Tuina intervention i kanin model af knæ slidgigt
Summary
Protokollen beskriver en metode til Tuina-intervention i en kaninmodel af knæartrose.
Abstract
Knæartrose (KOA) er hovedsageligt karakteriseret ved degenerative ændringer i knæleddets brusk og omgivende blødt væv. Effekten af Tuina til behandling af KOA er blevet bekræftet, men den underliggende mekanisme skal undersøges. Denne undersøgelse har til formål at etablere en videnskabeligt gennemførlig KOA-kaninmodel behandlet med Tuina for at afsløre de underliggende mekanismer. Til dette blev 18, 6 måneder gamle normale mandlige New Zealand kaniner tilfældigt opdelt i sham, model og Tuina grupper, med 6 kaniner i hver gruppe. KOA-modellen blev etableret ved at injicere 4% papain-opløsning i knæledshulen. Tuina-gruppen blev interveneret med Tuina kombineret med knæleddets roterende korrektionsmetode i 4 uger. Kun standardgreb og fiksering blev udført i humbug- og modelgrupper. Ved afslutningen af den 1-ugers intervention blev knæleddets bevægelsesområde (ROM) observeret, og bruskhæmatoxylin-eosin (HE) farvning blev udført. Undersøgelsen viser, at Tuina kunne hæmme chondrocytapoptose, reparere bruskvæv og genoprette knæleds-ROM. Afslutningsvis viser denne undersøgelse den videnskabelige gennemførlighed af Tuina-behandling for KOA-modelkaniner og fremhæver dens potentielle anvendelse i undersøgelsen af KOA og lignende knæledsrelaterede tilstande.
Introduction
Knæartrose (KOA) er en degenerativ sygdom i knæleddet, hovedsageligt manifesteret af knæsmerter, hævelse, deformation og begrænset bevægelse, med en høj invaliditetsrate og en højere forekomst hos kvinder, med 527.81 millioner patienter med slidgigt over hele verden i 2019 og dens globale prævalens, der tegner sig for 60.6% af den samlede globale forekomst af OA1. Klinisk er behandlingen af KOA normalt opdelt i ikke-kirurgiske og kirurgiske behandlinger. Ikke-kirurgiske behandlinger omfatter fysioterapi, farmakoterapi og blodpladerig plasmainjektionsterapi 2,3. Tuina er en almindelig, sikker, pålidelig og effektiv behandlingsmetode i kinesisk medicin. Denne undersøgelse bruger Tuina kombineret med knæleddets roterende korrektionsmetode til behandling af KOA. Tuina-teknikker såsom den roterende æltning og presningsmetode kan balancere muskelvæv, reducere smerte, justere inflammatoriske faktorniveauer, forbedre vævsmetabolisme og hæmme ledbruskdegeneration 4,5. Knæleddets roterende korrektionsmetode kan justere justeringen af knogler og led i underekstremiteterne, forbedre knæledsgabet, genoprette den normale kraftlinje og afbalancere biomekanikken i underekstremiteten 6,7,8,9. Modstandsøvelser kan øge muskelmasse og styrke og fremme bruskvævsfornyelse10,11. En foreløbig undersøgelse viste, at denne Tuina-protokol er signifikant mere effektiv end orale glucosaminsulfatkapsler til behandling af KOA med en hurtigere virkningsgrad og signifikant hæmning af chondrocytdegeneration og reparation af beskadiget bruskvæv12. Ved behandling af KOA sammenlignet med Tuina-terapi har ikke-steroide antiinflammatoriske lægemidler bivirkninger og utilfredsstillende langsigtet effekt, relativt høje kirurgiske risici og omkostninger og kræver visse indikationer for kirurgisk behandling med postoperative problemer og periprostetiske komplikationer13,14,15. Sammenlignet med lægemiddelterapi og kirurgi tilbyder Tuina-behandling for KOA flere fordele, herunder reducerede bivirkninger, lavere risiko, forbedret sikkerhed, omkostningseffektivitet og længerevarende effekt. Derudover kan det effektivt lindre knæledssmerter, hævelse, popping og begrænset bevægelse 6,13,16,17.
Imidlertid skal Tuinas mekanisme til behandling af KOA præciseres, hvilket begrænser forbedringen og perfektionen af behandlingsprotokollen for KOA. Derfor er det en effektiv metode at studere mekanismen for Tuina-intervention i KOA gennem dyreforsøg. Kaniner, sammenlignet med rotter, har et fyldigt temperament og større knæled. Den anatomiske struktur og brusk biokemiske indekser ligner dem hos mennesker, så det er et egnet emne til at studere mekanismen for knæledssygdom ved Tuina18. KOA-modellen, der er etableret ved at injicere papain i knæledshulen hos kaniner, har fordelene ved kort modelleringstid, reduceret traume, høj succesrate, høj overlevelsesrate og lignende patologisk mekanisme til KOA19. Denne undersøgelse har til formål at etablere en videnskabeligt gennemførlig dyreforsøgsprotokol for Tuina-intervention i KOA og undersøge Tuina-mekanismen.
Protocol
Representative Results
Discussion
Udformningen af forsøgsprotokollen er særlig vigtig for at undersøge Tuinas mekanisme til behandling af KOA. KOA modellering blev udført på kaniner ved injektion af papain på Waixiyan. Waixiyan er placeret i patellarbåndets laterale krypt, som er let at lokalisere, og ledrummet mellem lårbenet og skinnebenet er stort her under knæbøjning, hvilket gør det nemt at injicere i knæledshulen og forhindrer skader på det omgivende væv, så det er let at etablere KOA model34. Under Tuina-inte…
Disclosures
The authors have nothing to disclose.
Acknowledgements
Dette arbejde blev støttet af Shandong Provincial Traditional Chinese Medicine Science and Technology Project (2021Q080) og Qilu School of Traditional Chinese Medicine Academic School Inheritance Project [Lu-Wei-Letter (2022) 93].
Materials
| 0.9 % sodium chloride injection | Sichuan Keren Pharmaceutical Co. | Z22121903 | |
| -20°C refrigerator | Haier | BD-328WL | |
| 4 % fixative solution | Solarbio | P1110 | |
| 4°C refrigerator | Haier | SC-315DS | |
| Anhydrous ethanol | Sinopharm | ||
| Automatic tissue dewatering machine | Dakowei (Shenzhen) Medical Equipment Co. | HP30 | |
| Blast drying oven | Shanghai Yiheng Scientific Instruments Co. | DHG-9070A | |
| Coverslip | Biyuntian | FCGF50 | |
| Electric thermostat water bath | Shanghai Yiheng Scientific Instruments Co. | HWS-26 | |
| Embedding freezing table | Changzhou Paishijie Medical Equipment Co. | BM450 | |
| Embedding machine | Changzhou Paishijie Medical Equipment Co. | BM450A | |
| Ethylenediaminetetraacetic acid decalcification solution | Servicebio | G1105-500ML | |
| Fluorescent inverted microscope | Leica | Leica DM IL LED | |
| Hematoxylin-eosin staining kit | Cisco Jet | EE0012 | |
| Hydrochloric acid | Laiyang Economic and Technological Development Zone Fine Chemical Plant | ||
| Medical joint goniometer | KOSLO | ||
| Neutral gum | Cisco Jet | EE0013 | |
| Normal-grade male New Zealand rabbit | Jinan Xilingjiao Breeding and Breeding Center | SCXK (Lu) 2020 0004 | |
| Papain(3000 U/mg) | Bioss | D10366 | |
| Pathological tissue bleaching and drying instrument | Changzhou Paishijie Medical Equipment Co. | PH60 | |
| Pet electric clippers | Codos | CP-3180 | |
| Rabbit fixing box | any brand | ||
| Rotating Slicer | Leica | 531CM-Y43 | |
| Tuina technique parameter determination instrument | Shanghai DuKang Instrument Equipment Co. Ltd. | ZTC- |
|
| Ventilator | TALY ELECTRIC | C32 | |
| Xylene | Fuyu Reagent |
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