壮药骨痹方烫疗对兔KOA模型关节软骨组织病理变化影响实验研究.pdf

目 录 中文摘要 ················································1 英文摘要 ················································3 引 言 ················································5 正 文 ················································7 1.实验材料和方法······································7 1.1 实验材料·······································7 1.2 实验方法·········································7 2. 实验结果············································8 3.讨论············································ 10 4.存在的问题和展望··································29 结 论···············································31 参考文献 ··········································32 附 录 ···············································39 综 述 ··············································44 致 谢 ···············································51 攻读学位期间发表的学术论文目录 ····················52 作者声明 ··············································53 个人简历 ··············································54 中 文 摘 要 目的：研究壮药骨痹方烫疗对兔膝骨性关节炎模型的关节软骨病理 学变化的影响，探讨壮药骨痹方烫疗治疗膝骨性关节炎的机理以及用于 OA 保守治疗的可行性。 方法：分组 随机将24 只大白兔分为成A 、B 、C 、D 四组，A 组6 只为正常组，B 组6 只为造模组、C 组6 只温水烫疗组和D 组6 只壮药 骨痹方烫疗组。除A 组外，B 、C 、D 三组均采用关节制动法造模，将大 白兔右后肢膝关节长期伸直位石膏托固定，石膏上至髋关节下方，下至 踝关节上方，从而建立膝关节骨性关节炎实验诱发模型。造模后采用一 笼一兔喂养，每日检查石膏固定的情况，并及时进行修复，造模时间为6 周，6 周后解除制动。 治疗方法 壮药骨痹方烫疗组以壮药骨痹方粉碎成小块状，混合，加 45°米酒过面密封浸泡两月，装入小布袋备用。用时将药包臵微波炉加热 并在适度温度（40 ℃）下臵于兔右膝及周围烫熨，每次15 分钟，每天一 次。热水烫疗组用小方纱蘸适度温度（40 ℃）的热水臵于兔右膝及周围 烫熨，每次15 分钟，每天一次，连续四周。 病理形态学观察 实验动物处死后，先暴露胫骨平台内侧软骨，肉眼 大体观察软骨面情况，大体观察后，再用直径3mm 圆骨凿在胫骨内髁关 节定点取材，深达软骨下骨，各组取胫骨平台内侧软骨，做相关大体评 分；余下胫骨内侧平台软骨全部截取，臵 10%中性甲醛溶液固定，后经 脱水，脱钙，石蜡包埋，垂直软骨表面5μm 切片，待病理学检查。 结果：实验研究显示造模组膝关节软骨有明显退行性改变及滑膜炎 性改变，软骨表面有纤维裸露、龟裂、毛糙，对照组、治疗组病理改变 介于正常组、造模组之间，造模组关节软骨病理学评分较正常组明显升 高p ＜0.01。经壮药骨痹方烫疗后，治疗组关节软骨病理学评分较造模组 明显降低p ＜0.01。温水烫疗组关节软骨病理学评分与造模组无显著差异 1 p ＞0.05。 结论：壮药骨痹方烫疗对兔骨性关节炎软骨具有延缓和减轻关节退 变作用，对骨性关节炎早期有治疗作用，可用于骨性关节炎的保守治疗， 并能为下一步研究