中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (32): 6885-6892.doi: 10.12307/2025.942

• 肌肉肌腱韧带组织构建 tissue construction of the muscle, tendon and ligament • 上一篇    下一篇

不同浓度高渗葡萄糖修复大鼠肌腱损伤

周莉娜1，3，黎  芸1，3，刘夕霞2，3   

  1. 1广西中医药大学，广西壮族自治区南宁市  530200；2广西医学科学院，广西壮族自治区南宁市  530021；3广西壮族自治区人民医院(广西中医药大学联合培养基地)，广西壮族自治区南宁市  530021


  • 收稿日期:2024-11-04 接受日期:2024-12-12 出版日期:2025-11-18 发布日期:2025-04-26
  • 通讯作者: 刘夕霞，博士，副主任医师，广西医学科学院，广西壮族自治区南宁市 530021；广西壮族自治区人民医院(广西中医药大学联合培养基地)，广西壮族自治区南宁市 530021
  • 作者简介:周莉娜，女，2000年生，四川省彭州市人，汉族，广西中医药大学2022级硕士在读，主要从事康复研究。
  • 基金资助:
    广西自然科学基金项目(2022GXNSFBA035519；2023GXNSFAA026175)，项目负责人：刘夕霞

Effects of different concentrations of hypertonic glucose in the repair of tendon injury in rats

Zhou Lina1, 3, Li Yun1, 3, Liu Xixia2, 3   

  1. 1Guangxi University of Chinese Medicine, Nanning 530200, Guangxi Zhuang Autonomous Region, China; 2Guangxi Academy of Medical Sciences, Nanning 530021, Guangxi Zhuang Autonomous Region, China; 3The People’s Hospital of Guangxi Zhuang Autonomous Region (Joint Training Base of Guangxi University of Chinese Medicine), Nanning 530021, Guangxi Zhuang Autonomous Region, China
  • Received:2024-11-04 Accepted:2024-12-12 Online:2025-11-18 Published:2025-04-26
  • Contact: Liu Xixia, MD, Associate chief physician, The People’s Hospital of Guangxi Zhuang Autonomous Region (Joint Training Base of Guangxi University of Chinese Medicine), Nanning 530021, Guangxi Zhuang Autonomous Region, China; Guangxi Academy of Medical Sciences, Nanning 530021, Guangxi Zhuang Autonomous Region, China
  • About author:Zhou Lina, Master candidate, Guangxi University of Chinese Medicine, Nanning 530200, Guangxi Zhuang Autonomous Region, China; The People’s Hospital of Guangxi Zhuang Autonomous Region (Joint Training Base of Guangxi University of Chinese Medicine), Nanning 530021, Guangxi Zhuang Autonomous Region, China
  • Supported by:
    Guangxi Natural Science Foundation, Nos. 2022GXNSFBA035519 and 2023GXNSFAA026175 (both to LXX)

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摘要：


文题释义：
肌腱损伤(tendon injury)：是指由于机械负荷、过度使用或外力损伤导致的肌腱组织结构的损伤或病变，临床症状主要表现为与活动相关的疼痛、功能障碍、压痛、肿胀和肌腱僵硬。
高渗葡萄糖增生疗法(hypertonic glucose prolotherapy)：是一种注射疗法，主要用于治疗肌肉骨骼疼痛，如肌腱损伤、韧带松弛和关节不稳。该疗法通过将高渗葡萄糖溶液注射至病变部位或附近的软组织中，以诱导局部炎症反应，刺激成纤维细胞增殖和胶原蛋白合成，从而增强组织的修复和重建。

背景：许多临床试验结果表明，高渗葡萄糖增生疗法可以促进肌腱损伤的愈合，但其机制尚不清楚。
目的：观察不同浓度高渗葡萄糖对大鼠行为学、细胞形态学、肌腱细胞外基质成分、生长因子的影响。
方法：50只雄性SD大鼠随机分为空白组、模型组、5%葡萄糖组、15%葡萄糖组及25%葡萄糖组，每组10只。①造模：除空白组外，其余各组大鼠跟腱注射Ⅰ型胶原酶建立跟腱损伤模型；②干预：空白组和模型组不给予任何干预处理；造模后1周，5%葡萄糖组、15%葡萄糖组、25%葡萄糖组右侧跟腱分别注射5%，15%，25%葡萄糖30 μL ，每周1次，一共3次；③检测：行为学检测、苏木精-伊红染色病理学观察、Western blot和RT-qPCR检测跟腱组织中Ⅰ型胶原、Ⅲ型胶原、转化生长因子β1、血管内皮生长因子、SCX的表达。
结果与结论：①与空白组比较，模型组大鼠旷场实验5 min跑动距离显著减少(P < 0.05)；与模型组比较，25%葡萄糖组大鼠5 min跑动距离明显增加(P < 0.05)。②与空白组跟腱相比，其他各组均有不同程度的胶原纤维排列紊乱、血管数量增加、细胞数量增多；与模型组比较，葡萄糖干预组胶原纤维排列较模型组更加有序紧密。③与空白组相比，模型组Ⅰ型胶原α1 mRNA表达减少，Ⅲ型胶原mRNA表达增加(P < 0.05)；与模型组相比，25%葡萄糖组Ⅰ型胶原α1 mRNA表达增加，15%葡萄糖组、25%葡萄糖组Ⅲ型胶原mRNA表达量均明显下降，SCX mRNA表达量均明显增加(P < 0.05)。④与空白组相比，模型组Ⅰ型胶原蛋白表达减少，Ⅲ型胶原、血管内皮生长因子蛋白表达增加(P < 0.05)；与模型组相比，葡萄糖干预各组Ⅲ型胶原蛋白表达降低，25%葡萄糖组Ⅰ型胶原蛋白表达增加，15%葡萄糖组血管内皮生长因子、转化生长因子β1蛋白表达升高(P < 0.05)。⑤结果表明：高渗葡萄糖可以促进血管内皮生长因子蛋白、转化生长因子β1表达，调节胶原生成，增加Ⅰ型胶原含量，加速肌腱愈合，25%浓度高渗葡萄糖干预效果最佳。    

关键词: 高渗葡萄糖, 增生疗法, 肌腱损伤, 肌腱愈合, Ⅰ型胶原, Ⅲ型胶原, 转化生长因子, 血管内皮生长因子

Abstract: BACKGROUND: Numerous clinical trials have demonstrated that hypertonic glucose prolotherapy promotes tendon injury healing, yet the underlying mechanisms remain unclear.
OBJECTIVE: To investigate the effects of different concentrations of hypertonic glucose on rat behavior, cellular morphology, tendon extracellular matrix components, and growth factors.
METHODS: Fifty male Sprague-Dawley rats were randomly assigned into five groups: control blank, model, 5% glucose, 15% glucose, and 25% glucose groups, with 10 rats in each group. (1) Modeling: Except for the control blank group, all groups received an Achilles tendon injection of type I collagenase. (2) Intervention: The control blank and model groups received no treatment. The 5%, 15%, and 25% glucose groups received injections of 30 µL of 5%, 15%, and 25% glucose, respectively, into the right Achilles tendon once a week for 3 weeks. (3) Assessments: Behavioral assessments, hematoxylin-eosin staining, western blot, and RT-qPCR were conducted to assess type I collagen, type III collagen, transforming growth factor β1, vascular endothelial growth factor, and SCX expression levels in tendon tissue. 
RESULTS AND CONCLUSION: (1) Behavioral analysis: Compared with the control blank group, the model group showed a significant reduction in 5-minute running distance (P < 0.05). Compared with the model group, the 25% glucose group exhibited a significant increase in 5-minute running distance (P < 0.05). (2) Compared with the control blank group, tendon tissue in the other groups showed varying degrees of collagen disarray, increased number of blood vessels, and increased number of cells. However, glucose-treated groups exhibited more orderly collagen alignment than the model group. (3) Compared with the control blank group, the mRNA expression of type I collagen α1 was reduced, and the mRNA expression of type III collagen was increased in the model group (P < 0.05). Compared with the model group, the 25% glucose group exhibited increased mRNA expression of type I collagen α1, while both the 15% and 25% glucose groups showed significantly decreased mRNA expression of type III collagen and increased SCX mRNA expression (P < 0.05). (4) Compared with the control group, the model group displayed reduced protein expression of type I collagen and increased protein expression of type III collagen and vascular endothelial growth factor (P < 0.05). Compared with the model group, the glucose intervention groups had decreased protein expression of type III collagen, with the 25% glucose group showing increased protein expression of type I collagen and the 15% glucose group exhibiting elevated protein expression of vascular endothelial growth factor and transforming growth factor β1 (P < 0.05). To conclude, hypertonic glucose promotes vascular endothelial growth factor and transforming growth factor β1 expression, modulates collagen synthesis, increases the content of type I collagen, and accelerates tendon healing. Furthermore, 25% hypertonic glucose concentration has the optimal intervention effect.

Key words: hypertonic glucose, prolotherapy, tendon injury, tendon healing, type I collagen, type III collagen, transforming growth factor, vascular endothelial growth factor

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