关,持续冷疗的疗效优于间断冷疗。

BACKGROUND： Cryotherapy of acute soft tissue injury has been widely used in clinical practice. OBJECTIVE： To observe the histological changes and treatment effect of different cryotherapies on the rats＇ acute damage of soft tissue. METHODS： Neonatal Wistar rats were randomized to normal, model, intermittent cryotherapy and continuous cryotherapy groups Models of acute damage of soft tissue were established in model, intermittent cryotherapy and continuous cryotherapy groups. In intermittent cryotherapy group, the injury was treated by intermittent cryotherapy with ice bag at 4 ℃; in the continuous cryotherapy group, the injury was treated by continuous cryotherapy with ice bag at 4 ℃; the model group was not treated. Histological changes were observed at 48 hours. Injury degree was evaluated using injury symptom index. RESULTS AND CONCLUSION： Compared with model group, the scores of injury symptom index and histology were lower, interleukin-113 expression was reduced, and transforming growth factor-β1（TGF-β1） expression was increased in intermittent cryotherapy and continuous cryotherapy groups （P 〈 0.05）. Compared with intermittent cryotherapy group, the scores of injury symptom index and histology were reduced （P 〈 0.05）, interleukin-1β expression was reduced （P 〈 0.05）, and TGF-β1 expression was increased in continuous cryotherapy group （P 〈 0.05）. Results demonstrated that cryotherapy can cure the acute damage of soft tissue by reducing interleukin-1β expression and raising TGF-β1 expression. Continuous cryotherapy is superior over intermittent cryotherapy.