独活寄生汤治疗大鼠膝骨性关节炎软骨病理学分析

Pathological Analysis on Duhuojisheng Decoction for Articular Cartilage of Rat's Knee Osteoarthritis

目的:通过对大鼠膝骨关节炎模型的关节软骨病理学形态观察,研究独活寄生汤对骨关节炎的治疗效果,探讨其可能的病理学机制。方法:将60只SD大鼠随机分为空白组10只,实验组50只,行碘乙酸药物诱导法造模,2周后完成造模,随机选5只处死,以确定造模效果;将其余45只分为模型组15只、西药组10只、中药中剂量组10只、中药高剂量组10只,中药两组予独活寄生汤灌胃,西药组予托珠单抗注射液治疗,模型组分别于第4周、8周时各处死5只,8周后全部处死,在体肉眼观察各组动物关节软骨表面情况,制作病理切片,采用骨性关节炎软骨病理变化Mankin评分标准,评价各组关节软骨病理改变。结果:碘乙酸诱导造模,第2周、4周、8周分别处死,取关节软骨并制作切片,通过肉眼观察及光镜下观察,表现出膝骨关节炎早、中期病理改变。统计分析示:与造模第2周相比,第4、8周评分升高,软骨退行性病变进一步加重。造模第8周,中药中剂量组、中药高剂量组、西药组与模型组相比,评分均显著降低,疗效明显,差别均有统计学意义(P<0.01),三组同空白组相比,评分差异明显,差别有统计学意义(P<0.01),中药高剂量组较中药中剂量组相比,评分降低,疗效明显,差异有统计学意义(P<0.01),但中药组与西药组相比,疗效差异不明显,差别无统计学意义(P>0.05)。结论:独活寄生汤能延缓关节软骨的退行性病变,高剂量与托珠单抗注射液作用接近。

Objective: through observating the pathological morphology of articular cartilage of rat's knee osteoarthritis models,to study the therapeutic effect of Duhuojisheng decoction on osteoarthritis,and to explore the possible mechanisms of pathology. Methods: 60 SD rats were randomly divided into blank group of 10 rats and experimental group of 50 rats. The rats of experimental group were modeled by drug-inducing method of iodoacetic acid. After 2 weeks of modeling success,5 randomly selected rats were killed,so as to determine the modeling effect; other 45 were divided into model group(15),western medicine group(10),TCD middle-dose group(10)and TCD high-dose group(10). The two TCD groups were administrated Duhuojisheng decoction by gavage; the western medicine group was treated with the Tocilizumab Injection. In model group,each 5 rats were put to death respectively at the 4th and 8th week,and all rats were killed after 8 weeks. To observe visually the articular cartilage surfaces in animal vivo of each group,and to make pathological section. By Mankin score standard for pathological changes of osteoarthritis cartilage,the pathological changes of articular cartilage in each group were evaluated. Results: To model by drug-inducation of iodoacetic acid,to be killed all respectively in the 2nd,4th and 8th week,to take articular cartilage and make the sections,to observe with the naked eye and under light microscope,which showed the pathological changes of mid and early staging of knee osteoarthritis. The statistical analysis showed: compared with the 2nd week of modeling,the scores of the 4th and 8th weeks increased,the cartilage degeneration was aggravated further. In the 8 th week of modeling,compared TCD middle-dose group,TCD high-dose group and western medicine group with model group,the scores were all significantly reduced,the curative effect was obvious,the differences had statistical significance( P < 0. 01). Comparing these three groups with blank group,scoring differences were significant,the differences had statistical significance( P< 0. 01). Compared TCD high-dose group with TCDmiddle-dose group,the scoring was decreased,the curative effect was obvious,the differences had statistical significance( P < 0. 01). But compared TCD groups with western medicine group,the curative effects had no obvious difference,the differences had no statistical significance( P >0. 05). Conclusion: Duhuojisheng decoction can promote the repair of articular cartilage,and delay the degeneration of articular cartilage. The effect high-dose TCD is close to tocilizumab injection.