李涛 任景 李俐依

摘要 目的：探讨火针膝周密刺对膝关节骨性关节炎（Knee Osteoarthritis，KOA）大鼠行为学、关节形态及软骨中赖氨酰氧化酶相关蛋白2（LOXL2）影响性。方法：选择30只健康雄性大鼠，10只作为对照不作任何处理。20只大鼠建立KOA模型，成模后随机分成2组，分别予普通针刺和火针膝周密刺，1次/3 d，连续6次。观察各组大鼠Leauesne MG评分、关节软骨细胞情况，外周血及关节软骨转化生长因子-β1（TGF-β1）、肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶3（MMP-3）、LOXL2水平变化。结果：治疗后火针组Leauesne MG评分中的局部疼痛刺激反应、步态、关节活动范围、关节肿胀度较对照组、模型组差异有统计学意义（P<0.05）。血清及关节软骨MMP-3、TGF-β1、TNF-α含量水平显著低于模型组（P<0.05），LOXL2显著高于模型组（P<0.05）。火针组电镜下软骨细胞形状规则、细胞核完整且饱满，微绒毛少量存在，内质网丰富，有散在的染色质。结论：火针膝周密刺能减轻K0A关节软骨损伤，降低炎性反應，改善软骨LOXL2水平，这可能是火针治疗KOA一个作用机制。

关键词  火针膝周密刺;膝关节骨性关节炎;大鼠;行为学;关节形态;软骨细胞;赖氨酰氧化酶相关蛋白2

Effect of Around knee Fire Needling on Joint Morphology and LOXL2 in Cartilage of Rats with Knee Osteoarthritis

LI Tao， REN Jing， LI Liyi

（Department of Acupuncture， Urumqi Chinese Medicine Hospital， Urumqi 830000， China）

Abstract Objective：To investigate the effect of fire needle acupuncture around the knee on behavior， joint morphology and lysyl oxidase related protein 2 （LOXL2） in cartilage of rats with knee osteoarthritis （Knee osteoarthritis，KOA）.Methods：30 healthy male rats were selected and 10 rats were used as control without any treatment.KOA model was established in 20 rats.After the model was established， the rats were randomly divided into two groups.They were treated with common acupuncture and around knee fire needling respectively， once every 3 days for 6 consecutive times.The Leauesne MG score， articular chondrocytes and the levels of transforming growth factor-β 1 （TGF-β 1）， tumor necrosis factor-α （TNF-α）， matrix metalloproteinase-3 （MMP-3） and LOXL2 in peripheral blood and articular cartilage were observed.Results：After treatment， the local pain stimulation response， gait， joint range of motion and joint swelling of the Leauesne MG scoring in the fire needling group were significantly different from those in the control group and the model group （P<0.05）.The levels of MMP-3， TGF-β 1 and TNF-α in serum and articular cartilage in the fire needling group were significantly lower than those in the model group（P<0.05）， while LOXL2 was significantly higher than that in the model group（P<0.05）.Under electron microscope， the chondrocytes in the fire needling group had regular shape， complete and full nucleus， a small amount of microvilli， abundant endoplasmic reticulum and scattered chromatin.Conclusion：Fire needling around the knee can reduce the injury of K0A articular cartilage， reduce the inflammatory reaction and improve the level of cartilage LOXL2， which may be one of the mechanisms of fire needling in the treatment of KOA.

Keywords Around knee fire needling; Knee osteoarthritis; Rats; Behavior; Joint morphology; Chondrocyte; Lysyl oxidase-related protein 2

中图分类号：R245 文献标识码：A doi：10.3969/j.issn.1673-7202.2020.08.007

膝关节骨性关节炎（Knee Osteoarthritis，KOA）是临床上常见慢性退行性疾病，临床病理改变以关节软骨管进行性变性、破坏，且呈骨质增生反应为主，临床症状常表现为：关节肿胀、疼痛、活动障碍等。随着我国老龄化程度的加深，KOA患者呈不断上升之势，严重影响患者及其家属的生命质量，增加家庭经济负担及国家医疗支出。如何防治KOA成为骨科医师所面临的重要课题之一。本病防治的关键在于避免或者延缓或者逆转软骨细胞变性、凋亡过程。中医将膝骨关节炎划为痹证范畴，八纲辨证认为风、寒、湿是导致经络阻滞不通而发病[1]。針刺作为中医治疗重要组成部分，具有疏通经络气血、消肿止痛功效，疗效显著。火针是针灸一种集经络、穴位、针法、灸法为一体的复合性治疗方法，具有温经散寒、消肿止痛、舒筋通络，能显著改善KOA临床症状。……