“骨肉不相亲”理论探讨针刺对绝经后骨质疏松的作用机制
The effect of acupuncture on postmenopausal osteoporosis based on the theory of disharmony between bone and muscle
  
DOI:10.3969/j.issn.1006-7108.2025.03.007
中文关键词:  绝经后骨质疏松症  针刺  骨肉不相亲  血流  氧化应激
英文关键词:postmenopausal osteoporosis  acupuncture  disharmony between bone and muscle  blood flow  oxidative stress
基金项目:国家自然科学基金(8206150574);云南省 2020 年高层次中医药领军人才(云卫中医发展发〔2021〕1号);云南省“万人计划”名医专项(YNWR-MY-2018-052);云南省教育厅科学研究基金项目(2023Y0431)
作者单位
余顺1 董芹作2 尹国臣1 张君宝1 贺明1 何喆1 孙玉环1 张刘美3 李加成4 赵荣2* 邢利威2* 1.云南中医药大学第二临床医学院云南 昆明 650500 2.云南中医药大学第一临床医学院云南 昆明 650500 3.云南省昭通市盐津县盐井镇卫生院云南 昭通 657599 云南省文山壮族自治州广南县坝美镇堂上卫生院中医科云南 文山 663318 
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中文摘要:
      目的 基于肌肉与骨骼系统的密切关系与相互作用探讨健脾益肾强骨针法在去卵巢骨质疏松模型大鼠中的作用及其机制。方法 将24只SD雌鼠随机分为空白组、模型组、药物组、针刺组,每组各6只,利用去势手术构建绝经后骨质疏松大鼠模型,模型制备成功后,药物组予以阿仑膦酸钠0.1 mL/kg,每日1次灌胃治疗,针刺组予每周3次针刺治疗。连续干预12周后,采用大鼠抓力测试仪测试前肢肌力,Micro-CT检测股骨骨密度(BMD),彩色多谱勒观察股动脉平均流速与最大峰值流速,透射电镜观察线粒体数量与形态结构,DHE染色观察活性氧(ROS)数量。结果 与空白组比较,模型组大鼠体重升高(P<0.05),股四头肌质量指数下降(P<0.05),前肢肌力降低(P<0.05),BMD下降(P<0.05),股动脉平均流速与最大峰值流速降低(P<0.05),线粒体数量增加,结构肿胀,ROS数量增加(P<0.05);与模型组比较,药物组与针刺组大鼠体重升高(P<0.05),股四头肌质量指数增加(P<0.05),前肢肌力增强(P<0.05),骨小梁密度增加(P<0.05),线粒体数量减少、结构改善,ROS数量减少(P<0.05),股动脉平均流速与最大峰值流速增快,其中针刺组差异有统计学意义(P<0.05),药物组差异无统计学意义;与药物组比较,针刺组上述各项指标差异均无统计学意义。结论 健脾益肾强骨针法可能是通过调节骨骼肌微循环血流,改善骨骼肌线粒体氧化应激,从而起到正向影响骨骼肌结构和功能而干预绝经后骨质疏松的作用。
英文摘要:
      Objective To explore the effect of acupuncture with invigorating spleen and tonifying kidney method on rat osteoporosis model based on the relationship between muscular and skeletal system. Methods Twenty-four SD female rats were randomly divided into blank group, model group, drug group, and acupuncture group, with six rats in each group. A postmenopausal osteoporosis rat model was constructed using debridement surgery. After the model was successfully prepared, rats in the drug group received alendronate 0.1 ml/kg by gavage once a day. Rats in the acupuncture group received acupuncture three times a week. After 12 consecutive weeks of intervention, bone mineral density (BMD) of the femur was observed with micro-CT. Mean flow rate and maximum peak flow rate of the femoral artery were observed with color multispectral. Mitochondrial number and morphological structure were observed with transmission electron microscopy. The amount of reactive oxygen species (ROS) was observed using DHE staining. Results Compared to those in the blank group, rats in the model group had elevated body weight (P<0.05), decreased quadriceps muscle mass index (P<0.05), forelimb grip strength (P<0.05), BMD (P<0.05), femoral artery mean flow rate and maximum peak flow rate (P<0.05), increased mitochondrial number, structural swelling, and increased ROS number (P<0.05). Compared to those in the model group, the body weight of rats in the drug group and the acupuncture group increased (P<0.05), the quadriceps muscle mass index increased (P<0.05), the forelimb muscle strength increased (P<0.05), the density of bone trabeculae increased (P<0.05), the number of mitochondria decreased and the structure improved, the number of ROS decreased (P<0.05), and the mean flow velocity of the femoral artery and the maximal peak flow velocity accelerated, with a statistically significant difference between the acupuncture group (P<0.05) and no statistically significant difference between the drug group and the acupuncture group. The difference between the drug group and the acupuncture group was not statistically significant. Conclusion The acupuncture with invigorating spleen, tonifying kidney, and strengthening bone method may regulate skeletal muscle microcirculation blood flow and relieve skeletal muscle mitochondrial oxidative stress, thus positively affecting skeletal muscle structure and function to intervene postmenopausal osteoporosis.
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