刺血疗法对急性痛风性关节炎模型局部关节软骨超微结构的影响

The Effects of Pricking Blood Therapy on Articular Cartilage Ultrastructure of Acute Gouty Arthritis Model

目的观察刺血疗法对于急性痛风性关节炎大鼠模型的局部症状、光镜下形态学改变、电镜下超微结构改变的影响,初步探索刺血疗法治疗本病的效应机制。方法 40只SD大鼠随机分为正常组、模型组、药物组、刺血组。通过右踝关节腔注射尿酸钠建立急性痛风性关节炎模型。药物组以布洛芬灌胃治疗,刺血组在右侧昆仑穴刺血。测量4组4个时间点的造模踝关节的周径,光镜下观察造模后关节腔组织形态学改变,电镜观察软骨组织的超微结构。结果刺血组24h后造模踝关节周径与药物组、模型组比较,差异有统计学意义(P<0.05);48h后与药物组、正常组比较,差异无统计学意义(P>0.05)。光镜结果显示:模型组关节腔内有尿酸钠结晶沉积,并有大量炎细胞浸润;药物组关节腔内有部分尿酸钠结晶沉积,并有部分炎细胞浸润;刺血组关节腔内有少量粉色团块状物体沉积,及少量炎细胞浸润。电镜结果显示:模型组细胞有渗出,突起,胶原纤维排列乱且密集;药物组细胞有渗出,突起,胶原纤维排列紊乱;刺血组细胞结构正常,胶原纤维排列较乱。结论刺血疗法能有效快速地减轻关节腔尿酸钠的沉积,减少炎细胞的浸润,改善关节软骨的超微结果,改善局部症状。与常规的药物疗法比较,有疗效好、起效快、毒副作用小的优势,值得推广。

OBJECTIVE To observe the effects of pricking blood therapy on local symptoms of the acute gouty arthritis rat model,morphological changes and ultra-structure,and to explore the effective mechanism of pricking blood therapy.METHODS Forty SD rats were randomly divided into control group,model group,drug group and pricking blood group.The acute gouty arthritis model was set by injecting uric acid into the right ankle joint cavity of the rats.The drug group received 120 mg/ kg gastric perfusion of ibuprofen; the pricking blood group pricked the right Kunlun points.The diameter of the injected right ankle joint of the forty rats were measured and recorded before modeling,and 6 h,24 h,and 48 h after the rats were modeled.The morphological changes were observed under light microscope and ultra-structure was under electron microscope.RESULTS For modeling after 24 hours,there were significant statistical differences between pricking blood group and drug group,and between pricking blood group and model group （P＜0.05）,while there was no significant statistical difference for modeling after 48 h （P＞0.05）.From light microscope,sodium urate crystal deposition had been found in model group with dense inflammation infiltration; there were also some sodium urate crystal and inflammation infiltration in drug group; small amount of pink crumby deposition and inflammation infiltration were found in pricking blood group.As shown in electron microscope,for model group,a few of articular cartilage cell membrane was damaged.Inflammation infiltration occurred and cell process endopasmic reticulum expansion turned up with the same occasion for drug group and arrangement of collagen fibers was disordered and dense.For drug group,mitochondria decreased and arrangement of collagen fibers was disordered.For pricking blood group,there was slight disorder in collagen fibers and cell structure was normal.CONCLUSION Pricking blood therapy may reduce the deposition of uric acid sodium in articular cavity,lessen infiltration of the inflammatory cells,and improve the ultra-structure of artbrodial cartilage rapidly and effectively.Compared with conventional therapy,pricking blood therapy has a better effect,and works quickly with less side-effect.