羌活桂枝膏联合推拿对兔膝骨关节炎滑膜中IL-1及MMP-9表达的影响

Effect of Qiang Huo Guizhi manipulation combined with Tuina on IL-1 and MMP-9 in rabbit knee osteoarthritis

目的通过观察羌活桂枝膏联合推拿对膝骨关节炎(KOA)兔滑膜中白介素1(IL-1)、基质金属蛋白酶-9(MMP-9)表达的影响,探索羌活桂枝膏联合推拿治疗膝骨关节炎的作用机制。方法选取大白兔40只,随机分为正常对照组、模型组、推拿组、羌活桂枝膏贴敷组、羌活桂枝膏联合推拿组5组,每组8只。采用木瓜蛋白酶注射法造模,正常对照组不予任何处理,模型组同样固定右膝关节3 h,羌活桂枝膏贴敷组用羌活桂枝膏外敷于兔右膝关节,推拿组手法治疗,羌活桂枝膏联合推拿手法治疗组在兔膝关节涂膏的同时施以手法。治疗后应用半定量方法检查兔膝滑膜中白介素1(IL-1)、基质金属蛋白酶-9(MMP-9)表达水平。结果 IL-1及MMP-9在模型组、羌活桂枝膏贴敷组、推拿组的表达均较正常对照组升高,差异具有统计学意义(P <0.05)。IL-1及MMP-9在羌活桂枝膏贴敷组、推拿组、羌活桂枝膏联合推拿组表达较模型组均有所下降,差异有统计学意义(P <0.05)。MMP-9在羌活桂枝膏联合推拿组相较羌活桂枝膏贴敷表达低,差异有统计学意义,和推拿组表达水平差异无统计学意义。IL-1在正常对照组与羌活桂枝膏联合推拿组表达水平差异无统计学意义(P> 0.05)。结论羌活桂枝膏联合推拿治疗膝兔膝骨关节炎疗效显著,对比单一推拿组及羌活桂枝膏贴敷疗效更佳。

Objective To observe the effect of Qiang Huo Guizhi ointment combined with Tuina on the ex pression of IL^-1 and MMP-9 in the synovium of rabbits with knee osteoarthritis(KOA).To explore the mechanism of Qiang Huo Guizhi ointment combined with Tuina in the treatment of knee osteoarthritis.Methods Forty rabbits were randomly divided into normal control group,model group,Tuina group,Qiang Huo Guizhi ointment sticking group and Qiang Huo Guizhi ointment combined with Tuina group(8 rabbits in each group).The model was made by papain injection.The normal control group was not recieved any treatment.The model group also fixed the right knee joint for 3 hours.Qiang Huo Guizhi ointment sticking group with Qiang Huo Guizhi ointment applied to the right knee joint of rabbits,while Tuina group was received Massage manipulation treatment.Qiang Huo Guizhi Ointment combined with Tuina group was received massage with knee joint ointment at the same time.After the treatment,the expression of IL^-1 and MMP-9 in synovial membrane of rabbit knee were detected by semi-quantita tive method.Results The expression of IL^-1 and MMP-9 in the model group,Qianghuo Guizhi plaster group and massage group were higher than those in the normal control group(P<0.05).The difference was statistically sig nificant(P<0.05).IL^-1 and MMP-9 were significantly higher in the Qiang Huo Guizhi paste application group and massage group.Compared with the model group,the expression of Qiang Huo Guizhi plaster combined with massage group was lower than that of the model group,and the difference was statistically significant(P<0.05).The expression of MMP-9 in Qiang Huo Guizhi ointment combined with massage group was lower than that in Qiang Huo Guizhi plaster group,and the difference was statistically significant.There was no significant difference in the expression level of IL^-1 between the normal control group and Qianghuo Guizhi ointment.There was no significant difference in expression level of combined massage group(P >0.05).Conclusion The curative effect of Qiang Huo Guizhi ointment combined with massage on knee osteoarthritis of knee rabbits is remarkable,which is better than that of single massage group and Qiang Huo Guizhi plaster.