| 针刀干预对膝骨关节炎兔股直肌组织形态及超微结构的影响 |
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Received:November 17, 2020
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| 作者 | Author | 单位 | Unit | E-Mail |
| 刘晶 |
LIU Jing |
福建中医药大学附属人民医院, 福建 福州 350004 |
The People's Hospital Affiliated of Fujian University of Traditional Chinese Medicine, Fuzhou 350004, Fujian, China |
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| 林巧璇 |
LIN Qiao-xuan |
福建中医药大学中医学院, 福建 福州 350122 |
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| 卢莉铭 |
LU Li-ming |
福建中医药大学中医学院, 福建 福州 350122 |
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| 郭泽兴 |
GUO Ze-xing |
福建中医药大学中医学院, 福建 福州 350122 |
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| 刘洪 |
LIU Hong |
福建中医药大学附属人民医院, 福建 福州 350004
中医骨伤及运动康复教育部重点实验室, 福建 福州 350122 |
The People's Hospital Affiliated of Fujian University of Traditional Chinese Medicine, Fuzhou 350004, Fujian, China |
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| 张良志 |
ZHANG Liang-zhi |
福建中医药大学附属人民医院, 福建 福州 350004
中医骨伤及运动康复教育部重点实验室, 福建 福州 350122 |
The People's Hospital Affiliated of Fujian University of Traditional Chinese Medicine, Fuzhou 350004, Fujian, China |
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| 修忠标 |
XIU Zhong-biao |
福建中医药大学附属人民医院, 福建 福州 350004
中医骨伤及运动康复教育部重点实验室, 福建 福州 350122
福建省骨伤研究所, 福建 福州 350004 |
The People's Hospital Affiliated of Fujian University of Traditional Chinese Medicine, Fuzhou 350004, Fujian, China |
xzbdoctor@sina.com |
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| 期刊信息：《中国骨伤》2022年35卷，第3期，第281-286页 |
| DOI：10.12200/j.issn.1003-0034.2022.03.016 |
| 基金项目:国家自然基金项目（编号:81873315，82004388）；福建省科技厅卫生联合面上项目（编号:2019J01496）；国家中医临床研究基地专项科研课题（编号:JDZX201906） |
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目的: 观察针刀干预对膝骨关节炎（knee osteoarthritis，KOA）兔股直肌组织形态及超微结构的影响，揭示针刀治疗KOA可能的疗效机制。
方法: 选取6月龄新西兰雄性兔24只，体质量（2.0±0.5） kg，采用随机数字表法分为空白组、模型组、针刀组，每组8只。改良Videman法左后肢伸直位石膏固定制动6周复制KOA模型，针刀组采用经筋理论指导下针刀松解股四头肌经筋病灶点鹤顶次、髌外上、髌内上治疗，每周1次，共治疗4次；空白组和模型组正常饲养，不干预。治疗结束后1周，采用肌骨超声观察股直肌羽状角（pennation angle，PA），肌肉厚度（muscle thickness，MT），横截面积（cross-sectional area，CSA）及弹性应变率比值（atrain ratio，SR）的变化；HE染色观察股直肌组织形态、肌纤维数量及平均横截面积的变化；透射电镜观察股直肌组织肌原纤维、肌节和肌丝的超微结构变化。
结果: 模型组股直肌PA、MT和CSA均较空白组小（P<0.05），针刀组较模型组大（P<0.05）。模型组股直肌SR较空白组增大（P<0.05），针刀组较模型组减小（P<0.05）。HE染色结果显示，空白组股直肌纤维排列整齐；模型组股直肌肌束排列紊乱，少量炎细胞浸润；针刀组股直肌肌束排列趋于整齐，炎细胞减少；模型组在固定视野内肌纤维数量较空白组增加（P<0.05），平均横截面积较空白组减小（P<0.05）；针刀组在固定视野内肌纤维数量较模型组减少（P<0.05），平均横截面积较模型组增加（P<0.05）。电镜结果显示，与空白组比较，模型组股直肌纤维整体排列欠规整，Z线断裂不连续；与模型组比较，针刀组股直肌纤维排列趋于整齐，Z线较整齐。
结论: 基于经筋理论针刀松解股四头肌经筋病灶点能够有效改善KOA兔股直肌组织病理形态和结构，促进骨骼肌慢性损伤的修复和重建，这可能是针刀治疗KOA的作用机制之一。 |
| [关键词]:膝骨关节炎 针刀 股直肌 肌骨超声 弹性成像 电镜 |
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| Effect of acupotomy intervention on the morphology and ultrastructure of rectus femoris muscle in rabbits with knee osteoarthritis |
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Abstract:
Objective: To observe the effect of acupotomy on the morphology and ultrastructure of rectus femoris muscle in rabbits with knee osteoarthritis and to reveal the possible therapeutic mechanism involved in the effect of acupotomology on the treatment of knee osteoarthritis(KOA).
Methods: Twenty-four male New Zealand rabbits aged 6 months and weighed (2.0±0.5) kg were randomly divided into blank group,model group and acupotomy group,8 rabbits in each group. KOA model was established by modified Videman method with left hind limb extended plaster immobility for 6 weeks. In acupotomy group,the transfascial focal points of quadriceps femoris muscle were released by acupotomy under the guidance of Jingjin theory for 4 times and once a week,and the treatment points include Hedingci,Binwaixia,Binneixia. Blank group and model group were fed normally without intervention. One week after the end of the intervention,the pennation angle(PA),muscle thickness(MT),cross-sectional area(CSA) and strain ratio(SR) of rectus femoris were measured by ultrasound. HE staining was used to observe the changes of the tissue morphology,the number of muscle fibers and the average area of muscle fibers. The myofibril of rectus femoris,sarcomere and myofilament were observed by transmission electron microscope.
Results: The PA of rectus femoris muscle in the blank group was (9.05±0.21)°. The MT was(1.09±0.09) cm and the CSA was(1.30±0.01) cm2. The PA of rectus femoris muscle in the model group was (3.06±0.15)°. The MT was (0.71±0.02) cm and the CSA was(0.77±0.02) cm2. The PA of rectus femoris muscle in the acupotomy group was (6.94±0.28)°. The MT was (0.80±0.05) cm and the CSA was(0.94±0.03) cm2. The muscle PA,MT and CSA of rectus femoris in the model group were significantly smaller than those in the blank group (P<0.05). Those in acupotomy group were significantly increased compared with those in model group (P<0.05). The SR of rectus femoris muscle was 1.19±0.02 in the blank group,3.50±0.05 in the model group and 1.99±0.07 in the acupotomy group. The elastic SR of the model group was significantly higher than that of the blank group (P<0.05). These in acupotomy group was significantly lower than that in model group(P<0.05). The results of HE staining showed:in blank group,the fascicles of rectus femoris were arranged neatly,the number of beam of muscle fibers within the fixed visual field was 94.38±3.50 and the average CSA was(0.75±0.22) mm2. In model group,the fascicles of rectus femoris with different sizes were disorganized with a small amount of inflammatory cell infiltration,the number of beam of muscle fibers within the fixed visual field was 196.63±2.62 and the average CSA was(0.26±0.03) mm2. Compared to the blank group,a significant increase in the number of muscle fibers in the fixed field in the model group (P<0.05) and the average CSA decreased significantly(P<0.05). In acupotomy group,the rectus femoris fascicles in the acupotomy group tended to be arranged in a more orderly manner,with the inflammatory cells decreased,the number of beam of muscle fibers within the fixed visual field was 132.88±4.61 and the average CSA was(0.70±0.07) mm2. Compared to the model group,a significant decrease in the number of muscle fibers in the fixed field in the model group(P<0.05) and the average CSA increased significantly(P<0.05). The results of transmission electron microscope showed:compared with the blank group,the overall arrangement of the myofibrils of the rectus femoris in the model group was less structured. There was fracture between the muscle fibers and the sarcomere,the myofilaments were disordered,and the fracture of the Z line was discontinuous. Compared with the model group,the myofibrillar texture of rectus femoris in acupotomy group was clearer,and the Z line was more continuous.
Conclusion: Based on the jingjin theory,the release of quadriceps femoris by acupotomy can effectively improve the morphology and structure of rectus femoris,and promote the repair and reconstruction of chronic skeletal muscle injury in rabbits with KOA,which may be one of the mechanisms of acupotomy in the treatment of KOA. |
| KEYWORDS:Knee osteoarthritis Acupotomy Rectus femoris Musculoskeletal ultrasound Elastography Electron microscope |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘晶,林巧璇,卢莉铭,郭泽兴,刘洪,张良志,修忠标.针刀干预对膝骨关节炎兔股直肌组织形态及超微结构的影响[J].中国骨伤,2022,35(3):281~286 |
| 英文格式: | LIU Jing,LIN Qiao-xuan,LU Li-ming,GUO Ze-xing,LIU Hong,ZHANG Liang-zhi,XIU Zhong-biao.Effect of acupotomy intervention on the morphology and ultrastructure of rectus femoris muscle in rabbits with knee osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(3):281~286 |
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