【摘要】：目的:觀察揉髕手法對(duì)兔膝骨關(guān)節(jié)炎模型血清IL-1β、IL-6、IL-13、IL-26、TNF-α等細(xì)胞因子含量的影響,探尋該手法在膝骨關(guān)節(jié)炎治療中的獲效機(jī)制,為膝骨關(guān)節(jié)炎的臨床診治提供理論支持。方法:運(yùn)用隨機(jī)數(shù)字表法將52只新西蘭大白兔分組:手法組、對(duì)照組、假模組和正常組,每組均為13只。手法組、對(duì)照組共26只新西蘭大白兔施行右臀下肢靜脈結(jié)扎手術(shù)。假模組13只新西蘭大白兔則手術(shù)顯露出上述靜脈,但不予結(jié)扎。剩余13只兔子是正常組,不做上述相關(guān)處理。造模1周后,研究者開(kāi)始針對(duì)手法組進(jìn)行揉髕手法治療。為減小實(shí)驗(yàn)誤差,本次研究揉髕手法采用專(zhuān)人施術(shù)。手法治療方案:隔日1次,5周共17次,10min/次,另外三組不做任何治療。首次靜脈采血時(shí)間為造模第1周末,第2次靜脈采血時(shí)間是第12周末。沿耳緣靜脈緩慢抽取2ml血液,然后出針。采血操作嚴(yán)格遵守?zé)o菌原則,減少采血后實(shí)驗(yàn)動(dòng)物的感染率,降低微生物代謝對(duì)實(shí)驗(yàn)造成的影響。將采出的血液樣本注入事先準(zhǔn)備好的無(wú)菌EP管中,處理完的EP管放置于保溫箱中。用ELISA法檢測(cè)IL-1β、IL-6、IL-13、IL-26、TNF-α的含量。在完成第2次靜脈采血后(第12周末),使用注射器從耳緣靜脈注入空氣,空氣栓塞處死所有兔子,取右脛骨平臺(tái)內(nèi)側(cè)軟骨送病理檢測(cè)以評(píng)估軟骨退變情況。結(jié)果:1、手法組兔膝關(guān)節(jié)軟骨Mankin,s評(píng)分為輕度損傷,明顯優(yōu)于對(duì)照組的中重度損傷;2、12周末,手法組血清中IL-1β、IL-6、IL-13、IL-26、TNF-α含量均低于對(duì)照組,組間比較有統(tǒng)計(jì)學(xué)差異。結(jié)論:1、膝骨關(guān)節(jié)炎的骨內(nèi)高壓和骨靜脈瘀血,導(dǎo)致炎癥因子積累,致關(guān)節(jié)軟骨細(xì)胞和軟骨基質(zhì)的丟失,加速軟骨退變。此外,膝關(guān)節(jié)周?chē)植縿?chuàng)傷,在一定程度上影響關(guān)節(jié)軟骨的退變進(jìn)程。2、揉髕手法可明顯降低動(dòng)物模型血清IL-1β、IL-6、IL-13、IL-26、TNF-α的含量,緩解了關(guān)節(jié)軟骨退變,這可能是該手法在臨床上治療膝OA獲效機(jī)制之一。
[Abstract]:Objective: to observe the effect of patellar kneading manipulation on the content of serum IL-1 尾, IL-6,IL-13,IL-26,TNF- 偽 and other cytokines in rabbit knee osteoarthritis model, and to explore the effective mechanism of patellar kneading manipulation in the treatment of knee osteoarthritis. To provide theoretical support for the clinical diagnosis and treatment of knee osteoarthritis. Methods: fifty-two New Zealand white rabbits were divided into three groups: manipulation group, control group, sham model group and normal group, 13 rabbits in each group were randomly divided into three groups: manipulation group, control group, sham model group and normal group. Manipulation group, control group 26 New Zealand rabbits underwent right gluteal and lower limb vein ligation. In the sham model group, 13 New Zealand white rabbits showed the above vein, but did not ligate it. The remaining 13 rabbits were normal and were not treated above. A week later, the researchers began kneading patellar manipulations for the manipulative group. In order to reduce the experimental error, the patellar kneading technique was used in this study. Manual therapy regimen: every other day, 5 weeks, 17 times, 10min/, the other three groups without any treatment. The first venous sampling time was at the end of the model, and the second vein sampling time was at the end of the 12th week. The 2ml blood was drawn slowly along the auricular vein and then the needle was given. The operation of blood collection strictly obeys the principle of asepsis, reduces the infection rate of experimental animals after blood sampling, and reduces the influence of microbial metabolism on the experiment. The collected blood samples were injected into the pre-prepared sterile EP tube, and the treated EP tube was placed in the insulation box. The contents of IL-1 尾 and IL-6,IL-13,IL-26,TNF- 偽 were determined by ELISA. At the end of the 12th week, air was injected into the auricular vein with a syringe, and all rabbits were killed by air embolization. The medial cartilage of the right tibial plateau was taken for pathological examination to evaluate the degeneration of cartilage. Results: 1. The Mankin, s of knee joint cartilage in the manipulation group was classified as mild injury, which was obviously superior to the moderate and severe injury in the control group. At the end of 2 and 12 weeks, the serum levels of IL-1 尾 and IL-6,IL-13,IL-26,TNF- 偽 in the manipulation group were lower than those in the control group, and there was a statistical difference between the two groups. Conclusions: 1. Intraosseous hypertension and blood stasis of bone vein in knee osteoarthritis lead to accumulation of inflammatory factors, loss of articular chondrocytes and cartilage matrix, and acceleration of cartilage degeneration. 2. In addition, the local trauma around the knee joint affects the degeneration of articular cartilage to a certain extent. 2. Patellar manipulation can significantly reduce the content of serum IL-1 尾 and IL-6,IL-13,IL-26,TNF- 偽 in the animal model. Remission of articular cartilage degeneration may be one of the effective mechanisms of this technique in the clinical treatment of knee OA.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R244.1;R-332

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