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["艾灸“肝俞”(BL18)和“肾俞”(BL23)对骨质疏松大鼠肌肉骨骼相互作用的影响]

[Effect of moxibustion of "Ganshu"(BL18) and "Shenshu" (BL23) on musculoskeletal interaction in osteoporosis rats].

作者信息

Xu Dao-Ming, Liu Jing, Zhu Lu, Chen Ming, Liu Lan-Ying, Xu Hua-Ning, Shi Wen, Cao Ya-Na, Wu Wen-Zhong

机构信息

Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.

出版信息

Zhen Ci Yan Jiu. 2022 Jul 25;47(7):605-10. doi: 10.13702/j.1000-0607.20210653.

Abstract

OBJECTIVE

To observe the effect of moxibustion of "Ganshu" (BL18)and "Shenshu" (BL23) on bone mineral density (BMD), biomechanics, bone metabolism and musculoskeletal morphology of osteoporosis (OP) rats, so as to explore its mechanism underlying treatment of OP via bone-muscle interaction.

METHODS

Thirty-two female SD rats were randomly divided into sham operation, OP model, moxibustion and medication (nilestriol) groups, with 8 rats in each group. For rats of the sham operation group, a small amount of fat around the ovaries was removed, and those of the other 3 groups received removal of bila-teral ovaries for establishing OP model. Moxibustion was applied to bilateral BL18 and BL23 for 30 min, once every other day, 3 times a week for 12 weeks. Rats of the medication group received gavage of nilestriol (1 mg/kg) once a week for 12 weeks.After the interventions, a dual-energy absorptiometry was used to determine the BMD and bone mineral content of the rats' right femur and the fourth lumbar vertebrae under anesthesia, and three-point bending test used to detect the biomechanical properties (including load, displacement, stiffness) of the right femur. The levels of serum type I collagen C-terminal peptide (CTX-I), acid-resis-tant tartrate phosphatase (TRACP) and estradiol (E) were determined using enzyme-linked immunosorbent assay, and histopathological changes of the left femur and the quadriceps observed after hematoxylin-eosin (H.E.) staining.

RESULTS

Compared with the sham operation group, the BMD and bone mineral contents of the right femur and the fourth lumbar vertebra, the load and stiffness of the right femur, and concentration of serum E were significantly decreased (<0.01, <0.05), and the displacement of the right femur, and concentrations of serum CTX-Ⅰ and TRACP notably increased in the model group (<0.01). After the interventions, the decreased levels of BMD and bone mineral contents, the load and stiffness and concentration of serum E, and the increased levels of the displacement, and concentrations of serum CTX-Ⅰ and TRACP were all reversed by both moxibustion (except the bone mineral content of the fourth lumbar vertebra) and medication (<0.01,<0.05). No signi-ficant differences were found between moxibustion and medication in up-regulating the levels of BMD and bone mineral contents, the load and stiffness (except serum E2) and down-regulating the levels of the displacement, and concentrations of serum CTX-Ⅰ and TRACP (>0.05). H.E. staining revealed that rats in the sham operation group showed mild thinness of the bone cortex, uneven thickness of trabecular bone, with distortion, fracture and osteoporosis of the left femur, and different size of rhabdomyocytes in the right quadriceps femoris muscle, with obvious proliferation of interstitial fibrous tissue and inflammatory cell infiltration, which were relatively and clearly milder in both moxibustion and medication groups.

CONCLUSION

Moxibustion of BL18 and BL23 can increase the BMD and bone mineral content, improve biomechanical performance, adjust bone metabolism, and mitigate bone and the attached muscle histopathological changes in OP rats, suggesting that modulating interaction between bones and muscles is probably one of the ideas in the treatment of OP.

摘要

目的

观察艾灸“肝俞”(BL18)和“肾俞”(BL23)对骨质疏松(OP)大鼠骨密度(BMD)、生物力学、骨代谢及肌肉骨骼形态的影响,以探讨其通过骨 - 肌肉相互作用治疗OP的机制。

方法

将32只雌性SD大鼠随机分为假手术组、OP模型组、艾灸组和药物(尼尔雌醇)组,每组8只。假手术组大鼠仅去除卵巢周围少量脂肪,其余3组大鼠均行双侧卵巢切除以建立OP模型。艾灸双侧BL18和BL23,每次30分钟,隔日1次,每周3次,共12周。药物组大鼠每周灌胃尼尔雌醇(1mg/kg),共12周。干预后,麻醉下采用双能吸收法测定大鼠右股骨和第四腰椎的BMD及骨矿物质含量,采用三点弯曲试验检测右股骨的生物力学性能(包括载荷、位移、刚度)。采用酶联免疫吸附测定法测定血清Ⅰ型胶原C末端肽(CTX - Ⅰ)、抗酒石酸酸性磷酸酶(TRACP)和雌二醇(E)水平,苏木精 - 伊红(H.E.)染色后观察左股骨和股四头肌的组织病理学变化。

结果

与假手术组比较,模型组大鼠右股骨和第四腰椎的BMD及骨矿物质含量、右股骨的载荷和刚度、血清E浓度显著降低(<0.0[1],<0.05),右股骨位移、血清CTX - Ⅰ和TRACP浓度显著升高(<0.01)。干预后,艾灸组(除第四腰椎骨矿物质含量外)和药物组均使降低的BMD和骨矿物质含量、载荷和刚度、血清E浓度以及升高的位移、血清CTX - Ⅰ和TRACP浓度得到逆转(<0.01,<0.05)。在提高BMD和骨矿物质含量、载荷和刚度(血清E2除外)以及降低位移、血清CTX - Ⅰ和TRACP浓度方面,艾灸组与药物组比较差异无统计学意义(>0.05)。H.E.染色显示,假手术组大鼠骨皮质轻度变薄,小梁骨厚度不均,左股骨有变形、骨折及骨质疏松,右股四头肌肌细胞大小不一,间质纤维组织明显增生,有炎性细胞浸润,艾灸组和药物组上述改变相对明显较轻。

结论

艾灸BL18和BL23可提高OP大鼠的BMD和骨矿物质含量,改善生物力学性能,调节骨代谢,减轻骨骼及附着肌肉的组织病理学变化,提示调节骨与肌肉的相互作用可能是治疗OP的思路之一。

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