温针灸、谢氏点穴及其联合治疗对高脂饮食诱导的膝骨关节炎大鼠的作用机制研究
Mechanism of Action of Warm Acupuncture and Xies Acupoint Therapy Used Alone or in Combination in Treatment of Rats with Knee Osteoarthritis Induced by High-fat Diet
  
DOI:
中文关键词:  膝骨关节炎  肥胖  脂质代谢  针灸疗法
英文关键词:Knee osteoarthritis  Obesity  Lipid metabolism  Acupuncture therapy
基金项目:泸州市科技局项目(2018-SYF-22)
作者单位
谢林林,赵玉粒,陈 辉,钟振东,刘益如,庞显伦 1.西南医科大学附属中医医院经典中医诊疗中心四川 泸州 6460002.西南医科大学 附属中医医院老年科四川 泸州 6460003.四川省人民医院检验科四川 成都 6100004.西南医科大学附属中医医院健康管理中心四川 泸州 646000 
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中文摘要:
      目的 探讨温针灸、谢氏点穴及其联合治疗对肥胖大鼠膝骨关节炎的治疗效果与作用机制。〖JP1〗方法 采用高脂饮食诱导肥胖大鼠膝骨关节炎,检测温针灸、谢氏点穴以及温针灸+谢氏点穴治疗后肥胖大鼠体质量,血清总胆固醇(total cholesterol,TC)、三酰甘油(total triglyceride,TG)、高密度脂蛋白(high-density lipoprotein,HDL)与低密度脂蛋白(low-density lipoprotein,LDL),膝关节病变,关节滑液中白细胞介素1β(interleukin 1β, IL-1β)、肿瘤坏死因子α(tumor necrosis factor α,TNF-α)、单核细胞趋化蛋白1(monocyte chemoattractant protein-1,MCP-1)和血管内皮生长因子(vascular endothelial growth factor,VEGF)的含量以及膝关节软骨层中基质金属蛋白酶-1(matrix metalloproteinases-1,MMP-1)和MMP-13表达的水平。结果 与对照组比较,模型组大鼠体质量,血清TC、TG、LDL水平,膝关节Mankin得分,关节滑液中IL-1β、TNF-α、MCP-1、VEGF水平及膝关节软骨层中MMP-1与MMP-13的表达水平均显著升高(P<0.05),血清HDL水平显著降低(P<0.05)。与模型组比较,各治疗组大鼠血清TC、TG水平,膝关节Mankin得分,关节滑液中MCP-1、VEGF水平及膝关节软骨层中MMP-13表达水平均显著下降(P<0.05)。谢氏点穴疗法、温针灸+谢氏点穴疗法显著升高大鼠血清HDL水平,降低关节滑液中TNF-α含量和膝关节软骨层中MMP-1表达水平(P<0.05);温针灸+谢氏点穴疗法显著降低大鼠血清LDL水平、关节滑液中IL-1β含量(P<0.05);温针灸+谢氏点穴疗法降低大鼠血清TC、TG、LDL水平,膝关节Mankin得分及膝关节软骨层中MMP-1、MMP-13表达水平显著优于温针灸治疗组和谢氏点穴治疗组(P<0.05)。结论 温针灸联合谢氏点穴能够调节脂质代谢,减少关节滑液中VEGF与MCP-1的分泌,从而缓解高脂饮食诱导的膝骨关节炎。
英文摘要:
      Objective To investigate the therapeutic effect and mechanism of action of warm acupuncture and Xie's acupoint therapy used alone or in combination in the treatment of obese rats with knee osteoarthritis. Methods High-fat diet was used to induce knee osteoarthritis in obese rats, and related indices were measured after warm acupuncture alone, Xie's acupoint therapy alone, and warm acupuncture+Xie's acupoint therapy, including body weight, serum levels of blood lipids [total cholesterol (TC), total triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL)], knee joint lesions, the content of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), and vascular endothelial growth factor (VEGF) in synovial fluid, and the levels of matrix metalloproteinase-1 (MMP-1) and matrix metalloproteinase-13 (MMP-13) in the cartilage layer of the knee joint. Results Compared with the control group, the model group had significant increases in body weight, the serum levels of TC, TG, and LDL, Mankin score of the knee joint, the levels of IL-1β, TNF-α, MCP-1, and VEGF in synovial fluid, and the expression levels of MMP-1 and MMP-13 in the cartilage layer of the knee joint (P<0.05), and a significant decrease in serum level of HDL(P<0.05). Compared with the model group, the treatment groups had significant reductions in the serum levels of TC and TG, Mankin score of the knee joint, the levels of MCP-1 and VEGF in synovial fluid, and the expression level of MMP-13 in the cartilage layer of the knee joint (P<0.05). Xie's acupoint therapy and warm acupuncture+Xies acupoint therapy significantly increased the serum level of HDL, reduced the level of TNF-α in synovial fluid, and the expression of MMP-1 in the cartilage layer of the knee joint; warm acupuncture+Xie's acupoint therapy significantly reduced the serum level of LDL and the level of IL-1β in synovial fluid (P<0.05); compared with the warm acupuncture group and the Xie's acupoint therapy group, the warm acupuncture+Xie's acupoint therapy group had significantly better reductions in the serum levels of TC, TG, and LDL, Mankin score of the knee joint, and the expression levels of MMP-1 and MMP-13 in the cartilage layer of the knee joint (P<0.05). Conclusion Warm acupuncture combined with Xie's acupoint therapy can alleviate obesity-induced knee osteoarthritis by regulating lipid metabolism and reducing the secretion of VEGF and MCP-1 in synovial fluid.
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