低强度脉冲超声波治疗冻结肩模型兔的实验研究

doi:10.3877/cma.j.issn.2095-5790.2023.01.006

中华肩肘外科电子杂志 ›› 2023, Vol. 11 ›› Issue (01) : 30 -34. doi: 10.3877/cma.j.issn.2095-5790.2023.01.006

论著

低强度脉冲超声波治疗冻结肩模型兔的实验研究

蒋梦洁¹, 钱治军², 徐思³, 梁伟⁴^,^†(

)

^1. 200043　上海，海军军医大学长海医院检验科
^2. 200043　上海，海军军医大学长海医院医务处
^3. 200043　上海，海军军医大学长海医院病理科
^4. 200043　上海，海军军医大学长海医院创伤骨科

收稿日期:2022-09-15 出版日期:2023-02-05
通信作者: 梁伟
基金资助:
虹口区卫健委重点科研基金(虹卫1702-10)

Experimental study on the treatment of frozen shoulder model Rabbit with low-intensity pulsed ultrasound

Mengjie Jiang¹, Zhijun Qian², Si Xu³, Wei Liang⁴^,^†()

^1. Department of Clinical Laboratory, Changhai Hospital, Naval Medical University, Shanghai 200043, China
^2. Department of Medical Affarir, Changhai Hospital, Naval Medical University, Shanghai 200043, China
^3. Department of Pathology, Changhai Hospital, Naval Medical University, Shanghai 200043, China
^4. Department of Orthopaedic Trauma, Changhai Hospital, Naval Medical University, Shanghai 200043, China

Received:2022-09-15 Published:2023-02-05
Corresponding author: Wei Liang

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目的

探讨低强度脉冲超声波（low-intensity pulsed ultrasound, LIPUS）对冻结肩模型兔的疗效和机制。

方法

将60只雌性新西兰兔随机分为空白对照组、模型组和LIPUS治疗组。采用持续劳损并且冰敷的方法制作冻结肩模型后，观察患肩周围组织的病理变化，并检测血清中的转化生长因子-β1（transforming growth factor-β, TGF-β1）、前列腺素-E2（prostaglandin E2, PGE-2）及羟脯氨酸（hydroxyproline，HYP）的含量。

结果

采用多组资料的单项方差分析方法进行统计分析，发现LIPUS治疗组中TGF-β1、PGE-2、HYP含量较模型组明显降低，而模型组中含量较空白对照组明显增高，差异均有统计学意义（P<0.05）。病理切片结果显示治疗组患肩滑膜增生和肌腱纤维增生程度改善，组织修复加速。

结论

LIPUS通过降低新西兰兔冻结肩周围组织中TGF-β1、PGE-2、HYP含量，达到抗炎镇痛效果，值得在临床中推广使用。

关键词: 低强度脉冲超声波, 冻结肩, 转化生长因子-β1, 前列腺素-E2, 羟脯氨酸

Background

Diffuse shoulder pain and shoulder joint mobility disorder are the main clinical manifestations of a frozen shoulder. It often occurs on the shoulder of middle-aged and older adults. The lesion involves the shoulder, joint bursae, and other soft tissues. The incidence of frozen shoulder is 2%-5%, but its pathogenesis is unknown, and there are many limitations and poor curative effects in current treatment methods. Therefore, further understanding its pathogenesis and exploring new therapies to improve the quality of life of patients with frozen shoulders is of great significance. Animal and clinical trials have demonstrated that low-intensity pulsed ultrasound (LIPUS) can accelerate fracture healing and promote the repair of other connective tissue injuries, such as muscles, tendons, cartilage, ligaments, etc. So far, no reports have been found about the effect of LIPUS on frozen shoulder animal models. Objective To investigate the effect and mechanism of LIPUS on frozen shoulder model rabbits.

Methods

Sixty female New Zealand rabbits were randomly divided into a control group, a model group, and a LIPUS treatment group. After the frozen shoulder model was made by the method of continuous strain and ice compress, the pathological changes of the tissues around the affected shoulder were observed, and the contents of transforming growth factor-β1 (TGF-β1), prostaglandin-E2 (PGE-2) and hydroxyproline (HYP) in serum were detected.

Results

With a single variance analysis of multiple data groups, it was found that the contents of TGF-β1, PGE-2, and HYP in the LIPUS treatment group were significantly decreased compared with the model group. In contrast, the contents in the model group were significantly increased compared with the blank control group, with statistically significant differences (P < 0.05). The results of the pathological section showed that the degree of synovial hyperplasia and tendon fiber hyperplasia were improved in the treatment group, and the tissue repair was accelerated.

Conclusion

LIPUS can achieve anti-inflammatory and analgesic effects by reducing the contents of TGF-β1, PGE-2, and HYP in the frozen shoulder tissues of New Zealand rabbits, which is worth promoting in clinical use.

Key words: Low intensity pulsed ultrasound, Frozen shoulder, Transforming growth factor-β1, Prostaglandin E-2, Hydroxyproline

表1 三组新西兰兔血清中TGF-β1、PGE-2、HYP的变化（±s）

组别	例数	TGF-β1	PGE-2	HYP
对照组	20	13.24±1.13	14.27±l.01	71.47±3.39
模型组	20	25.44±2.01	39.16±9.50	139.66±10.34
治疗组	20	22.07±1.07	26.74±4.59	116.52±6.75
F值		369.058	82.839	440.282
P值		<0.05	<0.05	<0.05

表1 三组新西兰兔血清中TGF-β1、PGE-2、HYP的变化（±s）

组别	例数	TGF-β1	PGE-2	HYP
对照组	20	13.24±1.13	14.27±l.01	71.47±3.39
模型组	20	25.44±2.01	39.16±9.50	139.66±10.34
治疗组	20	22.07±1.07	26.74±4.59	116.52±6.75
F值		369.058	82.839	440.282
P值		<0.05	<0.05	<0.05

图1 对照组低倍镜（×40）

图2 对照组高倍镜（×400）

图3 模型组低倍镜（×40）

图4 模型组高倍镜（×400）

图5 治疗组低倍镜（×40）

图6 治疗组高倍镜（×400）

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Experimental study on the treatment of frozen shoulder model Rabbit with low-intensity pulsed ultrasound

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