针刀干预对中期膝骨关节炎兔模型伸肌-屈肌萎缩状态及肌肉拉伸弹性模量的影响

目的 探索针刀治疗对中期膝骨关节炎（knee osteoarthrits，KOA）兔模型伸肌-屈肌萎缩状态及肌肉拉伸弹性模量的影响。方法 24只新西兰兔按体质量随机分为空白组（6只）及KOA造模组（18只），造模组应用改良的Videman法制动6周建立KOA兔模型，解除固定后根据Lequesne评分再随机分为模型组、针刀组和西药组（每组6只）。随后各组分别进行干预治疗4周，治疗结束后，应用Lequesne评分标准进行行为学评价，兔股直肌、股二头肌分别进行HE染色及拉伸弹性模量检测。结果 （1）与模型组相比，针刀组和西药组能明显降低Lequesne评分（P<0.01）和改善局部疼痛程度（P<0.05或P<0.01）。（2）与模型组相比，针刀组和西药组可显著改善股直肌、股二头肌萎缩状态，表现在固定视野内肌纤维数量显著减少（P<0.01）、平均横截面积显著增加（P<0.01）。（3）与模型组相比，针刀组股直肌和股二头肌弹性模量（elasticity modulus，EM）显著降低（P<0.01），西药组股直肌和股二头肌EM值明显降低（P<0.05），且针刀组股直肌EM值低于西药组（P<0.05）。结论 针刀干预中期KOA兔具有改善关节功能及缓解疼痛的作用，减轻KOA兔股直肌、股二头肌肌肉萎缩状态，促进股直肌-股二头肌拉伸弹性模量的改善。

Effects of Acupotomy Intervention on Extensor-flexor Atrophy and Elastic Modulus of Muscular Tension in Rabbit Model of Medium-term Knee Osteoarthritis

Objective To explore effects of acupotomy therapy on extensor-flexor atrophy and elastic modulus of muscular tension in rabbit model of medium-term knee osteoarthritis (KOA). Methods Twenty-four New Zealand rabbits were randomly divided into blank group (6 rabbits) and KOA model group (18 rabbits) according to the body weight. The KOA rabbit model in the KOA model group was established through modified Videman method (immobilization for 6 weeks). After removing the immobilization, the KOA rabbits were randomly divided into model, acupotomy and western medicine groups (6 rabbits in each group) according to Lequesne score. After 4 weeks of treatment in each group, the Lequesne score standard was used to evaluate the behavior of rabbits, and rectus femoris and biceps femoris of rats were performed HE staining and measured by modulus of elasticity for tension. Results (1) Compared with the model group, the Lequesne score in the acupotomy and western medicine groups was significantly decreased (P<0.01) and the degree of local pain was improved (P<0.05 or P<0.01); (2) compared with the model group, the atrophy of rectus femoris and biceps femoris in the acupotomy and western medicine groups was significantly improved, which showed that the number of muscle fibers was significantly decreased (P<0.01) and the average cross-sectional area was significantly increased (P<0.01) in fixed field of vision; (3) compared with the model group, the elastic modulus (EM) of rectus femoris and biceps femoris in the acupotomy group was decreased significantly (P<0.01), the EM in the western medicine group was decreased significantly (P<0.05), and the EM in the acupotomy group was lower than that in the western medicine group (P<0.05). Conclusion Acupotomy intervention could improve the function of joint and relieve pain in medium-term KOA rabbits, alleviate atrophy of rectus femoris and biceps femoris in KOA rabbits, and promote the improvement of elastic modulus of muscular tension in rectus femoris and biceps femoris.