针刀干预对KOA兔关节软骨病理学及股四头肌收缩性能的影响

Effect of Acupotomy Intervention on Contractility of Quadriceps Femoris and Pathological Changes of Articular Cartilage in KOA Rabbits

目的:通过观察针刀干预对膝骨关节炎(KOA)兔HE染色及Mankin评分、股四头肌收缩性能的影响,探讨针刀治疗KOA的作用机制。方法:28只清洁级新西兰雄兔,随机分成正常组、模型组、电针组和针刀组。采用改良Videman左后肢伸直位固定制动法复制KOA模型,针刀组、电针组分别采用针刀和电针疗法治疗4周。采用光镜、电生理的方法对软骨形态学情况、股四头肌收缩性能进行检测。结果:造模后,模型组兔膝关节软骨HE染色显示软骨结构紊乱、破坏,Mankin评分较正常组明显升高(P <0. 01),股四头肌单收缩幅度和强直收缩幅度较正常均显著降低(P <0. 05或P <0. 01)。电针、针刀干预后,电针组兔膝关节软骨HE染色较模型组有所改善,Mankin评分较模型组显著降低(P <0. 01),股四头肌单收缩幅度和强直收缩幅度较模型组无显著差异(P> 0. 05);针刀组兔膝关节软骨HE染色较模型组改善明显,Mankin评分较模型组显著降低(P <0. 01),股四头肌单收缩幅度和强直收缩幅度较模型组显著升高(P <0. 05或P <0. 01),且与电针组相比Mankin评分显著降低(P <0. 05),股四头肌单收缩幅度和强直收缩幅度较电针组显著升高(P <0. 05)。结论:针刀干预能改善关节软骨退变,促进关节软骨修复,并能提高股四头肌的收缩性能。提高股四头肌的收缩性能是针刀干预KOA的重要机制。

Objective:To explore the mechanism of acupotomy intervention for knee osteoarthritis(KOA)through observing the effect on HE staining,Mankin score,and contractility of quadriceps femoris in KOA rab-bits. Methods:28 New Zealand rabbits were randomly divided into the normal group(group N),the modelgroup(group M),electro - acupuncture group(group E),and the acupotomy group(group A). The KOAmodel was established by modified Videman method of left hind leg unbent fixed and immobilized. The treat-ment was four weeks. Light microscope and electrophysiology technique were used for testing cartilage morphologyand contractility of quadriceps femoris. Results:After modeling,the HE staining showed that the structure ofthe articular cartilage was disorder and destructed,and Mankin score was significantly increased in group Mcompared to that in group N(P < 0. 01); the single contraction and tetanic contraction of quadriceps femoriswere significantly decreased(P <0. 05,P <0. 01). After electro - acupuncture intervention,the improvementsof articular cartilage were seen in HE staining test,and Mankin score was significantly decreased compared to that in group M(P < 0. 01); however,there were no significant differences in single contraction and tetaniccontraction of quadriceps femoris compared to those in group M(P >0. 05). After acupotomy intervention,theHE staining showed better improvement,Mankin score was significantly decreased(P <0. 01),and single con-traction and tetanic contraction of quadriceps femoris were significantly increased compared to those in group M(P <0. 05,P < 0. 01). The Mankin score was significantly lower(P < 0. 05),and single contraction andtetanic contraction of quadriceps femoris were significantly higher in group A compared to those in group E(P <0. 05). Conclusion:Acupotomy intervention can improve the metamorphosis of articular cartilage and protomeits repair,also it can increase the contractility of quadriceps femoris. The improvement of contractility of quadri-ceps femoris plays an important role in acupotomy intervention treating KOA.