经筋手法干预膝骨关节炎模型兔骨骼肌收缩力学的改变

Musculoaponeurotic manipulation changes contractile mechanics of the skeletal muscle in rabbits with knee osteoarthritis

背景:团队前期研究发现,足阳明经筋及足太阳经筋在膝骨关节炎的发病中起重要的作用,二者循行对应的是腘绳肌及股四头肌。在经筋辨证指导下以手法治疗膝骨关节炎取得较好疗效,但其作用机制尚不明确。目的:观察经筋手法对兔膝骨关节炎骨骼肌收缩力学改变的影响。方法:12只新西兰兔随机分为经筋手法组、常规手法组和对照组,每组4只,均以Videman右后膝伸直位固定制动法构建右膝关节炎模型。经筋手法组及常规手法组分别在造模后第2天接受经筋手法及常规手法治疗,3次/周,治疗2周;对照组造模成功后正常饲养。治疗结束后1周对各组兔大腿股四头肌及腘绳肌进行收缩力学实验测试。实验经广州中医药大学实验动物伦理委员会批准(批准号:20190221018)结果与结论:①在治疗2周后2个手法组股四头肌及腘绳肌的单收缩幅度、强直收缩幅度、弹性模量优于对照组(P<0.05)。经筋手法组的单收缩幅度、强直收缩幅度优于常规手法组(P<0.05);②结果说明,经筋手法可以有效改善兔膝关节炎模型骨骼肌的收缩力学指标,从而改善临床症状,延缓疾病的进展。

BACKGROUND:The team’s previous research found that foot-Yangming meridian and foot-Taiyang meridian play an important role in the pathogenesis of knee osteoarthritis,with the correspondence to the hamstring muscle and quadriceps muscle,respectively.Under the guidance of meridian syndrome differentiation,manipulative therapy for knee osteoarthritis has achieved good results,but its mechanism of action is not yet clear.OBJECTIVE:To observe the effect of aponeurotic channel manipulation on contractile mechanics of the skeletal muscle in rabbits with knee osteoarthritis.METHODS:Twelve New Zealand rabbits were randomly divided into three groups,a musculoaponeurotic manipulation group,a conventional manipulation group and a control group,with four rabbits in each group.The right knee arthritis model was established by the method of video right rear knee extension and fixed brake.The former two groups were treated by musculoaponeurotic manipulation and conventional manipulation respectively on the 2nd day after modeling,three times a week for 2 weeks in total.Rats in the control group were fed normally.At 1 week after the end of the treatment,the quadriceps and hamstring muscles of the right thigh were taken for contractile mechanics test.The experiment was approved by the Experimental Animal Ethics Committee of Guangzhou University of Chinese Medicine(approval No.20190221018)RESULTS AND CONCLUSION:After 2 weeks of treatment,the single contraction amplitude,tetanic contraction amplitude and elastic modulus of the quadriceps femoris and hamstring muscle in the two treatment groups were better than those in the control group(P<0.05).The amplitude of single contraction and tetanic contraction in the musculoaponeurotic manipulation group was better than that in the conventional manipulation group(P<0.05).These findings indicate that musculoaponeurotic manipulation can effectively improve the contractile mechanics index of rabbit knee osteoarthritis model,so as to improve the clinical symptoms and delay the progress of the disease.