Li Yuanyuan, Hou Yimin, Sun Jiwei, Wei Jiabi, Chai Yemao, Guo Mengwei, Wang Rongguo
School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China.
J Inflamm Res. 2023 May 24;16:2241-2254. doi: 10.2147/JIR.S400956. eCollection 2023.
Acupotomy based on the meridian-sinew theory of traditional Chinese medicine has benefits in treating knee osteoarthritis (KOA). The current study aims to prove that acupotomy at the sinew points of Sanheyang protect the knee joint and alleviate the progression of moderate KOA by evaluating KOA symptoms, cartilage structure, and analyzing the changes of cytokines in rabbit cartilage.
The model used was mono-iodoacetate-induced moderate KOA in the rabbit's right leg. Rabbits were divided into the model group, the acupotomy group, and the control group, with each group receiving two parts of treatment for 2 weeks and 4 weeks. We evaluated pain in the knee joint and range of motion. The articular cartilage sections were stained with Safranin O/Fast Green and Masson. We used immunohistochemistry and real-time PCR to detect the protein and mRNA expressions of collagen prototype II (COL-II), matrix metalloproteinase 13 (MMP13), and integrin-β1 (ITG-β1).
Compared with the model group, the acupotomy group had higher body weight, lower pain score, higher range of motion, lower Mankin score, and significantly lower protein and mRNA expression of MMP13. After 4 weeks of treatment, Col-II expression in the acupotomy group was significantly higher than that in the model group and the expression of ITG-β1 in the model group was abnormally increased.
Acupotomy at Sanheyang improved the pain symptoms and range of joint motion in rabbits with moderate KOA, and could protect Col-II by regulating MMP13, which may be related to ITG-β1-mediated mechanical force transmission, thus reducing the damage to cartilage structure and delaying the progression of moderate KOA.
基于中医经筋理论的针刀疗法对膝关节骨关节炎（KOA）的治疗具有一定益处。本研究旨在通过评估KOA症状、软骨结构，并分析兔软骨中细胞因子的变化，证明在三阳经筋结点处进行针刀治疗可保护膝关节并缓解中度KOA的进展。
采用单碘乙酸诱导兔右下肢中度KOA模型。将兔子分为模型组、针刀组和对照组，每组接受两部分治疗，为期2周和4周。我们评估了膝关节疼痛和活动范围。关节软骨切片用番红O/固绿和Masson染色。我们使用免疫组织化学和实时PCR检测Ⅱ型胶原（COL-II）、基质金属蛋白酶13（MMP13）和整合素-β1（ITG-β1）的蛋白质和mRNA表达。
与模型组相比，针刀组体重更高，疼痛评分更低，活动范围更大，Mankin评分更低，MMP13的蛋白质和mRNA表达显著更低。治疗4周后，针刀组的Col-II表达明显高于模型组，且模型组中ITG-β1的表达异常增加。
在三阳经筋处进行针刀治疗可改善中度KOA兔的疼痛症状和关节活动范围，并可通过调节MMP13来保护Col-II，这可能与ITG-β1介导的机械力传递有关，从而减少对软骨结构的损伤，延缓中度KOA的进展。
