[1]马靖哲,康武林,姚彬,等.蠲痹方含药血清对绝经后膝骨关节炎大鼠软骨细胞自噬的影响及其作用机制[J].中医正骨,2024,36(02):7-16.
 MA Jingzhe,KANG Wulin,YAO Bin,et al.Effects and mechanism of Juanbi Fang(蠲痹方)medicated serum on autophagy of chondrocytes in postmenopausal rats with knee osteoarthritis:an experimental study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(02):7-16.
点击复制

蠲痹方含药血清对绝经后膝骨关节炎大鼠软骨细胞自噬的影响及其作用机制()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期数:
2024年02期
页码:
7-16
栏目:
基础研究
出版日期:
2024-02-20

文章信息/Info

Title:
Effects and mechanism of Juanbi Fang(蠲痹方)medicated serum on autophagy of chondrocytes in postmenopausal rats with knee osteoarthritis:an experimental study
作者:
马靖哲1康武林1姚彬1黄文博1李越1陈小林2李思聪1袁普卫1
(1.陕西中医药大学附属医院,陕西 咸阳 712046; 2.陕西中医药大学药学院,陕西 咸阳 712046)
Author(s):
MA Jingzhe1KANG Wulin1YAO Bin1HUANG Wenbo1LI Yue1CHEN Xiaolin2LI Sicong1YUAN Puwei1
1.The Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712046,Shaanxi,China 2.College of Pharmacy,Shaanxi University of Chinese medicine,Xianyang 712046,Shaanxi,China
关键词:
骨关节炎 绝经后期 软骨细胞 自吞噬 蠲痹方 大鼠
Keywords:
osteoarthritisknee postmenopause chondrocytes autophagy Juanbi Fang rats
摘要:
目的:探讨蠲痹方含药血清对绝经后膝骨关节炎(knee osteoarthritis,KOA)大鼠软骨细胞自噬的影响及其作用机制。方法:①绝经后KOA动物模型的建造和蠲痹方含药血清的制备。采用摘取大鼠卵巢,并切断膝关节内侧副韧带、前交叉韧带,摘除膝关节内侧半月板的方法,建造绝经后KOA大鼠模型。造模成功后,对模型大鼠进行蠲痹方浓缩液灌胃,制备蠲痹方含药血清。②大鼠软骨细胞的提取。分别取正常大鼠和模型大鼠的膝关节软骨分离、提取软骨细胞。③蠲痹方含药血清最佳作用浓度筛选。将模型大鼠软骨细胞分为模型组及1.25%、2.5%、5%、10%、20%含药血清组6组,除模型组外,其余各组分别加入相应体积分数的蠲痹方含药血清干预24 h。检测各组软骨细胞的活力,筛选蠲痹方含药血清最佳作用浓度。④蠲痹方含药血清对大鼠软骨细胞G蛋白耦联受体30(G protein-coupled receptor 30,GPR30)表达影响的检测。将模型大鼠软骨细胞分为模型组及1.25%、2.5%、5%、10%含药血清组,并取正常大鼠软骨细胞设为空白组。除模型组和空白组外,其他各组软骨细胞用相应体积分数的蠲痹方含药血清干预24 h。检测各组大鼠软骨细胞GPR30的相对表达量。⑤蠲痹方含药血清对大鼠软骨细胞自噬相关蛋白表达和AMP活化蛋白激酶(AMP-activated protein kinase,AMPK)/哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,mTOR)信号通路影响的检测。将模型大鼠软骨细胞分为模型组、含药血清组、含药血清+Compound C组、Compound C组,并取正常大鼠软骨细胞设为空白组。除模型组和空白组外,含药血清组、含药血清+Compound C组、Compound C组分别用10%蠲痹方含药血清、10%蠲痹方含药血清+Compound C及Compound C干预24 h。检测各组软骨细胞中自噬相关蛋白微管相关蛋白轻链3β(microtubule-associated protein light chain 3 beta,MAPLC3β)、Beclin-1、p62,及AMPK/mTOR信号通路相关蛋白磷酸化AMP活化蛋白激酶(phosphorylated AMP-activated protein kinase,p-AMPK)、磷酸化哺乳动物雷帕霉素靶蛋白(phosphorylated mammalian target of rapamycin,p-mTOR)的相对表达量。结果:①动物模型鉴定结果。造模8周后,可见造模大鼠膝关节表面软骨毛糙或缺损,关节间隙变窄,滑膜增生,绝经后KOA大鼠模型造模成功。②软骨细胞鉴定结果。甲苯胺蓝染色及Ⅱ型胶原蛋白免疫荧光鉴定结果显示,所提取的细胞符合软骨细胞特征。③蠲痹方含药血清最佳作用浓度筛选结果。5%、10%、20%含药血清组细胞活力均高于1.25%、2.5%含药血清组和模型组(LSD-t=6.767,P=0.003,LSD-t=7.666,P=0.002,LSD-t=5.091,P=0.007; LSD-t=5.080,P=0.007,LSD-t=6.690,P=0.003,LSD-t=3.433,P=0.027; LSD-t=7.590,P=0.002,LSD-t=8.200,P=0.001,LSD-t=6.031,P=0.004); 10%含药血清组细胞活力高于5%含药血清组和20%含药血清组(LSD-t=3.204,P=0.033,LSD-t=4.671,P=0.010)。④蠲痹方含药血清对大鼠软骨细胞GPR30表达影响的检测结果。模型组GPR30相对表达量低于空白组及5%、10%含药血清组(LSD-t=5.695,P=0.005,LSD-t=5.400,P=0.006,LSD-t=9.006,P=0.001),5%、10%含药血清组GPR30相对表达量均高于1.25%含药血清组(LSD-t=2.782,P=0.049,LSD-t=4.473,P=0.011),10%含药血清组GPR30相对表达量高于2.5%含药血清组(LSD-t=4.544,P=0.011)。⑤蠲痹方含药血清对大鼠软骨细胞自噬相关蛋白表达影响的检测结果。模型组、含药血清+Compound C组、Compound C组MAPLC3β相对表达量均低于空白组、含药血清组(LSD-t=6.855,P=0.002,LSD-t=8.675,P=0.001; LSD-t=5.096,P=0.007,LSD-t=5.931,P=0.004; LSD-t=5.560,P=0.005,LSD-t=5.354,P=0.006); 模型组、Compound C组MAPLC3β相对表达量均低于含药血清+Compound C组(LSD-t=4.627,P=0.010,LSD-t=8.677,P=0.001)。模型组、Compound C组Beclin-1相对表达量低于空白组、含药血清组、含药血清+Compound C(LSD-t=12.912,P=0.000,LSD-t=7.401,P=0.002,LSD-t=5.360,P=0.006; LSD-t=2.950,P=0.042,LSD-t=5.484,P=0.005,LSD-t=3.903,P=0.018); 含药血清+Compound C组Beclin-1相对表达量低于空白组(LSD-t=26.840,P=0.000)。含药血清组、空白组p62相对表达量低于模型组、含药血清+Compound C组、Compound C组(LSD-t=3.925,P=0.017,LSD-t=3.985,P=0.019,LSD-t=0.016,P=0.001; LSD-t=3.149,P=0.035,LSD-t=5.094,P=0.007,LSD-t=8.740,P=0.001),含药血清+Compound C组p62相对表达量低于Compound C组(LSD-t=3.455,P=0.026)。⑥蠲痹方含药血清对大鼠软骨细胞AMPK/mTOR信号通路影响的检测结果。含药血清组p-AMPK相对表达量高于模型组、Compound C组(LSD-t=3.623,P=0.022,LSD-t=6.537,P=0.003),空白组p-AMPK相对表达量高于模型组、含药血清+Compound C组、Compound C组(LSD-t=4.149,P=0.014,LSD-t=2.791,P=0.049,LSD-t=5.734,P=0.004),含药血清+Compound C组p-AMPK相对表达量高于Compound C组(LSD-t=5.958,P=0.004)。空白组、含药血清组、含药血清+Compound C组p-mTOR相对表达量均低于模型组(LSD-t=8.722,P=0.001,LSD-t=8.849,P=0.001,LSD-t=5.558,P=0.005),含药血清组、空白组p-mTOR相对表达量均低于含药血清+Compound C组、Compound C组(LSD-t=4.201,P=0.014,LSD-t=10.030,P=0.001; LSD-t=4.879,P=0.008,LSD-t=9.782,P=0.001),含药血清+Compound C组p-mTOR相对表达量低于Compound C组(LSD-t=6.934,P=0.002)。结论:蠲痹方含药血清作用于绝经后KOA大鼠软骨细胞,可增加细胞活力,并通过上调MAPLC3β、Beclin-1的表达和抑制p62的表达增强细胞自噬能力; 其作用机制可能与促进GPR30表达,上调AMPK磷酸化水平,下调mTOR磷酸化水平,激活GPR30和AMPK/mTOR信号通路有关。
Abstract:
Objective:To observe the effects of Juanbi Fang(蠲痹方,JBF)medicated serum on autophagy of chondrocytes in postmenopausal rats with knee osteoarthritis(KOA),and to explore its mechanism.Methods:①Twenty rats were subjected to ovariectomy,transection of knee medial collateral ligament(MCL)and anterior cruciate ligament(ACL),followed by knee medial meniscectomy for inducing postmenopausal KOA.After successful modeling,15 model rats were intragastric administrated with JBF concentrate for making JBF medicated serum.②The normal rats and model rats were sacrificed and their knee cartilages were harvested for isolating and extracting chondrocytes.③The chondrocytes extracted from the model rats were divided into model group,1.25% medicated serum group,2.5% medicated serum group,5% medicated serum group,10% medicated serum group,and 20% medicated serum group.Except for the model group,the chondrocytes in the other groups were intervened with JBF medicated serum in their corresponding volume fraction for consecutive 24 hours.After the end of intervention,the viability of chondrocytes in each group was detected,and the optimal acting concentration of the JBF medicated serum was screened.④The chondrocytes extracted from the model rats were assigned into model group,1.25% medicated serum group,2.5% medicated serum group,5% medicated serum group,and 10% medicated serum group,and the chondrocytes from the normal rats were taken as blank group.Except for the model group and blank group,the chondrocytes in other 4 groups were intervened with JBF medicated serum in their corresponding volume fraction for consecutive 24 hours.After the end of intervention,the relative expression level of G protein-coupled receptor 30(GPR30)in chondrocytes was detected by using Western blotting assay.⑤The chondrocytes extracted from the model rats were divided into model group,medicated serum group,medicated serum+Compound C group,and Compound C group,and the chondrocytes from the normal rats were taken as blank group.Except for the model group and blank group,the chondrocytes in medicated serum group,medicated serum+Compound C group,and Compound C group were intervened with 10% JBF medicated serum,10% JBF medicated serum combined with Compound C,and Compound C,respectively,for consecutive 24 hours.After the end of intervention,the relative expression levels of autophagy-related protein microtubule-associated protein light chain 3 beta(MAPLC3β),Beclin-1 and p62,as well as the relative expression levels of AMP-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR)signaling pathway-related protein phosphorylated AMP-activated protein kinase(p-AMPK)and phosphorylated mammalian target of rapamycin(p-mTOR)in chondrocytes was detected by using Western blotting assay.Results:①Eight weeks after the modeling,the coarse or defective cartilage on the knee surface,narrowed joint space,and proliferated synovial membrane were observed in the model rats,which suggested the models were successfully built.②The primary cells were stained with toluidine blue,and the intracellular typeⅡcollagen was detected by immunofluorescence staining,the results showed that the extracted cells were indicated as chondrocytes.③The chondrocyte viability was higher in 5%,10%,and 20% medicated serum group compared to 1.25%,2.5% medicated serum group and model group(LSD-t=6.767,P=0.003,LSD-t=7.666,P=0.002,LSD-t=5.091,P=0.007; LSD-t=5.080,P=0.007,LSD-t=6.690,P=0.003,LSD-t=3.433,P=0.027; LSD-t=7.590,P=0.002,LSD-t=8.200,P=0.001,LSD-t=6.031,P=0.004),and was higher in 10% medicated serum group compared to 5% and 20% medicated serum group(LSD-t=3.204,P=0.033,LSD-t=4.671,P=0.010).④The relative expression level of GPR30 in chondrocytes was lower in model group compared to blank group,5%,and 10% medicated serum group(LSD-t=5.695,P=0.005,LSD-t=5.400,P=0.006,LSD-t=9.006,P=0.001),and was higher in 5% and 10% medicated serum group compared to 1.25% medicated serum group(LSD-t=2.782,P=0.049,LSD-t=4.473,P=0.011),and was higher in 10% medicated serum group compared to 2.5% medicated serum group(LSD-t=4.544,P=0.011).⑤The relative expression level of MAPLC3β was lower in model group,medicated serum+Compound C group,and Compound C group compared to blank group and medicated serum group(LSD-t=6.855,P=0.002,LSD-t=8.675,P=0.001; LSD-t=5.096,P=0.007,LSD-t=5.931,P=0.004; LSD-t=5.560,P=0.005,LSD-t=5.354,P=0.006),and was lower in model group and Compound C group compared to medicated serum+Compound C group(LSD-t=4.627,P=0.010,LSD-t=8.677,P=0.001).The relative expression level of Beclin-1 was lower in model group and Compound C group compared to blank group,medicated serum group,and medicated serum+Compound C group(LSD-t=12.912,P=0.000,LSD-t=7.401,P=0.002,LSD-t=5.360,P=0.006; LSD-t=2.950,P=0.042,LSD-t=5.484,P=0.005,LSD-t=3.903,P=0.018),and was lower in medicated serum+Compound C group compared to blank group(LSD-t=26.840,P=0.000).The relative expression level of p62 was lower in medicated serum group and blank group compared to model group,medicated serum+Compound C group,and Compound C group(LSD-t=3.925,P=0.017,LSD-t=3.985,P=0.019,LSD-t=0.016,P=0.001; LSD-t=3.149,P=0.035,LSD-t=5.094,P=0.007,LSD-t=8.740,P=0.001),and was lower in medicated serum+Compound C group compared to Compound C group(LSD-t=3.455,P=0.026).⑥The relative expression level of p-AMPK was higher in medicated serum group compared to model group and Compound C group(LSD-t=3.623,P=0.022,LSD-t=6.537,P=0.003),and was higher in blank group compared to model group,medicated serum+Compound C group,and Compound C group(LSD-t=4.149,P=0.014,LSD-t=2.791,P=0.049,LSD-t=5.734,P=0.004),and was higher in medicated serum+Compound C group compared to Compound C group(LSD-t=5.958,P=0.004).The relative expression level of p-mTOR was lower in blank group,medicated serum group and medicated serum+Compound C group compared to model group(LSD-t=8.722,P=0.001,LSD-t=8.849,P=0.001,LSD-t=5.558,P=0.005),and was lower in medicated serum group and blank group compared to medicated serum+Compound C group and Compound C group(LSD-t=4.201,P=0.014,LSD-t=10.030,P=0.001; LSD-t=4.879,P=0.008,LSD-t=9.782,P=0.001),and was lower in medicated serum+Compound C group compared to Compound C group(LSD-t=6.934,P=0.002).Conclusion:JBF medicated serum can increase the viability of chondrocytes and enhance the autophagy ability of chondrocytes via up-regulating the expression of MAPLC3β and Beclin-1 and inhibiting the expression of p62 in postmenopausal rats with KOA.It may work by promoting the expression of GPR30,up-regulating the phosphorylation level of AMPK,down-regulating the phosphorylation level of mTOR,and activating signaling pathways of GPR30 and AMPK/mTOR.

参考文献/References:

[1] HUNTER D J,BIERMA-ZEINSTRA S.Osteoarthritis[J].Lancet,2019,393: 1745-1759.
[2] SOFAT N.Analysing the role of endogenous matrix molecules in the development of osteoarthritis[J].Int J Exp Pathol,2009,90(5):463-479.
[3] PRIMORAC D,MOLNAR V,ROD E,et al.Knee Osteoarthritis:a review of pathogenesis and state-of-the-art non-operative therapeutic considerations[J]. Genes(Basel),2020,11(8):854.
[4] LOESER R F,GOLDRING S R,SCANZELLO C R,et al.Osteoarthritis:a disease of the joint as an organ[J]. Arthritis Rheum,2012,64(6):1697-1707.
[5] 王欢,孙贺,张耀南,等.中国40岁以上人群原发性膝骨关节炎各间室患病状况调查[J].中华骨与关节外科杂志,2019,12(7):528-532.
[6] SRIKANTH V K,FRYER J L,ZHAI G,et al.A meta-analysis of sex differences prevalence,incidence and severity of osteoarthritis[J].Osteoarthritis Cartilage,2005,13(9):769-781.
[7] CHARLIER E,DEROYER C,CIREGIA F,et al.Chondrocyte dedifferentiation and osteoarthritis(OA)[J].Biochem Pharmacol,2019,165:49-65.
[8] FAVERO M,BELLUZZI E,TRISOLINO G,et al.Inflammatory molecules produced by meniscus and synovium in early and end-stage osteoarthritis:a coculture study[J].J Cell Physiol,2019,234(7):11176-11187.
[9] MOBASHERI A,RAYMAN M P,GUALILLO O,et al.The role of metabolism in the pathogenesis of osteoarthritis [J].Nat Rev Rheumatol,2017,13(5):302-311.
[10] KLIONSKY D J,ABDALLA F C,ABELIOVICH H,et al.Guidelines for the use and interpretation of assays for monitoring autophagy[J].Autophagy,2012,8(4):445-544.
[11] SHAPIRO I M,LAYFIELD R,LOTZ M,et al.Boning up on autophagy:the role of autophagy in skeletal biology[J].Autophagy,2014,10(1):7-19.
[12] 王军威,朱添,郭小兰,等.关节镜手术联合蠲痹胶囊治疗膝骨性关节炎[J].长春中医药大学学报,2019,35(4):693-696.
[13] 楚向东,李玥.关节镜结合内服蠲痹胶囊为主治疗膝骨关节炎的临床观察[J].陕西中医,2015,36(8):995-997.
[14] 袁普卫,李小群,康武林,等.蠲痹胶囊对膝骨关节炎豚鼠关节软骨组织形态及滑膜中Toll样受体4、NF-κB p65及肿瘤坏死因子-α表达的影响[J].中医正骨,2016,28(9):5-12.
[15] 刘献祥,李西海,周江涛.改良Hulth造模法复制膝骨性关节炎的实验研究[J].中国中西医结合杂志,2005,25(12):1104-1108.
[16] 黄继汉,黄晓晖,陈志扬,等.药理试验中动物间和动物与人体间的等效剂量换算[J].中国临床药理学与治疗学,2004,9(9):1069-1072.
[17] 许学猛,刘文刚,许树柴,等.膝骨关节炎(膝痹)中西医结合临床实践指南[J].实用医学杂志,2021,37(22):2827-2833.
[18] 胡兴律,冯伟,袁普卫,等.蠲痹胶囊治疗早期膝骨性关节炎45例临床观察[J].中国民族民间医药,2014,23(21):43-44.
[19] 成冬,郭磊,姜天龙,等.17β-雌二醇通过GPR30和PI3K/Akt信号通路影响ATDC5软骨细胞线粒体自噬的机制[J].中国医科大学学报,2019,48(4):289-294.
[20] LI M,ZHANG L,LIU Z,et al.Sanse powder essential oil nanoemulsion negatively regulates trpa1 by ampk/mtor signaling in synovitis:knee osteoarthritis rat model and fibroblast-like synoviocyte isolates[J].Mediators Inflamm,2021,2021:4736670.
[21] DONG J,ZHANG J, LI G C,et al.CDDO-Im ameliorates osteoarthritis and inhibits chondrocyte apoptosis in mice via enhancing Nrf2-dependent autophagy[J].Acta Pharmacol Sin,2022,43(7):1793-1802.
[22] VALENTI M T,DALLE CARBONARE L,ZIPETO D,et al.Control of the autophagy pathway in osteoarthritis:key regulators,therapeutic targets and therapeutic strategies[J].Int J Mol Sci,2021,22(5):2700.
[23] LUO P,GAO F,NIU D,et al.The role of autophagy in chondrocyte metabolism and osteoarthritis:a comprehensive research review[J].Biomed Res Int,2019,2019:5171602.
[24] SHIMODA M,ODA S,SHIBATA M,et al.Change in regional cerebral blood flow following glycerol administration predicts.Clinical result from shunting in normal pressure hydrocephalus[J]. Acta Neurochir(Wien),1994,129(3/4):171-176.
[25] YAN Y,ZHOU XE,XU H E,et al.Structure and physiological regulation of AMPK[J].Int J Mol Sci,2018,19(11):3534.
[26] YAO Q,WU X,TAO C,et al.Osteoarthritis:pathogenic signaling pathways and therapeutic targets[J].Signal Transduct Target Ther,2023,8(1):56.
[27] SAXTON R A,SABATINI D M.mTOR signaling in growth,metabolism,and disease[J].Cell,2017,169(2):361-371.
[28] SARBASSOV D D,GUERTIN D A,ALI S M,et al.Phosphorylation and regulation of Akt/PKB by the rictor-mTOR complex[J]. Science,2005,307(5712):1098-1101.
[29] CARAMéS B,HASEGAWA A,TANIGUCHI N,et al.Autophagy activation by rapamycin reduces severity of experimental osteoarthritis[J].Ann Rheum Dis,2012,71(4):575-581.
[30] LEIDAL A M,LEVINE B,DEBNATH J.Autophagy and the cell biology of age-related disease[J].Nat Cell Biol,2018,20(12):1338-1348.
[31] LI Z,LIU L,YANG Y,et al.Metformin ameliorates sene-scence of adipose-derived mesenchymal stem cells and attenuates osteoarthritis progression via the ampk-dependent autophagy pathway[J].Oxid Med Cell Longev,2022,2022:4620254.

相似文献/References:

[1]樊庆阳,任凯晶.定制3D打印切模辅助全膝关节置换术治疗 膝骨关节炎合并股骨干骨折畸形愈合[J].中医正骨,2015,27(11):37.
[2]刘晓雅,孙永强,刘国杰.主动快速康复锻炼对全膝关节置换术后关节活动度的影响[J].中医正骨,2015,27(09):73.
[3]郑春松,叶蕻芝,李西海,等.透骨消痛胶囊中补肾柔肝药和活血祛风药治疗 骨关节炎作用方式的计算机模拟比较[J].中医正骨,2015,27(07):6.
 ZHENG Chunsong,YE Hongzhi,LI Xihai,et al.Comparison of the mode of action of Bushen Rougan(补肾柔肝)drugs versus Huoxue Qufeng(活血祛风)drugs contained in Tougu Xiaotong Jiaonang(透骨消痛胶囊)for the treatment of osteoarthritis:A computer simulation study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):6.
[4]宋兵华,孙俊英,倪增良,等.全膝关节置换术前CT测量股骨后髁角的临床意义[J].中医正骨,2015,27(07):38.
[5]郑春松,叶蕻芝,李西海,等.独活寄生汤含药血清对白细胞介素1β诱导的 退变关节软骨细胞中基质金属蛋白酶 和环氧化酶2表达的影响[J].中医正骨,2015,27(12):1.
 ZHENG Chunsong,YE Hongzhi,LI Xihai,et al.Impact of Duhuo Jisheng Tang(独活寄生汤)medicated serum on expression of matrix metalloproteinase and cyclooxygenase 2 in degenerative articular chondrocytes induced by interleukin-1 beta[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):1.
[6]王金良,孙京涛,李玲,等.骨水泥联合螺钉修复全膝关节置换术中 胫骨平台内侧骨缺损[J].中医正骨,2015,27(12):55.
[7]冯荣,王平,李炳奇,等.铍针刺络拔罐结合中药口服治疗膝骨关节炎合并 原发性血小板增多症1例[J].中医正骨,2015,27(12):73.
[8]蔡云仙.围手术期耳穴按压联合平衡针疗法 在全膝关节置换术后镇痛中的应用[J].中医正骨,2015,27(06):41.
[9]张荣,王健.人工全膝关节置换术的围手术期心理护理[J].中医正骨,2015,27(05):77.
[10]喻长纯,杨明路,王战朝.不同手术方式治疗胫骨平台骨折畸形愈合的体会[J].中医正骨,2015,27(03):37.
[11]孟维娜,明立功,王新德,等.关节镜下清理联合腓骨近1/3段截骨治疗膝骨关节炎[J].中医正骨,2015,27(11):40.
[12]明立功,孟维娜,王新德,等.腓骨近端截骨治疗内侧间室膝骨关节炎的近期疗效观察[J].中医正骨,2015,27(10):25.
[13]张杰,王人彦,张玉柱.膝骨关节炎的治疗进展[J].中医正骨,2015,27(10):68.
[14]梁朝,蔡静怡,闫立,等.针刀疗法改善膝骨关节炎早期疼痛症状的疗效评价[J].中医正骨,2015,27(09):9.
 LIANG Zhao,CAI Jingyi,YAN Li,et al.Evaluation of the curative effect of needle-knife therapy for relieving knee pain in patients with early knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):9.
[15]王建武,党建军,李强,等.四联疗法治疗膝骨关节炎[J].中医正骨,2015,27(08):44.
[16]刘红娟,郭会利,郭树农.云克联合中药治疗膝骨关节炎的护理[J].中医正骨,2015,27(08):75.
[17]陈卫衡.探索建立系统的膝骨关节炎中医临床科研范式 和理论体系[J].中医正骨,2015,27(07):1.
[18]帅波,沈霖,杨艳萍,等.加味青娥丸治疗膝骨关节炎的作用机制研究[J].中医正骨,2015,27(07):15.
 SHUAI Bo,SHEN Lin,YANG Yanping,et al.Study on the mechanism of action of Jiawei Qing'e Wan(加味青娥丸)for the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):15.
[19]梅其杰,袁长深,段戡,等.壮药骨痹方烫熨联合运动疗法治疗膝骨关节炎的临床研究[J].中医正骨,2015,27(07):27.
 MEI Qijie,YUAN Changshen,DUAN Kan,et al.Clinical study of the curative effect of hot compressing and rubbing with packet of Gubi Fang(骨痹方)combined with exercise therapy in the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):27.
[20]王丹辉,张燕,刘丽娟,等.重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白 关节腔注射联合中药薰洗治疗膝骨关节炎的临床研究[J].中医正骨,2015,27(07):31.
 WANG Danhui,ZHANG Yan,LIU Lijuan,et al.Clinical study on intra-articular injection of TypeⅡrecombinant human tumor necrosis factor receptor-Fc fusion protein combined with Chinese herbal steaming and washing therapy for treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):31.

备注/Memo

备注/Memo:
基金项目:陕西省教育厅青年创新团队建设科研计划项目(21JP035); 陕西省教育厅服务地方专项计划项目(21JC010); 咸阳市重点研发计划项目(2019k01-53)
通讯作者:袁普卫 E-mail:spine_surgeon@163.com
更新日期/Last Update: 1900-01-01