电针配合穴位注射骨瓜提取物治疗日本大耳白兔类风湿关节炎的实验研究

Experimental Study of Electro Acupuncture Combined with Acupoint Injection of Bone Melon Extract for the Treatment of Rheumatoid Arthritis of Japanese Big Ear Rabbits

目的:研究电针配合穴位注射骨瓜提取物治疗日本大耳白兔类风湿关节炎镇痛消炎作用机制。方法:日本大耳白兔40只,随机分为模型组、电针组、骨瓜提取物组及联合治疗组,4组大鼠均经右膝关节腔内多点注射小牛软骨Ⅱ型胶原加福氏完全佐剂0.1 ml制备类风湿性关节炎动物模型,造模成功后电针组取血海、足三里、阳陵泉3穴为主穴电针刺激30 min;骨瓜提取物组肌注骨瓜提取物注射液;联合治疗组取足三里、血海、阳陵泉3穴为主穴电针刺激30 min后穴位注射骨瓜提取物;模型组注射生理盐水。以上各组均治疗14天,并于治疗前后14天测定关节滑膜BMPs及MMP-1阳性表达率,测关节积液前列腺素E2(PGE2)、透明质酸(HA)、白细胞介素-8(IL-8),并计算膝关节肿胀百分率。结果:经14天治疗,联合治疗组关节滑膜BMPs及关节积液中HA分泌增高,PGE2、IL-18、MMP-1细胞阳性表达率及肿胀百分率明显降低,与治疗前及电针组、骨瓜提取物组比较,P<0.05,差异均有统计学意义。结论:电针配合穴位注射骨瓜提取物能有效治疗日本大耳白兔类风湿性关节炎,其作用机制可能为电针刺激经络激发经气,促进关节局部血液循环及病变组织新陈代谢,提高关节滑膜BMPs分化及关节积液中HA分泌,抑制IL-1β、PGE2等炎性因子合成,提高病变部位痛阈,减轻关节疼痛而起到协同治疗作用。

Objective： To study the analgesic and anti- inflammatory mechanism of electroacupuncture combined with acupoint injection of bone melon extract for the treatment of rheumatoid arthritis of Japanese big ear rabbits. Methods： 40 white rabbits were randomly divided into a model group,an electro acupuncture group,a bone melon extract group and a combined treatment group. In four groups rats were treated by the right knee joint cavity of multi point injection of bovine type II collagen with Freund＇s complete adjuvant 0. 1 m L preparation in animal models with rheumatoid arthritis. After the success of modeling of electro acupuncture group,Zusanli,Xuehai and Yanglingquan were electroacupunctured for 30 min; the bone and melon extract group was injected with bone melon extract injection and in the combined treatment group,Zusanli,Xuehai and Yanglingquan were electroacupunctured for 30 min and then received acupoint injection of bone melon extract,and the model group was injected with physiological saline. All groups were treated for 14 days（ D）. Determine the synovial joint BMPs and MMP- 1 positive expression rate before and after treatment and measure joint effusion of prostaglandin E2（ PGE2）,hyaluronic acid（ HA）,interleukin- 8（ IL- 8）,and calculate the percentage of knee joint swelling. Results： After 14 d treatment,in the combined treatment group the joint effusion synovial BMPs secretion of HA was increased and PGE2,IL- 18,MMP- 1 positive cells rate and swelling percentages were decreased significantly,compared with those before treatment and those in the acupuncture group,bone and melon extract group,P〈0. 05,and the difference had a statistical significance. Conclusion： Electro acupuncture combined with acupoint injection of bone melon extract can be effective in the treatment of rheumatoid arthritis of Japanese big ear rabbits,and its mechanism may be through main and collateral channels and electroacupuncture stimulation,promoting the joint local blood circulation and superseding diseased tissues with the new. It can increase HA secretion of synovial BMPs differentiation and joint effusion,inhibit IL- 1 beta,PGE2 and other inflammatory cytokines synthesis,raise the pain threshold and reduce joint pain. Therefore,it has a synergistically therapeutic effect.