Tan Qian, Li Jia, Li Bo-Cun, Xiang Hong-Chun, Cai Guo-Wei
Department of Acupuncture-moxibustion, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Hubei University of Chinese Medicine/ Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan 430061.
Zhen Ci Yan Jiu. 2022 Apr 25;47(4):321-8. doi: 10.13702/j.1000-0607.20210308.
To observe the effect of warm needling on the expression of oxidative stress related factors and pro-inflammatory factors in cartilage of mono sodium iodoacetate (MIA) induced knee osteoarthritis (KOA) model rats, so as to explore its mechanisms underlying improvement of KOA.
Sixty male Sprague Dawley rats were randomly divided into 5 groups: control, model, acupuncture, moxibustion,warm needling, with 12 rats in each group. Rats of the acupuncture, moxibustion,warm needling groups received manual acupuncture or moxibustion or both stimulation of "Zusanli" (ST36) for 15 minutes, once a day for 21 days beginning from the third day after modeling. The foot volume was measured by drainage method, and the plantar mechanical contraction reflex threshold (mechanical pain threshold, MPT) measured by using an electronic pain meter. After 21 days of treatment, the histopathological changes of knee joint were observed by HE staining, and Mankin score was calculated to evaluate the degree of cartilage destruction. The malondialdehyde (MDA) level was measured by colorimetry, and immunofluorescence staining was used to observe the expression of NOX2, SOD2 or IL-1β.
Compared with the control group, the knee joint swelling volume from the 3 day after modeling, Mankin score, MDA level, and the number of NOX2 and IL-1β positive cells were significantly increased (<0.01, <0.05), while the MPT from the 3 day after modeling, and the number of SOD2 positive cells were considerably decreased (<0.01) in the model group. After the interventions, the increased levels of the knee joint swelling volume from the 12 day after modeling, and the Mankin score, MDA level, NOX2 and IL-1β positive cells, and the levels of decreased MPT from the 9 day after modeling and SOD2 positive cell number were reversed in the acupuncture, moxibustion,warm needling groups (<0.05, <0.01), and the effects of warm needling were significantly superior to those of simple manual acupuncture and simple moxibustion in down-regulating knee joint volume, Mainkin score, MDA le-vel, and NOX2 and IL-1β positive cells, and in up-regulating MPT from the 12 day after modeling, and the number of SOD2 positive cells (<0.05). No significant differences were found between the acupuncture and moxibustion groups in the levels of all the indexes mentioned above (>0.05). HE staining showed rough and damaged articular surface, with subchondral neovascularization and moderate connective tissue hyperplasia, and abundant lymphocyte and monocyte infiltration in the model group, which was milder in the acupuncture, moxibustion groups particularly in the warm needling group after 21 days' interventions.
Warm needling can relieve knee joint pain, swelling and inflammatory damage in KOA rats, which may be associated with its function in inhibiting oxidative stress and inflammation in the cartilage of KOA. The therapeutic effect of warm needling is better than that of manual acupuncture and moxibustion alone.
观察温针疗法对碘乙酸钠(MIA)诱导的膝骨关节炎(KOA)模型大鼠软骨中氧化应激相关因子及促炎因子表达的影响,以探讨其改善KOA的作用机制。
将60只雄性Sprague Dawley大鼠随机分为5组:对照组、模型组、针刺组、艾灸组、温针组,每组12只。针刺组、艾灸组、温针组大鼠从造模后第3天开始,每天接受1次“足三里”(ST36)穴位的手法针刺或艾灸或两种刺激,每次15分钟,共21天。采用排水法测量足容积,使用电子痛觉仪测量足底机械收缩反射阈值(机械痛阈,MPT)。治疗21天后,通过HE染色观察膝关节组织病理学变化,并计算Mankin评分以评估软骨破坏程度。采用比色法测定丙二醛(MDA)水平,采用免疫荧光染色观察NOX2、SOD2或IL-1β的表达。
与对照组相比,模型组造模后第3天膝关节肿胀体积、Mankin评分、MDA水平以及NOX2和IL-1β阳性细胞数量显著增加(<0.01,<0.05),而造模后第3天MPT以及SOD2阳性细胞数量显著减少(<0.01)。干预后,针刺组、艾灸组、温针组造模后第12天膝关节肿胀体积增加水平、Mankin评分、MDA水平、NOX2和IL-1β阳性细胞数量以及造模后第9天MPT降低水平和SOD2阳性细胞数量均得到逆转(<0.05,<0.01),且温针在下调膝关节体积、Mainkin评分、MDA水平、NOX2和IL-1β阳性细胞数量以及上调造模后第12天MPT和SOD2阳性细胞数量方面的效果明显优于单纯手法针刺和单纯艾灸(<0.05)。针刺组和艾灸组在上述所有指标水平上均无显著差异(>0.05)。HE染色显示模型组关节表面粗糙、受损,软骨下新生血管形成,结缔组织中度增生,淋巴细胞和单核细胞浸润丰富,而针刺组、艾灸组干预21天后情况较轻,温针组尤其明显。
温针可缓解KOA大鼠膝关节疼痛、肿胀及炎性损伤,可能与其抑制KOA软骨氧化应激和炎症的作用有关。温针的治疗效果优于单纯的手法针刺和艾灸。