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目的观察超声导入复方三七消痛软膏对兔膝骨性关节炎(KOA)滑膜形态和软骨细胞含半胱氨酸的天冬氨酸蛋白水解酶-9(caspase-9)及X-连锁凋亡抑制蛋白(XIAP)表达的影响,探讨超声导入复方三七消痛软膏对KOA的疗效和机制。方法 32只6月龄新西兰白兔随机分为超声导入复方三七消痛软膏治疗组、普通耦合剂超声治疗组、模型组、正常组4组,每组各8只。除正常组外,其余动物均行前交叉韧带切断术(ACLT),术后6周后对超声导入复方三七消痛软膏治疗组、普通耦合剂超声治疗组2组分别用超声导入复方三七消痛软膏和单纯超声治疗2个疗程;模型组和正常组不予干预。2个疗程结束后处死各组动物,HE染色光镜下观察滑膜组织形态学,免疫组化检测各组软骨组织中caspase-9及XIAP的表达情况。结果光镜下滑膜退变程度由轻至重:正常组,超声导入复方三七消痛软膏治疗组,普通耦合剂超声治疗组,模型组。与正常组相比较,超声导入复方三七消痛软膏治疗组、普通耦合剂超声治疗组、模型组caspase-9免疫组化IOD值高于正常组,而XIAP免疫组化IOD值低于正常组;与模型组相比较,超声导入复方三七消痛软膏治疗组、普通耦合剂超声治疗组caspase-9免疫组化IOD值低于模型组,而XIAP免疫组化IOD值高于模型组。超声导入复方三七消痛软膏治疗组caspase-9免疫组化IOD值低于普通耦合剂超声治疗组,而XIAP免疫组化IOD值高于普通耦合剂超声治疗组。结论超声导入复方三七消痛软膏治疗兔KOA优于超声波,能够起到保护软骨和减轻滑膜炎症的作用,延缓KOA的发展,其治疗机制可能是通过降低软骨细胞caspase-9及增加XIAP的表达实现。
Objective To observe the effect of ultrasound on the synovial morphology of rabbit knee osteoarthritis (KOA) and the expression of caspase-9 and X- Apoptosis inhibitor protein (XIAP) expression of the impact of ultrasonic introduction of compound Sanqi Xiaotong Ointment on KOA efficacy and mechanism. Methods Thirty-two New Zealand white rabbits aged 6 months were randomly divided into four groups: ultrasound-treated Fufang Sanqi Xiaogan Ointment group, normal couplant ultrasound treatment group, model group and normal group, with 8 rats in each group. Except for the normal group, the other animals underwent anterior cruciate ligament resection (ACLT). Six weeks after the operation, ultrasound was introduced into Fufang Sanqi Xiaotong Ointment group and normal coupling agent ultrasound group, respectively. Pain relief ointment and simple ultrasound treatment of 2 courses; model group and normal group without intervention. The animals in each group were sacrificed after 2 courses of treatment. The synovial tissue morphology was observed by HE staining and the expressions of caspase-9 and XIAP in each group were detected by immunohistochemistry. Results The degree of degeneration of synovial membrane under light microscope ranged from light to heavy: the normal group, the ultrasound group was infused with Fufang Sanqi Xiaotong Ointment, the ordinary coupling agent ultrasound group and the model group. Compared with the normal group, the IOD value of caspase-9 immunohistochemistry was significantly higher than that of the normal group in ultrasound-treated Fufang Sanqi Xiaotong Ointment group and the normal couple ultrasound treatment group, while the IOD value of XIAP immunohistochemistry was lower than that of the normal group Compared with the model group, the IOD value of caspase-9 immunohistochemistry was lower in the ultrasound-treated group than in the untreated group, while the IOD value of XIAP immunohistochemistry was higher than that in the untreated group. The IOD value of caspase-9 immunohistochemistry guided by ultrasound in Compound Panax Qiao Tong Ointment group was lower than that of ordinary coupling agent ultrasound group, while the IOD value of XIAP immunohistochemistry was higher than that of ordinary coupling agent ultrasound group. Conclusion Ultrasound induction of Compound Panax Qiao Tong Ointment is superior to ultrasound in the treatment of rabbit KOA, which can play a role in protecting cartilage and reducing synovial inflammation, and retarding the development of KOA. The therapeutic mechanism may be that by reducing caspase-9 and increasing XIAP in cartilage Express to achieve.