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针刀与透明质酸钠治疗兔膝骨关节炎的比较

Acupotomy versus sodium hyaluronate for treatment of knee osteoarthritis in rabbits.

作者信息

Ding Yu, Shi Xian, Wang Lu, Daniela Litscher, Gerhard Litscher, Yuan Xueling, Wang Yongcheng, Wang Aiyuan, Wang Lu, Irmgard Th Lippe

机构信息

Daniela Litscher, Gerhard Litscher, Department of Acupuncture & Moxibustion, People's Liberation Army General Hospital, Beijing 100853, China.

Department of Acupuncture & Moxibustion, People's Liberation Army General Hospital, Beijing 100853, China.

出版信息

J Tradit Chin Med. 2017 Jun;37(3):404-411.

Abstract

OBJECTIVE

To investigate the possible advantages of acupotomy over sodium hyaluronate injection for the treatment of knee osteoarthritis (KOA).

METHODS

Twenty rabbits were divided randomly into four groups (n = 5 in each): a control group, model group, acupotomy group, and sodium hyaluronate injection group. The model, acupotomy, and sodium hyaluronate groups underwent anterior cruciate ligament transection plus partial medial meniscectomy. Sodium hyaluronate injection and acupotomy were administered to the respective groups from weeks 5 to 8, and samples of the tibial plateau and medial condyle of the femur were collected in week 9. Vascular endothelial growth factor (VEGF) expression was assessed in cartilage and subchondral bone by immunohistochemical staining.

RESULTS

Articular cartilage degeneration was less pronounced in the acupotomy compared with the model and sodium hyaluronate groups. VEGF expression levels in cartilage and subchondral bone were increased in the model group compared with the control group (P < 0.01), and acupotomy had a more pronounced therapeutic effect than sodium hyaluronate injection (P < 0.01).

CONCLUSION

Acupotomy and sodium hyaluronate injection may both reduce degeneration in the cartilage and subchondral bone in KOA based on the results from a rabbit model, but acupotomy improved the histopathology and reduced the VEGF content more effectively than sodium hyaluronate injection, probably by reducing venous stasis and intraosseous pressure. Acupotomy may improve KOA by lowering VEGF.

摘要

目的

探讨针刀治疗与透明质酸钠注射治疗膝关节骨关节炎(KOA)的潜在优势。

方法

将20只兔随机分为4组(每组n = 5):对照组、模型组、针刀组和透明质酸钠注射组。模型组、针刀组和透明质酸钠组行前交叉韧带切断术加部分内侧半月板切除术。第5至8周分别对相应组进行透明质酸钠注射和针刀治疗,第9周采集胫骨平台和股骨内侧髁样本。通过免疫组织化学染色评估软骨和软骨下骨中血管内皮生长因子(VEGF)的表达。

结果

与模型组和透明质酸钠组相比,针刀组关节软骨退变较轻。与对照组相比,模型组软骨和软骨下骨中VEGF表达水平升高(P < 0.01),针刀治疗的疗效比透明质酸钠注射更显著(P < 0.01)。

结论

基于兔模型的结果,针刀和透明质酸钠注射均可减轻KOA中软骨和软骨下骨的退变,但针刀比透明质酸钠注射更有效地改善了组织病理学并降低了VEGF含量,可能是通过减轻静脉淤滞和骨内压实现的。针刀可能通过降低VEGF来改善KOA。

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