| 针刀干预对膝骨关节炎兔股四头肌肌腱拉伸力学的影响 |
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投稿时间：2019-01-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 王丽娟 |
WANG Li-juan |
北京中医药大学针灸推拿学院, 北京 100029 |
School of Acupuncture, Moxibustion and Tuina, Beijing University of Traditional Chinese Medicine, Beijing 100029, China |
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| 史晓伟 |
SHI Xiao-wei |
北京中医药大学针灸推拿学院, 北京 100029 |
School of Acupuncture, Moxibustion and Tuina, Beijing University of Traditional Chinese Medicine, Beijing 100029, China |
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| 张伟 |
ZHANG Wei |
北京中医药大学针灸推拿学院, 北京 100029 |
School of Acupuncture, Moxibustion and Tuina, Beijing University of Traditional Chinese Medicine, Beijing 100029, China |
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| 王彤 |
WANG Tong |
北京中医药大学针灸推拿学院, 北京 100029 |
School of Acupuncture, Moxibustion and Tuina, Beijing University of Traditional Chinese Medicine, Beijing 100029, China |
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| 周帅 |
ZHOU Shuai |
北京中医药大学针灸推拿学院, 北京 100029 |
School of Acupuncture, Moxibustion and Tuina, Beijing University of Traditional Chinese Medicine, Beijing 100029, China |
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| 郭长青 |
GUO Chang-qing |
北京中医药大学针灸推拿学院, 北京 100029 |
School of Acupuncture, Moxibustion and Tuina, Beijing University of Traditional Chinese Medicine, Beijing 100029, China |
guochangqing66@163.com |
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| 期刊信息：《中国骨伤》2019年，第32卷，第5期，第462-468页 |
| DOI：10.3969/j.issn.1003-0034.2019.05.015 |
| 基金项目:国家自然科学基金资助项目（编号：8157150725） |
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中文摘要:
目的：观察针刀干预对膝骨关节炎（KOA）兔行为学、形态学及拉伸力学的影响，探讨针刀治疗KOA的生物力学效应。
方法：24只新西兰雄兔随机分为4组：正常组、模型组、电针组、针刀组，每组各6只。模型组以改良Videman左后肢伸直位固定制动固定6周建立兔KOA模型。电针组电针左侧梁丘、血海、内膝眼、外膝眼，每周3次，治疗3周。针刀组以针刀松解左侧股四头肌肌腱，每周1次，治疗3周。分别于造模措施解除1周后和治疗结束1周后应用Lequesne MG膝关节评估法进行行为学检测，治疗结束1周后进行HE染色和力学测试。
结果：行为学治疗前观察显示：在局部疼痛、步态反应、关节活动和关节肿胀方面，正常组与模型组比较差异有统计学意义（P<0.05），而模型组、电针组和针刀组之间差异无统计学意义（P>0.05）。治疗后结果显示：与正常组相比，模型组、电针组和针刀组在局部疼痛、步态反应、关节活动和关节肿胀上差异均有统计学意义（P<0.05）；在局部疼痛上，电针组较模型组降低，差异无统计学意义（P>0.05），针刀组与模型组比较差异有统计学意义（P<0.05），电针组和针刀组之间比较差异无统计学意义（P>0.05）；在步态改变上，模型组与电针组比较差异有统计学意义（P<0.05）；针刀组与模型组比较差异无统计学意义（P>0.05）；在关节活动度方面，电针组、针刀组与模型组相比，差异均有统计学意义（P<0.05）；在关节肿胀上，电针组和针刀组分别与模型组比较，差异均有统计学意义（P<0.01），而电针组和针刀组之间比较差异无统计学意义（P>0.05）。力学方面：与空白组相比，模型组的极限载荷显著降低（P<0.01），电针组极限载荷有下降趋势（P>0.05），针刀组极限载荷有上升趋势（P>0.05）；与模型组比较，电针组极限载荷升高（P<0.05），针刀组极限载荷显著升高（P<0.01）；与电针组相比，针刀组极限载荷有上升趋势（P>0.05）。与空白组比较，模型组的最大位移显著降低（P<0.01），电针组和针刀组最大位移均有下降趋势（P>0.05），与模型组比较，电针组最大位移有升高趋势（P>0.05），针刀组最大位移显著升高（P<0.05），与电针组相比，针刀组最大位移有上升趋势（P>0.05）。在刚度方面各组数据间均无统计学意义（P>0.05）。
结论：针刀干预可使行为学及形态学发生明显改变，可显著改善股四头肌肌腱拉伸力学特性，并发挥其生物力学效应从而达到治疗KOA的目的。 |
| 【关键词】骨关节炎,膝 针刀 股四头肌肌腱 动物实验 |
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| Effect of needle knife intervention on tensile mechanics of femoral quadriceps tendon in rabbits with knee osteoarthritis |
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ABSTRACT
Objective:To observe the effects of acupotomy intervention on the behavior,morphology and tensile mechanics of knee osteoarthritis (KOA) rabbits,and to explore the biomechanical effects of acupotomy on KOA.
Methods:Twenty-four New Zealand male rabbits were randomly divided into four groups:normal group,model group,electroacupuncture group and needle-knife group,with 6 rabbits in each group. In each model group,rabbit KOA model was established by fixing Videman's left hind limb in straight position for 6 weeks. In the electroacupuncture group,rats were treated left on Liang Qiu(梁丘),Xue Hai(血海),Nei Xi Yan(内膝眼) and Wai Xi Yan(外膝眼)3 times a week for 3 weeks. In the acupotomology group,the left quadriceps femoris tendon was released with acupotomology,and the treatment was once a week for 3 weeks. Behavioral tests were performed using Lequesne MG knee joint evaluation method one week after the end of modeling and one week after the end of treatment,and HE staining and mechanical tests were performed one week after the end of treatment.
Results:Behavioral observation before treatment showed that there were significant differences in local pain,gait response,joint activity and joint swelling between the normal group and the model group(P<0.05),while there was no significant difference among the model group,electro-acupuncture group and needle-knife group(P>0.05). After treatment,the results showed that there were significant differences in local pain,gait response,joint activity and joint swelling among model group,electro-acupuncture group and needle-knife group compared with normal group(P<0.05);In local pain,the electro-acupuncture group was lower than the model group,and there was no significant difference(P>0.05);there was significant difference between needle knife group and model group(P<0.05);there was no significant difference between electro-acupuncture group and needle-knife group(P>0.05). In gait change,there was significant difference between model group and electro-acupuncture group(P<0.05);there was no significant difference between needle-knife group and model group(P>0.05). In joint activity,there was significant difference between electro-acupuncture group and model group(P<0.05). In joint swelling,compared with model group,there was significant difference on electro-acupuncture group and electro-knife group(P<0.01),but there was no significant difference between the electro-acupuncture group and the needle-knife group(P>0.05). Mechanics:Compared with the blank group,the ultimate load of the model group decreased significantly(P<0.01),the ultimate load of the electro-acupuncture group decreased(P>0.05),and the ultimate load of the needle-knife group increased(P>0.05). Compared with the model group,the ultimate load of the electro-acupuncture group increased significantly(P<0.05),and the ultimate load of the needle-knife group increased significantly (P<0.01). Compared with the electro-acupuncture group,the ultimate load of the needle-knife group increased(P>0.05). Compared with the blank group,the maximum displacement of the model group decreased significantly(P<0.01),and the maximum displacement of the electro-acupuncture group and the needle-knife group decreased(P>0.05). Compared with the model group,the maximum displacement of the electro-acupuncture group increased(P>0.05),and the maximum displacement of the needle-knife group increased significantly(P<0.05). Compared with the electro-acupuncture group,the maximum displacement of the needle-knife group increased(P>0.05). There was no significant difference in stiffness among groups(P>0.05).
Conclusion:Acupotomy intervention can significantly change the behavior and morphology,significantly improve the mechanical properties of quadriceps femoris tendon stretch,and exert its biomechanical effects to achieve the purpose of treating KOA. |
| KEY WORDS Osteoarthritis,knee Needle-knife Quadriceps tendon Animal experimentation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王丽娟,史晓伟,张伟,王彤,周帅,郭长青.针刀干预对膝骨关节炎兔股四头肌肌腱拉伸力学的影响[J].中国骨伤,2019,32(5):462~468 |
| 英文格式: | WANG Li-juan,SHI Xiao-wei,ZHANG Wei,WANG Tong,ZHOU Shuai,GUO Chang-qing.Effect of needle knife intervention on tensile mechanics of femoral quadriceps tendon in rabbits with knee osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(5):462~468 |
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