王春林 田启东 胡鸾 向勇 艾健 赵志勇 董有康

摘要：目的 研究拔伸松动手法对兔膝关节骨性关节炎（KOA）模型兔关节液中的超氧化物歧化酶（SOD）、过氧化脂质（LPO）、丙二醛（MDA）的影响，探讨拔伸松动法促进兔KOA软骨损伤修复的机制。方法 将80只健康成年家兔随机分为实验组、对照组、模型组、空白组，每组20只。除空白组外，其余各组采用Videman T法建立KOA模型。实验组采用拔伸松动手法干预;对照组塞来昔布胶囊经胃灌药干预;模型组和空白组，不做治疗干预。实验完成后，抽取实验兔膝关节液，黄嘌呤酶法测定超氧化物歧化酶（SOD）活性，硫代巴比妥酸法检测丙二醛（MDA）含量，ELISA法检测过氧化脂质（LPO）含量。结果 实验组关节液中SOD浓度高于对照组和模型组（P<0.05）;LPO浓度和MDA浓度均低于对照组和模型组（P<0.05）。结论 拔伸松动手法可以升高KOA模型兔关节液中SOD浓度，降低LPO和MDA浓度，增强机体清除氧自由基的能力，促进损伤软骨的修复。

关键词：拔伸松动手法;关节骨性关节炎;SOD;LPO;MDA

中图分类号：R684.3 文献标志码：A 文章编号：1007-2349（2021）03-0069-04

【Abstract】Objective： To study the effect of pulling-stretching-loosening manipulation on superoxide dismutase （SOD）， lipid peroxide （LPO） and malondialdehyde （MDA） in rabbit synovial fluid of rabbit knee osteoarthritis （KOA） model and to explore the mechanism of pulling-stretching-loosening method to promote the repair of rabbit KOA cartilage damage. Methods： 80 healthy adult rabbits were randomly divided into experimental group， control group， model group， and blank group， 20 rabbits per group. Except for the blank group， the other groups were given Videman T method to establish KOA models. The experimental group was intervened by pulling-stretching-loosening manipulation， the control group was intervened by intragastric administration of Celecoxib capsules and the model group and the blank group were not treated with therapeutic intervention. After the experiment was completed， the experimental rabbit knee joint fluid was extracted. The xanthine enzyme method was used to determine the superoxide dismutase （SOD） activity， the thiobarbituric acid method was used to detect the content of malondialdehyde （MDA）， and the ELISA method was used to detect lipid peroxide （LPO） content. Results： The concentration of SOD in the joint fluid of the experimental group was higher than that of the control group and the model group （P<0.05）. The concentration of LPO and MDA of the experiment group were lower than that of the control group and the model group （P<0.05）. Conclusion： The pulling-stretching- loosening manipulation can increase the SOD concentration in the synovial fluid of KOA model rabbits， reduce the concentration of LPO and MDA， enhance the bodys ability to scavenge oxygen free radicals and promote the repair of damaged cartilage.

【Key words】Pulling-stretching-loosening manipulation; Joint osteoarthritis; SOD; LPO; MDA

膝關节骨性关节炎（Knee Osteoarthritis，KOA）是一种以膝关节软骨变性、损伤，软骨基质降解为早期病理特征的慢性骨关节疾病。一般认为KOA的发病与氧自由基代谢、炎症介质、细胞因子及自身免疫有关[1-3]。氧自由基代谢失衡是KOA病变的重要机制，其中超氧化物歧化酶（SOD）活性降低，丙二醛（MDA）、过氧化脂质（LPO）含量增高，软骨细胞凋亡加速[3]。本研究在临床实践基础上，观察拔伸松动手法对兔KOA模型关节液中SOD、MDA、LPO含量的变化，探讨拔伸松动法对兔KOA损伤软骨修复的机制，为临床推广应用提供客观依据。

1 材料与方法

1.1 实验动物 健康成年家兔80只，普通级别，单重：1.8～2.5Kg，雌雄不限，重量分布均一，均由昆明医科大学实验动物学部提供。……