针刀疗法对大鼠膝骨关节炎模型炎症及软骨损伤的影响OA

Objective:To clarify the anti-inflammatory effect and chondroprotective effect of acupotomy therapy on knee osteo-arthritis(KOA)rat models,and to explore its mechanism.Methods:Thirty-six SPF-grade male Sprague-Dawley(SD)rats were ac-climatized and then randomly assigned to three groups(n=12 per group):the blank control group,the model group,and the acupoto-my group.KOA was induced in the model and acupotomy groups by immobilizing the right hind limb in extension with a plaster cast for 6 weeks using a modified Videman method.The blank control group was housed under standard conditions without any in-tervention.The Lequesne MG index was used to assess knee joint function post-modeling,with a total score of≥4 points considered indicative of successful model establishment.Following successful modeling,the acupotomy group received acupotomy release ther-apy at common myofascial trigger points around the knee:the medial and lateral vastus muscles,the medial and lateral patellar reti-nacula,the patellar ligament attachment on the patella,and the pes anserinus attachment on the medial tibial condyle.Treatment was administered once weekly for a total of 4 weeks.The blank control and model groups underwent only skin disinfection without nee-dle insertion,following the same treatment schedule.After the intervention period,knee joint function was reassessed using the Lequesne MG index in all three groups.Macroscopic changes in knee joint cartilage were evaluated visually.Radiographic changes in the rat knee joints were assessed using a small-animal micro-CT imaging system.Serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-1β(IL-1β)were measured by enzyme-linked immunosorbent assay(ELISA).Ultrastructural changes in knee joint chondrocytes were observed via transmission electron microscopy(TEM).Results:Compared with the blank group,the model group showed a significantly increased Lequesne MG score of the right knee joint(P<0.05);gross observation re-vealed obviously rough articular surfaces,incomplete structure in some regions,loss of normal gloss of the cartilage surface,thick-ened prepatellar synovium,and yellowish discoloration;imaging results indicated significantly narrowed joint space,a large number of osteophytes formed in the joint cavity,accompanied by obvious structural damage;serum levels of TNF-α,IL-6,and IL-1β were significantly elevated(P<0.05).Compared with the model group,the acupotomy group showed a significant reduction in the Lequesne MG score for the right knee joint(P<0.05);gross observation showed that the cartilage surface was relatively smooth with reduced defects,increased cartilage thickness and improved density;imaging results demonstrated a relatively smooth articular sur-face,wider joint space than that of the model group,fewer osteophytes formed in the joint cavity,and significantly improved joint structural damage compared with the model group;serum levels of TNF-α,IL-6,and IL-1β were significantly reduced(P<0.05).Transmission electron microscopy(TEM)results showed that in the blank group,mitochondria in the cytoplasm were short rod-shaped with intact structure and basically clear cristae;the endoplasmic reticulum had a clear structure with a few dilated endoplas-mic reticula;normal autolysosomes and obvious lipid droplets could be seen in the cytoplasm.In the model group,mitochondria in the cytoplasm showed mild to moderate dilatation,decreased electron density of the mitochondrial matrix,and partial rupture of mi-tochondrial cristae;the endoplasmic reticulum was significantly dilated;a small number of autolysosomes could be seen in the cyto-plasm.In the acupotomy group,mitochondria in the cytoplasm were short rod-shaped with a slightly blurred outer membrane but ba-sically clear cristae;the endoplasmic reticulum had a clear structure with a few dilated endoplasmic reticula;an increased number of autolysosomes and a small amount of lipid droplets could be seen in the cytoplasm.Conclusion:Acupotomy therapy,by releasing common myofascial trigger points around the knee,can alleviate KOA and improve cartilage damage.The mechanism may be asso-ciated with the reduction of inflammatory factor(TNF-α,IL-6,and IL-1β)expression and the upregulation of cellular autophagy levels in KOA rats.