“拔伸松动手法”对兔膝骨性关节炎IL-1β、TNF-α的影响

王春林1，向勇1*，田启东1，胡鸾1，赵志勇1，邵长丽2, 董有康2，

赵永康1，林云1  1. 云南中医学院第一附属医院;2. 云南中医学院针灸推拿康复学院

　　【摘要】 目的：研究拔伸松动手法对兔膝骨性关节炎白细胞介素1(IL-1β)、肿瘤坏死因子α(TNF-α)的影响。方法：采用成年日本大白兔，按Videman T的造模方法制作兔膝骨性关节炎模型，随机分成拔伸松动手法组、注射透明质酸钠组、模型组及正常组，拔伸松动手法组实施拔伸松动手法治疗，注射透明质酸钠组采用注射透明质酸钠治疗，模型组仅给饲料喂养，正常组予饲料喂养。观察治疗后对兔膝关节关节液中的IL-1β、TNF-α的影响。结果：治疗后拔伸松动手法组关节液中的IL-1β、TNF-α浓度与正常兔膝关节液中的浓度无显著差异，较模型组中兔膝关节液中的浓度低;拔伸松动手法组和注射透明质酸钠组，均能降低兔膝骨性关节炎关节液中的IL-1β、TNF-α浓度，两组没有统计学意义。结论：拔伸松动手法可明显降低兔膝骨性关节炎关节液中的白细胞介素1(IL-1β)、肿瘤坏死因子α(TNF-α)的水平，说明拔伸松动手法可以抑制膝骨性关节炎软骨基质降解和关节软骨破坏，对软骨损伤的修复有利。

　　【关键词】拔伸松动手法　膝骨性关节炎　IL-1β TNF-α

　　Influence of "pulling and release technique" on the IL-1 β, TNF- α

　　of rabbits knee osteoarthritis

　　Wang Chunlin 1,Xiang Yong 2, Tian Qidong 2, Hu Luan2,Zhaozhiyong2,Zhaoyongkang2,linyun2,Dongyoukang2

　　(1 the First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine; 2 Yunnan University of Traditional Chinese Medicine College of acupuncture and massage rehabilitation)

　　Corresponding author: Xiang Yong, male, 30 years old, lecturer, E-mail：xiangyong313@yahoo.com.cn

　　Abstract Objective: To investigate the effects of "pulling and release technique" on the interleukin 1 (IL-1 β), tumor necrosis factor alpha (TNF-α) of rabbits osteoarthritis. Methods: adult Japanese rabbits were established rabbits knee osteoarthritis model according to the method of Videman T, and randomly divided into pulling and release technique group, sodium hyaluronate injection group, model group and normal group. The pulling and release technique group were treated with pulling and release technique, The sodium hyaluronate injection group were treated with sodium hyaluronate, the model group and the normal group were fed to feed. To observe the levels of IL-1 β, TNF- α of the serum and synovial fluid after treatment. Results: After treatment, the IL-1 β, TNF- α levels of the serum and synovial fluid were no significant difference between pulling and release technique group and normal group, the IL-1 β, TNF- α levels of the serum and synovial fluid were also decrease to compared with the model group. The pulling and release technique group and the sodium hyaluronate injection group were also decrease the levels of IL-1 β, TNF- α, two groups had no statistical significance. Conclusion: The pulling and release technique was significantly decrease the the IL-1 β, TNF- α levels of the serum and synovial fluid, it can prevent the knee osteoarthritis degradation of cartilage matrix and lighten the degeneration of the cartilage, repair the cartilage.

　　[key words] pulling and release technique knee osteoarthritis IL-1 β TNF-α

　　骨性关节炎(Osteoarthritis，OA)的发病机制至今尚不清楚，现代医学认为其发病与NO、骨内高压、氧自由基、炎症介质、关节载荷紊乱、自身免疫反应等有关。近年来，细胞因子对OA的影响已引起广泛关注，尤其是细胞因子中的白细胞介素 (IL-1β)和肿瘤坏死因子-α(TNF-α)，被认为是骨关节炎病理过程中促进软骨基质降解和关节软骨破坏的两种最重要的细胞因子。本研究旨在研究拔伸松动手法对Videman T的造模方法制作的兔膝骨性关节炎模型关节液中的白细胞介素1(IL-1β)、肿瘤坏死因子-α(TNF-α)的影响，从细胞分子水平方面探索拔伸松动手法治疗兔膝骨性关节炎的机理，为该手法治疗膝关节骨性关节炎提供客观依据。

　　材料与方法

　　一、材料

　　1　主要药物与试剂：

　　1.1药物：透明质酸钠( 山东正大福瑞达公司生产，国药准字H10960136)。

　　1.2试剂：IL-1β及TNF-α试剂盒，检测按照IL-1β、TNF-α ELISA试剂盒酶标仪说明书操作。

　　2　实验动物及分组：健康成年白兔40只，体重1.8千克-2.5千克，雌雄不限，重量分布均一。30只实验兔造模后随机分三组(即拔伸松动手法组、注射透明质酸钠组、模型组)，余10只实验兔为正常组，共四组。