内热针治疗兔激素性股骨头坏死的机制.

BACKGROUND: Internal heat-type acupuncture therapy is a new treatment technique that combines acupuncture therapy with hyperthermia. It has good clinical effects on steroid-induced osteonecrosis of the femoral head, but the mechanism of action is still not fully clear. OBJECTIVE: To explore the possible mechanism of internal heat-type acupuncture therapy in treating steroid-induced osteonecrosis of the femoral head in rabbits. METHODS: Thirty-two New Zealand rabbits were randomly divided into blank group, model group, internal heat-type acupuncture group and shock wave group using a random number table method, with 8 rabbits in each group. The model group, internal heat-type acupuncture group and shock wave group were modeled using methylprednisolone sodium succinate combined with Escherichia coli endotoxin. The internal heat-type acupuncture group received an internal heat-type acupuncture intervention on the buttocks of rabbits, once a week, for 20 minutes each time. The shock wave group received shock wave intervention on the buttocks of rabbits, once a week, with 2 000 beats per session. The blank group and model group were not given any treatment. After 4 weeks of intervention, blood samples and bilateral femoral head samples were collected from experimental rabbits. The levels of tumor necrosis factor-α and interleukin-6 in serum were detected by ELISA; the histomorphology of the femoral head was observed using hematoxylin-eosin staining and the rate of empty lacunae was calculated; the protein expressions of matrix metalloproteinase 2, matrix metalloproteinase 9, matrix metalloproteinase tissue inhibitor 1, and matrix metalloproteinase tissue inhibitor 2 were detected by immunohistochemistry and western blot. RESULTS AND CONCLUSION: Compared with the blank group, the model rabbits showed reduced food intake, mental fatigue, and decreased activity; compared with the model group, the above performance of the experimental rabbits was significantly improved after internal heat-type acupuncture and shock wave treatment. Compared with the blank group, the histomorphology of the femoral head in the model group deteriorated significantly and the rate of empty bone lacuna increased (P < 0.001), while the histomorphology of the femoral head in the internal heat-type acupuncture group and shock wave group was significantly improved compared with the model group, and the rate of empty bone lacuna was reduced (P < 0.001). The serum levels of tumor necrosis factor-α and interleukin-6 in the model group were significantly higher than those in the blank group (P < 0.05), while the serum levels of tumor necrosis factor-α and interleukin-6 in the internal heat-type acupuncture group and the shock wave group were significantly lower than those in the model group (P < 0.05). Compared with the blank group, the expression levels of matrix metalloproteinase 2 and matrix metalloproteinase 9 in the femoral head of the model group were significantly increased, while the expression levels of matrix metalloproteinase tissue inhibitor 1 and matrix metalloproteinase tissue inhibitor 2 were significantly decreased (P < 0.001); compared with the model group, the protein expression levels of matrix metalloproteinase 2 and matrix metalloproteinase 9 were significantly decreased, while the protein expression levels of matrix metalloproteinase tissue inhibitor 1 and matrix metalloproteinase tissue inhibitor 2 were significantly increased in the internal heat-type acupuncture group and the shock wave group (P < 0.001). Overall, these findings indicate that internal heattype acupuncture may promote the repair of the necrotic femoral head by regulating the levels of matrix metalloproteinases/matrix metalloproteinase tissue inhibitors and serum inflammatory factors, thus treating early steroid-induced osteonecrosis of the femoral head. [ABSTRACT FROM AUTHOR]