揉髌手法对兔膝关节软骨组织退行性改变影响的实验研究

The Rou-Bin Manipulation on Degenerative Change of Knee Joint Cartilage in Rabbits

目的探讨揉髌手法对骨关节软骨组织退行性改变的影响,进而探讨揉髌手法取效的可能作用机制。方法采用100只新西兰兔,平分为8周组和12周组两组,每组动物分为手法组、针剂组、模型对照组、假模组和正常组各10只;前3组通过手术造成骨内高压型骨性关节炎模型,假模组手术但不结扎切断相应血管,正常组不做任何处理。手法组每只动物使用揉髌手法施术于右下肢5周共17次;针剂组每周右膝关节内注射一次玻璃酸钠液,共注射5次。其他3组动物不做任何处理。造模后分别于8周末、12周末处死同组所有动物,切取右膝关节胫骨平台内侧软骨组织进行肉眼和伊红染色光镜观察软骨组织的结构变化。结果 模型对照组动物软骨8周末处于早中期退变,12周末达到中期退变;假模组8周末软骨组织处于退变早期,12周末结构趋于正常;手法组和针剂组8周末、12周末软骨组织轻度改变。正常组8周末和12周末软骨组织无任何改变。结论 揉髌手法可明显延缓兔膝关节软骨组织的退行性改变,其可能作用机制与改善血液循环,改善软骨组织的代谢有关。

Objective To observe the influence of Rou-Bin Manipulation on degenerative change of knee joint cartilage and the possible mechanism.Methods 100 New Zealand rabbits were divided equally into 8-week group and 12-week group at random,each big group was subdivided into five small gourps： Manipulation group,injection group,Model group,dummy-model group and normal group,10 rabbits in each group.The first 3 groups were induced high intraosseous pressure by operative,dummy-model group was treated similarly without corresponding vessel damage,no treatment for normal group.17 times of Rou-Bin manipulation on right knee for each rabbit in manipulation group,the rabbit injection with sodium hyaluronate 5 times in injection group,no special treatment for other rabbits.8 weeks and 12 weeks after the model was established,all rabbits were sacrificed and right knee medial tibial plateau cartilage tissue was isolated and observed,by light microscope after HE staining.Results The model group was on the early and medial stages of cartilage degeneration at the 8th weekend,on the medial stages at the 12th weekend;the dummy-model group was on the early stages of cartilage degeneration at the 8th weekend,tend to the normal level at the 12th weekend;both manipulation group and injection group cartilaginous tissue lightly degenerated at the 8th weekend and 12th weekend;no obvious cartilage degeneration was observed for the normal group at the 8th weekend and 12th weekend.Conclusion The Rou-Bin manipulation can significantly delay the degeneration of cartilage tissue of knee joint in rabbits,and the mechanism is related to improving blood circulation and metabolism of the cartilage tissue for the Rou-Bin Manipulation.