中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (42): 7837-7842.doi: 10.3969/j.issn.2095-4344.2012.42.009

• 软骨组织构建 cartilage tissue construction • 上一篇    下一篇

丹参关节腔注射与针刺修复膝关节全层软骨缺损

马 勇1, 2，郭 杨1, 2，顾一煌1，周 信1，王建伟2，张亚峰2，黄桂成1   

  1. 1南京中医药大学省部共建针药结合实验室，江苏省南京市 210029
    2南京中医药大学骨伤研究所，江苏省无锡市 214001
  • 收稿日期:2012-02-01 修回日期:2012-02-14 出版日期:2012-10-14 发布日期:2012-10-14
  • 通讯作者: 黄桂成，教授，博士生导师，南京中医药大学省部共建针药结合实验室，江苏省南京市 210029 zhongyi-my@263.net
  • 作者简介:马勇☆，男，1963年生，江苏省扬中人，汉族，2008年南京中医药大学毕业，博士，教授，博士生导师，主要从事中西医结合治疗骨关节疾病的基础和临床研究。 Zhongyi-my@263.net

Integrated Salvia miltiorrhiza and acupuncture for repairing knee articular full-thickness cartilage defects

Ma Yong1, 2, Guo Yang1, 2, Gu Yi-huang1, Zhou Xin1, Wang Jian-wei2, Zhang Ya-feng2, Huang Gui-cheng1   

  1. 1Laboratory of Integrated Acupuncture and Medicine, Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
    2Institute of Traumatology & Orthopedics, Nanjing University of Chinese Medicine, Wuxi 214001, Jiangsu Province, China
  • Received:2012-02-01 Revised:2012-02-14 Online:2012-10-14 Published:2012-10-14
  • Contact: Huang Gui-cheng, Professor, Doctoral supervisor, Laboratory of Integrated Acupuncture and Medicine, Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China zhongyi-my@263.net
  • About author:Ma Yong☆, Doctor, Professor, Doctoral supervisor, Laboratory of Integrated Acupuncture and Medicine, Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China; Institute of Traumatology & Orthopedics, Nanjing University of Chinese Medicine, Wuxi 214001, Jiangsu Province, China Zhongyi-my@263.net

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摘要：

背景：研究表明软骨下钻孔可有效修复关节软骨缺损，应用针药结合能有效控制软骨损伤出现的症状。推测针药结合可与软骨下钻孔在修复软骨缺损中产生协同作用。
目的：观察针药结合联合软骨下钻孔对兔膝关节全层软骨缺损的修复效果。
方法：于50只新西兰兔双侧股骨髁关节面造成6 mm×8 mm全层软骨缺损，随机分为5组。模型组造模后不作任何处理；钻孔组只做钻孔处理；丹参组钻孔后1周向膝关节腔注射丹参注射液0.3 mL，1次/周，共5周；针刺组钻孔后1周针刺兔双侧足三里穴，1次/d，30 min/次，6次为1个疗程，共治疗5个疗程；针药组钻孔后1周同时行丹参关节腔注射与针刺治疗，方法和疗程同上。
结果与结论：组织学及透射电镜检查均显示，模型组主要为纤维组织，其余4组缺损修复组织均为类透明软骨、幼稚软骨和纤维软骨，且以针药组修复组织的数量和质量最佳。与模型组比较，其余4组的致密修复组织覆盖缺损的面积明显增大(P < 0.01)，以针药组的疗效最优，丹参组、针刺组次之。结果提示丹参关节腔注射、电针足三里和针药结合均可促进软骨下钻孔修复关节软骨缺损，且针药结合优于单纯的丹参关节腔注射及电针足三里治疗。

关键词: 关节软骨缺损, 软骨下钻孔, 针药结合, 丹参注射液, 针刺, 兔, 膝关节, 组织构建

Abstract:

BACKGROUND: Studies have shown that subchondral drilling can repair cartilage defects effectively. Integrated acupuncture and medicine can control the symptoms of cartilage damage effectively in clinic. It is supposed that integrated acupuncture and medicine can produce synergistic effect with subchondral drilling on cartilage defect repair.
OBJECTIVE: To investigate the effect of integrated acupuncture and medicine combined with subchondral drilling on the repair of articular cartilage defects.
METHODS: Full-thickness defects of 6 mm×8 mm were created over the articular surface of bilateral femoral condyles in 50 rabbits. The rabbits were randomly divided into five groups (n=10). The rabbits in A group (model group) were not given any treatment after modeled, and those in B group (drilling group) were only given drilling treatment. One week after drilling, the rabbits in C group (Salvia miltiorrhiza group) were injected 0.3 mL Salvia miltiorrhiza injecta into both knee joint cavity once a week for five times. The rabbits in D group (acupuncture group) were acupunctured bilateral Zusanli (ST36) once a day for 30 minutes, totally for 30 times. The rabbits in E group (acupuncture+Salvia miltiorrhiza group) were injected SM and acupunctured bilateral Zusanli, and the methods were identical to the C and D groups.
RESULTS AND CONCLUSION: The results of the histological observation and transmission electron microscope examination showed that the repair tissues in B, C, D and E groups were similar, including hyaline cartilage, immature cartilage and fibrous cartilage, while that in group A was mostly fibrous tissue in majority. The quantity and quality of repair tissue in E group was the best. Compared with the group A, the area of the repair tissue covering cartilage defects in B, C, D and E group was obviously increased (P < 0.01). The effect of E group was the optimum and that in C and D groups was worse. These findings suggest that Salvia miltiorrhiza, acupuncture, and acupuncture+Salvia miltiorrhiza all can promote subchondral drilling effect on cartilage defects repair, besides, the effect of integrated acupuncture and Salvia miltiorrhiza is superior to pure Salvia miltiorrhiza and acupuncture.

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