针刀疗法对膝骨关节炎兔胫骨前肌表面肌电与肌腱生物力学行为的影响

Effects of acupotomy on surface electromyogram of tibialis anterior and biomechanical parameters of tendons in rabbits with knee osteoarthritis

目的观察针刀疗法对膝骨关节炎兔胫骨前肌表面肌电和肌腱拉伸、蠕变及应力松弛的影响。方法 48只新西兰兔随机分为正常组、模型组、针刀组和电针组。针刀组以股内、外侧肌止点及内、外膝眼为松解进针点治疗,每周2次;电针组针刺左后肢"血海""梁丘""内膝眼""外膝眼"穴,每周3次。治疗3周后,先活体测量负荷分别为0、500、1 000 g时左侧胫骨前肌表面肌电数据。然后处死动物,取与膝关节相连的胫骨前肌肌腱试件,进行生物力学相关数据测试。结果无负荷下,模型组胫骨前肌肌肉积分肌电值比正常组下降(P<0.05),针刀组及电针组与正常组差异无统计学意义(P>0.05);500 g负荷下,针刀组胫骨前肌肌肉积分肌电值比模型组增加(P<0.01),且与正常组差异无统计学意义(P>0.05);在1 000 g负荷下,针刀组与电针组、模型组相比,差异均无统计学意义(P>0.05)。模型组胫骨前肌肌腱蠕变率、应力松弛率比正常组增加(P<0.05),针刀组及电针组蠕变率均比模型组降低(P<0.05),且与正常组比较差异无统计学意义(P>0.05)。模型组最大应变与正常组相比,差异具有统计学意义(P<0.05),针刀及电针干预可降低模型兔的最大应变(P<0.05)。结论针刀能够改善膝骨关节炎兔胫骨前肌疲劳程度,调整胫骨前肌肌腱生物力学行为,恢复膝关节力学平衡。

Objective To observe the effects of acupotomy on surface electromyogram（ EMG） of tibialis anterior and biomechanical parameters（ tendon stretching,creep and stress relaxation） of tendons in rabbits with knee osteoarthritis（ KOA）. Methods 48 New Zealand rabbits were randomly divided into normal group,model group,acupotomy group and electroacupuncture（ EA） group. The inserts points of the vastus medialis and vastus lateralis muscles,EX-LE4 and EX-LE5,were treated with needling and acupotomy manipulation in the acupotomy group. Rabbits in the EA group received acupuncture on SP10,ST34,EX-LE4 and EX-LE5. Treatment offered in the two groups were three sessions per week for three consecutive weeks. Surface EMG was performed in viable rabbits to collect data when load weight was set at 0,500,and 1 000 g; Biomechanical tests were performed on the tendons of the tibialis anterior in each group by using fatigue testing machine after the rabbits were sacrificed by using fatigue testing machine.Results In the model group,the EMG value was significantly decreased compared with that in the normal group（ P 〈 0. 05） when the load weight was zero. Compared with the model group,surface EMG was significantly increased（ P 〈 0. 01） in the acupotomy group at the load weight of 500 g; this difference,however,was not significant when the load weight reached 1000 g. The creep rate of the model group was significantly higher than that of the normal group（ P 〈 0. 01）. Compared with the model group,the creep rate of acupotomy group was significantly lower（ P 〈 0. 05） but not different from the normal group（ P 〈 0. 05）. The stress relaxation rate and maximum strain index of tensile mechanics in the model group were significantly different from those in the normal group（ P 〈 0. 05）. Both the acupotomy and EA treatment could reduce the maximum strain index（ P 〈 0. 05）. Conclusion Acupotomy could relieve the fatigue of tibialis anterior in rabbits with osteoarthritis adjust creep stress relaxation,and restore knee mechanical balance of the knee joint.