A Study On The Effects And Its Mechanism Of Manipulations And Nonloaded Equal-length Exercises On Early-middle Stage Degenerative Osteoarthritis

Osteoarthritis(OA) is encountered commonly and frequently inthe middle and the old until now, there is no satisfied methods inmanagement of OA in modern medicine. Treatment of traditionalChinese medicine(TCM)have some potentiality at this respect,tespecially ext ernal treatment of TCM. There are many advantagesaboutl ext ernal treatment, such as be ing easy to operate lowerexpenses of treat ing, no s ide effects and, SO on except for obviouseffects on OA, It ispaid attent ion more and more.Objective: The Object ive of thi s research i s to explore theeffects of manipletion preclusure of traditional Chinese medicineof the degenerative osteoarthritis, and their mechanism.Methods: In this study, 30 Japanese big-eared rabbits weredivided randomly into two groups: control group(A), treatedgroup(B), removal of articular Cartilage of fomeral medial condylein two groups.The group A were not treated, the group B were treated bymanipulations 3times per week.The end of eighth week, intrasseous pressure were measured, Allanimals were killed, the Samples of two groups were taken to measure:①SOD activity: using a modification of xanthenesoxides(XO)method.②MDA content using a thiobarbituric and(TBA)colorimetric method in synovim tissue of knee,③CRP content inserum in rabbits of groups,④content of hyaluronate(HA) in synovialfluid in synovial fluid in knee of rabbits.⑤activity ofplasminogen act ivator(PA)and inhibitor of PA(PAI) in cartilage,⑥contentrations of nitricoxide(NO) in synovium,⑦at the same time articular cartilage of internal condyle of femur weretaken to observe pathologic changes.The results showed as follows:①SOD activity in synovium tissuein the Group B was much higher than that in the groupA②the MDA content was much Lower;③the serum CRP content was much Lower. There were significant differences(P＜0.05)in these values between the. two groups. The SOD activity elevated, the MDA content reduced and the CRP conternt dropped obviously in the treated group(B) compared with that in the model group(A). These values differed significantly(P＜0.05)between the two groups.④The HA content in synovial fluid in the treated group(B)was higher than that in the model group, and there was significant difference(P＜0.05)between the two groups.⑤The PA activity in cartilage of the treated group(B)decreased while The PAI cativity increased.⑥The NO concentrations were loweg in synoviam tissuein the treated group(B) than the model group(A).⑦Histomorphologic observations revealed: in the model group(A), surface of articular cartilage roughered and fissured, cartiale ceils decreased, clusteres, degenerated and arrangement was disturbes, tidemarkindistincted, synovium presented a significant degree of inflammation, characterized by marked swell, engorgenment and hypertrophy, synovial cells and fiber proliferated highly, and infiltratedby inflammatory cells. In the treated group(B), surface of articular cartilage was smooth, cartilage cells increased and arrangement improved, tidemark was intack, synovium thickened, but no congestion, swell and inflammatory cells were found.⑧The intraosseous pressure of upper tibia is lower in the group B than the group A significantly(P＜0.05). clinicaly, groupAof 100 knees were treated by inarticalar injection HA(Hyaluronate), group B of 300 knees were treated by manipulations and nonleaded tqual-length exercises. All of groups A and B were treated continionusly for six weeks. The symptoms and the Signs of pain, swelling, tenderness and disability were used as evaluation indexes of effects of treatment, according to the Scoring, the results showed thatthe effects of two techniques are satisfactory to the patients.Conclusion: The results of the experimental and clinical studysuggested that the manipulation predusure has a evident effect onprotecting articular Cartilage from degenerative changes,prophylaxi s and treatment of OA by improving intraosseous and localtissue microcirculation, inhibiting excessive grenerating of NO insynovium tissue to decrease liberating and cleffusion of inflammagory substance, dropping PA activity in cartilage, elevatingPAI activity to eliminate the internal factors that resulted inarticular cartilage degeneration and increasing HA contentsin synovlal fluld.