Wu Yong-Li, Chen Ren-Zhi, Wang Ming-Lei, Liu Di, Liu Jun-Wei
Department of Orthopedics and Traumatology of Traditional Chinese Medicine, General Hospital of Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education (Ningxia Medical University), Yinchuan 750004.
Department of Rehabilitation, Wuzhong Rehabilitation Hospital, Wuzhong 751100, Ningxia Hui Autonomous Region.
Zhen Ci Yan Jiu. 2021 Feb 25;46(2):123-8. doi: 10.13702/j.1000-0607.200027.
To observe the effect of warm needle with moxibustion (WNM) on morphological changes of articular cartilage and subchondral bone tissues in knee osteoarthritis (KOA) rabbits, so as to explore whether WNM intervention can delay the development of KOA.
Forty male New Zealand rabbits were randomly divided into blank control, model, WNM and medication (Alendronate sodium) groups, with 10 rabbits in each group. A KOA model was established by immobilizing the right hind limb of rabbits with orthopedic casting tape for 6 weeks. The rabbits of the WNM group received WNM stimulation at "Neixiyan"(EX-LE4) "Waixiyan"(ST35) and "Heding"(EX-LE2) for 15 min, once a day for 4 weeks and those of the medication group received gavage of Alendronate sodium (150 μg·kg-1·d-1) once a day for 4 weeks. X-ray examination and magnetic resonance imaging (MRI) scanning were performed to observe the structure of the knee joints. Outcomes of X-ray examination were used to assess the degree of bone hyperplasia and joint space stenosis which were scaled according to Kellgren and Lawrence (K-L) standards, and those of MRI used to evaluate the degree of cartilage damage and bone marrow edema degrees which were respectively scored according to Recht scaling standards and semi-quantitative whole-organ MRI score (WORMS). Histopathological changes (degeneration degrees) of the articular cartilage were observed after H.E. staining, and given Mankin score. The ultrastructure of the cartilage surface and chondrocytes was observed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM), respectively.
Compared with the blank control group, the K-L grade, Recht grade, WORMS and Mankin score of the model group were significantly increased (P<0.05,P<0.01). After the intervention and in comparison with the model group, the K-L grade, Recht grade, WORMS and Mankin score of both WNM and medication groups were significantly decreased (P<0.05,P<0.01). Results of SEM showed severe defect, bulge and uneven surface of the cartilage with irregular growth and regeneration, and those of TEM showed degeneration and swelling of chondrocytes, margination of endonuclear chromatin, reduction in the number of organelles with disordered arrangement, extreme expansion of endoplasmic reticulum with detachment of the ribosome, unclear mitochondria, and disordered distribution of collagen fibers in the extracellular matrix in the model group, which was relatively milder in both the WNM and medication groups. Compared with the medication group, the Mankin score in the WNM group was evidently lower (P<0.05).
WNM can effectively slow down the degeneration of cartilage and subchondral bone of KOA rabbits, delay the development of KOA.
观察温针艾灸对膝骨关节炎（KOA）家兔关节软骨及软骨下骨组织形态学变化的影响，以探讨温针艾灸干预能否延缓KOA的发展。
将40只雄性新西兰兔随机分为空白对照组、模型组、温针艾灸组和药物（阿仑膦酸钠）组，每组10只。采用骨科石膏绷带固定兔右后肢6周建立KOA模型。温针艾灸组兔于“内膝眼”（EX-LE4）、“外膝眼”（ST35）和“鹤顶”（EX-LE2）接受温针艾灸刺激15分钟，每日1次，共4周；药物组兔每日灌胃阿仑膦酸钠（150μg·kg-1·d-1），共4周。进行X线检查和磁共振成像（MRI）扫描以观察膝关节结构。X线检查结果用于评估骨质增生程度和关节间隙狭窄程度，根据Kellgren和Lawrence（K-L）标准进行分级；MRI结果用于评估软骨损伤程度和骨髓水肿程度，分别根据Recht分级标准和半定量全器官MRI评分（WORMS）进行评分。苏木精-伊红（H.E.）染色后观察关节软骨的组织病理学变化（退变程度），并给予Mankin评分。分别通过扫描电子显微镜（SEM）和透射电子显微镜（TEM）观察软骨表面和软骨细胞的超微结构。
与空白对照组相比，模型组的K-L分级、Recht分级、WORMS评分和Mankin评分均显著升高（P<0.05，P<0.01）。干预后，与模型组相比，温针艾灸组和药物组的K-L分级、Recht分级、WORMS评分和Mankin评分均显著降低（P<0.05，P<0.01）。SEM结果显示模型组软骨严重缺损、隆起，表面不平整，生长和再生不规则；TEM结果显示模型组软骨细胞退变、肿胀，核内染色质边缘化，细胞器数量减少且排列紊乱，内质网极度扩张且核糖体脱落，线粒体不清晰，细胞外基质中胶原纤维分布紊乱，温针艾灸组和药物组相对较轻。与药物组相比，温针艾灸组的Mankin评分明显更低（P<0.05）。
温针艾灸可有效减缓KOA家兔软骨及软骨下骨的退变，延缓KOA的发展。
