推拿对膝关节骨性关节炎兔髌韧带、关节软骨作用效应的研究

【作者】 孙超；

【导师】 于天源；

【作者基本信息】 北京中医药大学 ， 针灸推拿学， 2006， 硕士

【摘要】 在软组织生物力学的研究和膝关节骨性关节炎强直关节的康复治疗中，大多利用了软组织的粘弹性。尽管在临床中早已应用了软组织的粘弹性特性来对膝关节骨性关节炎强直关节进行治疗，而且其疗效也是肯定的，但我们并没有对软组织，特别是强直关节周围的软组织进行深入的研究，而使推拿康复治疗缺乏科学的理论和指导。通过对强直关节周围软组织的粘弹性进行研究，可为膝关节骨性关节炎强直关节的康复治疗提供必要的理论依据。因此对膝关节骨性关节炎强直关节周围软组织的粘弹性进行研究，对了解膝关节骨性关节炎强直关节的治疗原理、改善治疗方案、提高疗效等都有重要的意义。在以往的膝关节生物力学研究中，推拿手法对韧带的作用研究较少，因此探讨推拿手法在生物力学方面对韧带的作用效应，具有一定的理论和临床意义。 基于以往课题研究，本课题以日本大耳白兔为受试对象，采用Videman经典造模方法，将兔右后肢从腹股沟到踝关节上缘行石膏管型固定，即膝关节伸直位，共制动6周。采用推拿手法治疗，从生物力学和病理学的角度探讨推拿对于膝关节骨性关节炎兔的关节活动度、髌韧带、关节软骨性能的作用，为进一步的深入研究打下基础。 本课题研究分为理论研究和实验研究两个部分。 理论研究总结了膝关节骨性关节炎的发病情况、病因病理、诊断要点、治疗要点、康复方法。追溯了推拿手法的历史渊源、发展、应用现状、相关的实验研究、推拿手法基础研究现状等。对古今文献进行了学习、归纳和探讨。 实验研究主要包括以下内容： 1．物理学：测量股胫角。 2．生物力学：髌韧带拉伸强度及拉伸位移。 3．病理学：股骨外髁关节软骨IL-1、IL-6表达及软骨厚度。 实验结果表明：推拿组、模型组、正常组的股胫角、髌韧带弹性、股骨外髁关节软骨IL-1、IL-6表达及软骨厚度均有明显差异。 结论：本实验通过对推拿组与模型组膝关节固定后，髌韧带拉伸长度及强度的对照比较、三组兔膝关节股骨外髁关节软骨病理切片比较；得出推拿对膝关节骨性关节炎兔的关节功能改善、髌韧带弹性恢复、延缓关节软骨缺失三方面均有明显的治疗意义。 通过本课题的研究，证实了推拿手法对膝关节骨性关节炎兔的关节活动度、韧带弹性、软骨厚度和软骨炎性因子都有良性调节作用。为今后临床应用和进一步研究推拿手法治疗膝关节骨性关节炎提供了初步的实验依据；从生物力学和病理学的角度初步探讨了推拿对于膝关节骨性关节炎兔的韧带、关节软骨性能的作用，为进一步的深入研究打下基础。更多还原

【Abstract】 Is restored to health in the treatment in soft tissue biology mechanics research and the strong straight joint, mostly has used the soft tissue viscoelasticity. In former knee joint biology mechanics research, the massage technique are less to the ligament function research, therefore discussion massage technique in biological mechanics aspect to ligament function effect, has the certain theory and the clinical significance.This topic as receives take the Japanese big ear white rabbit tries the object, uses the Videman classics to make the mold method, after Gypsum is fixed the rabbit right extremity from the inguen to the malleolus joint upper limb good gypsum, the knee joint unbends 180 positions, altogether applies the brake 6 weeks. Strongly uses the massage technique tr(?)atment rabbit knee joint to be straight, from the biological mechanics and the pathology angle discussion massage regarding the Knee joint osteoarthritis rabbit’s ligament, the articular cartilage performance function, builds the foundation for the further thorough research.This topic research divides into the fundamental research and the experimental study two parts.The fundamental research summarized the knee osteoarthritis to arise the situation, the cause of disease pathology, the diagnosis main point, the treatment main point, is restored to health the method.Has traced the massage technique historical origin, the development, the application present situation, the correlation experimental study,the massage technique basic research present situation and so on. Has carried on the study and the analysis, the induction and the discussion to the ancient and modern literature.Experimental study mainly including below content;1. Stock shin angle survey2. Biology mechanical testing3. Pathology observationThe experimental result indicated that, The massage group, the model group, the normal group’s stock shin angle, the inside Hgamentum accessorium viscoelasticity, articular cartilage immunity group IL-1, IL-6 averages optical density and articular cartilage thickness has the obvious difference.Conclusion; This experiment through after massages the group and the comparison group knee joint applies the brake the inside ligamentum accessorium to stretch the length and the intensity comparison compares, three groups of rabbits knee joints articular cartilage specimen and the pathological section compare, obtains the massage to the knee os(?)eoarthritis rabbit’s joint function improvement, the ligament elasticity restores, the carti’age repair has the obvious treatment significance.更多还原