| Osteoarthritis (OA) is a very common osteoarthropathy worldwide with high disability rate, and is of great concern to medical institutions due to the impact it has on patients' life, and social activities.2000 World Health Organization Assembly declared 2000-2010 the ten years of Osteoarthritis prevention and cure. In 2002, China Ministry of Health and Chinese Medical Association declared 2002-2012 "the ten years for healthy bones and joints of Chinese". Knee joint is susceptible to OA. Knee Osteoarthritis (KOA) is characterized mainly by knee joint pain, stiffness, and limitation to movement. Patients often seek treatment because of joint pain.Acupotomy lysis proved eutherapeutic in the treatment of KOA. The research on acupotomy is developing toward basic fields. This project relies on Acupotomy Lysis Basic Research under Specialized Traditional Chinese Medicine Programs funded by National Basic Research Program of China (973 Program). Through animal testing, this project studies how acupotomy lysis eases pain, and its central mechanism for the purpose of providing factual evidence to confirm the effectiveness of acupotomy.ObjectiveThrough observing the morphology of local tissues of rats with KOA, measuring threshold of pain, and detecting and analyzing pain-related substances in central nervous system before and after acupotomy intervention, this project studies how acupotomy lysis eases KOA pain, explores how it influences central analgesia function, and elucidates its pain alleviation mechanism, for the purpose of providing factual evidence to confirm the effectiveness of acupotomy.MethodsDivide 80 three-month-old healthy laboratory SD rats (equal between genders) randomLy into normal control group, model group, acupotomy lysis group, and electro-acupuncture group. Prepare KOA models by injecting papain solution into knee joint cavities of rats. Start treating acupotomy group and electro-acupuncture group rats on 36d after modeling. Treat acupotomy group once a week, electro-acupuncture group three times a week (once every other day), for three weeks. Measure the tail flick latency of rat using heat radiation to observe the variation of the pain threshold of rats. Observe the pathology of local tissues of rats through optical microscope. Measure the content of SP, I-ENK, (3-EP, and CCK-8 in tissues in spinal cord and brain using radioimmunOAssay. Measure the content of 5-HT, NE, and DA in tissues in spinal cord and brain using enzyme immunOAssay. Observe the regulatory function of acupotomy lysis on pain-related neuropeptide and monOAmine neurotransmitter.Result1. Pain threshold of model group is much lower than normal control group throughout the testing (P＜0.01, P<0.05). Pain threshold of acupotomy group and electro-acupuncture group has risen after treatment starts, and is significantly different than model group (P<0.01, P<0.05). Pain threshold of acupotomy group rises sharply after the 2nd treatment, and rises more than electro-ecupuncture group does (P<0.01)2. There are to the naked eye noticeable thickening of articular capsule, darkening and roughness of cantilage, exposed subchondral bone, and formation of osteophyte of rats in model group. Acupotomy lysis can reduce articular capsule thickening, and inhibit the forming of osteophyte.3. Changed joint structure and narrow joint space are seen through optical microscope. Inside joint cavity are found cartilage and synovial membrane that have come off. Joint cartilage is found with conspicuous degeneration. Denaturation and necrosis of cells is seen. Cells in different layers are in disorder. Synovial membrane is congestive and edematous. Capillary is hyperplastic. Inflammatory cell infiltration and pannus are found. Acupotomy lysis and electro-acupuncture can reduce inflammatory cell infiltration and damage to cartilage such that normal joint structure is maintained.4. In respect of SP content in spinal cord and thalamus, acupotomy group has risen sharply compared with normal control group(P<0.01, P<0.05). In respect of SP content in hypothalamus, acupotomy group is significantly lower than normal control group (P＜0.01). In respect of I-ENK andβ-EP content in spinal cord, acupotomy group has risen sharply compared with normal control group (P＜0.01). In respect of I-ENK andβ-EP content in midbrain, acupotomy group is significantly lower than normal control group (P＜0.01). In respect of CCK-8 content in spinal cord and midbrain, acupotomy group is significantly lower than normal control group (P＜0.01, P＜0.05). The indices of acupotomy group and electro-acupuncture group change with similar trends, that shows acupotomy lysis and electro-acupuncture can adjust in a favorable way the neuropeptide content in spinal cord and brain to make them closer to normal level.5. The 5-HT content in spinal cord and hypothalamus of rats treated with acupotomy lysis has risen sharply compared with that of normal control group rats (P＜0.05). Compared with normal control group, the NE content in spinal cord tissues of rats treated with acupotomy lysis has risen sharply (P＜0.05) NE content in brain shows a downward trend. In respect of midbrain DA content, model group has risen sharply compared with normal control group (P＜0.01). There is no significant difference between acupotomy group and normal control group The indices of acupotomy group and electro-acupuncture group change with similar trends, that shows acupotomy lysis and electro-acupuncture can adjust in a favorable way the monOAmine neurotransmitter content in spinal cord and brain to correct their anabolism imbalance.ConclusionAcupotomy lysis functions to ease pain. Through this project it can be found that acupotomy lysis influences pain alleviation function of the central nervous system of rats with KOA with the following characteristics:①acupotomy lysis functions to adjust in a favorable way the pain-alleviation-related substances (neuropeptide and monOAmine neurotransmitter) in central nervous system;②the favorable adjustment function of acupotomy lysis exists in both spinal cord and the tissues above it, though in spinal cord it is more conspicuous;③the adjustment by acupotomy lysis to KOA induced pain reflects compensatory mechanism of monOAmine neurotransmitter and opioid peptide system.It is difficult to conclude from the findings of this project either of acupotomy lysis and electro-acupuncture is more effective in adjusting pain-alleviation-related substances in central nervous system, so it cannot be determined which therapy is better. Observation in this project shows that acupotomy lysis is more effective than electro-acupuncture in raising pain threshold, that might be related to the adjustment to pain-alleviation-related substances in central nervous system, and the inhibition of inflammation of and damage to local tissues. Acupotomy lysis is more convenient for patients since it is administered far less frequently than electro-acupuncture.
|
PDF Full Text Request