針刀對膝骨性關節炎大鼠軸及軟骨細胞自噬的影響

膝骨性關節炎（KOA）是退行性慢性關節疾病，主要臨牀表現爲膝關節疼痛、僵硬、活動受限等。近年來，研究表明，膝關節周圍軟組織的損傷可導致軟骨應力異常，關節軟骨變性和破壞，軟骨細胞減少，從而導致軟骨退化。

針刀療法以西醫精細解剖、立體解剖及動態解剖理論爲指導，融合了中醫鍼灸療法與西醫手術刀的優勢進行治療，不僅能夠利用針刀鬆解膝關節周圍組織粘連，清除局部病變因素而恢復力學平衡，又可利用中醫穴位的刺激作用而改善神經功能、緩解疼痛。

來自安徽中醫藥大學的楊等採用藥物注射法制備大鼠KOA模型，探究針刀通過干預軟骨細胞自噬改善KOA大鼠膝關節軟骨損傷的作用機制。結果表明，針刀干預能明顯改善KOA模型大鼠膝關節軟骨損傷，降低mTOR的表達、提高Atg5、Atg12、Atg4a、ULK1、Beclin-1的表達。總之，針刀可以通過促進軟骨細胞自噬恢復細胞穩態，進而改善關節軟骨形態結構，延緩軟骨細胞的衰老退變。

相關研究由楊永暉、盧曼、黃小雙等完成。研究結果發表在《中國鍼灸》第42卷，第1期，2022年。

Effect of needle knife on mTOR/Atg/ULK1/Beclin-1 axis and chondrocyte autophagy in rats with knee osteoarthritis

Knee osteoarthritis (KOA) is a degenerative chronic joint disease, the main clinical manifestations of knee pain, stiffness, limited movement, etc. In recent years, studies have shown that damage to the soft tissues around the knee joint can lead to abnormal cartilage stress, degeneration and destruction of articular cartilage, and loss of chondrocytes, which can lead to cartilage degeneration.

Needle knife therapy is guided by western medicine, three-dimensional anatomical and dynamic anatomy theory. It integrates the advantages of acupuncture therapy of Traditional Chinese medicine and scalpel of Western medicine for treatment. It can not only use acupotomy to release the adhesion of tissues around the knee joint, remove local pathological factors and restore the mechanical balance, but also use the stimulation of acupuncture points of Traditional Chinese medicine to improve nerve function and relieve pain.

Yang et al. from Anhui University of Traditional Chinese Medicine prepared KOA rats by drug injection to explore the mechanism of acupotomology in improving knee cartilage injury in KOA rats by intervening chondrocyte autophagy. The results showed that needle knife intervention could significantly improve the knee cartilage injury in KOA rats, reduce the expression of mTOR and increase the expression of Atg5, Atg12, Atg4a, ULK1 and Beclin-1. In conclusion, needle knife can restore cell homeostasis by promoting chondrocyte autophagy, thus improving the morphology of articular cartilage and delaying the aging and degeneration of chondrocytes.

Related studies were completed by Yang Yong-hui, Lu Man and Huang Xiao-shuang. The results are published in Chinese Acupuncture & Moxibustion vol 42, No 1, 2022.