课题背景：中医外治法治疗运动创伤性骨关节炎后检测碱性成纤维细胞生长因子在兔关节滑膜中的表达及分布，观察中医外治对运动创伤性关节炎治疗作用的机制。

偏倚或不足：实验对照模型未进行安慰剂对照以及未采用双盲法可能对结果有一定影响。如果检测碱性成纤维细胞生长因子在兔关节软骨或软骨和滑膜中的表达及分布将更直接，更有意义。在治疗上采用内外兼治会更好。

相关链接：碱性成纤维细胞生长因子能够诱导外胚层和中胚层来源的细胞增殖及分化，具有强大的促有丝分裂作用，在软骨损伤后的修复中有很重要的作用。但动物研究显示使用碱性成纤维细胞生长因子可增加损伤后感染的机会，且过多的碱性成纤维细胞生长因子还促进软骨基质分解，因此如何避免这些问题值得关注。

摘要
目的:实验拟验证外治法治疗运动创伤性关节炎模型兔膝关节滑膜中碱性成纤维细胞生长因子的表达，探讨中医外治法治疗运动创伤性关节炎的可能机制。
方法：实验于2006-01/06在广州体育学院和南方医科大学内分泌实验室完成。①实验分组：普通级健康雄性新西兰大耳白兔24只，体质量2.1~2.6 kg；随机数字表法分为正常组、模型组和外治法组，每组8只。②实验方法：以Hulth模型制备运动创伤性关节炎模型。造模8周后外治法组用中药熏蒸配合手法弹拨以及电刺激治疗4周。③实验评估：4周后每组取部分切片行常规苏木精-伊红染色；另每组取部分石蜡切片行免疫组织化学SABC法观察实验动物膝关节滑膜碱性成纤维细胞生长因子的表达。
结果：纳入健康雄性新西兰大耳白兔24只，均进入结果分析。①滑膜组织结构变化：正常组滑膜无增生肥厚，滑膜组织苏木精-伊红染色见纤维细胞排列均匀、规则；关节软骨外观呈蓝白色，无裂纹及溃疡。模型组滑膜充血、部分粘连，苏木精-伊红染色见滑膜绒毛肥厚与纤维样化；关节软骨失去原有的光泽。外治法组的关节软骨皆仍有光泽，略发黄，软骨表面无明显的裂纹、糜烂及溃疡形成。②滑膜组织中细胞因子变化：碱性成纤维细胞生长因子免疫组织化学检测平均吸光度正常组为0.126 1±0.029 0，模型组为0.238 6±0.040 0，与外治法组0.513 5±0.038 0相比较，差异显著（P < 0.01）。
结论：外治法能够促进实验动物膝关节滑膜细胞碱性成纤维细胞生长因子的表达，以及受损软骨的修复。
关键词：运动创伤性关节炎；外治法；碱性成纤维细胞生长因子；组织构建

廖八根，徐勇，高鹏吉. 中医外治法干预运动创伤性膝关节炎模型兔膝关节滑膜中碱性成纤维细胞生长因子的表达[J].中国组织工程研究与临床康复，2008，12(11):2047-2050 [www.zglckf.com/zglckf/ejournal/upfiles/08-11/11k-2047(ps).pdf]

External treating therapy influences basic fibroblast growth factor expression in the knee synovium of rabbits with sports traumatic arthritis

Abstract

AIM：The study was to explore the expression of basic fibroblast growth factor (bFGF) in the synovial tissue of experimental sports traumatic arthritis in rabbit knee with treatment of external treating therapy (ETT) and to investigate possible mechanism of ETT for sports traumatic arthritis.
METHODS: The experiment was conducted at the Guangzhou Institute of Physical Education and Laboratory of Endocrinology of Southern Medical University from January to June 2006. ①A total of 24 healthy male New Zealand rabbits, were randomized into 3 groups ( 8 in each group), a normal group, model group and ETT group. ②The model of sports traumatic arthritis was developed by Hulth technique. At the end of 8th week after modeling, rabbits in the ETT group received additional Chinese herb in combination with manipulation and eletrostimulation for 4 weeks. ③ After 4 weeks of therapy, some synovia were analyzed for microscopic morphology using hematoxylin-eosin (HE) staining, and some for the expression of bFGF using SABC immunohistochemic staining.
RESULTS: All 24 rabbits were involved in the final analysis. ①In normal group, there were no hyperplasia in synovium, and HE staining showed regular array of fiber cells. The surface of articular cartilage exhibited blue-white, and no fissuring or ulcer. In model group, there were obvious congestion and adhesion in the synovium, and HE staining showed fiber tissue hyperplasia and fibrosis. Articular cartilage lost original luminosity. In the ETT group, articular cartilage showed luminous, mild yellow, no fissuring or ulcer. ②Average absorbance (A) was 0.126 1±0.029 0 in the normal group, 0.238 6±0.040 0 in the model group, 0.513 5±0.038 0 in the ETT group respectively and there was a significant differences compared to the ETT group (P < 0.01).
CONCLUSION: ETT increases the expression of bFGF in the synovium of experimental sports traumatic arthritis in rabbit knee, and promote the repair of injured articular cartilage with sports traumatic arthritis.

Liao BG, Xu Y, Gao PJ. External treating therapy influences basic fibroblast growth factor expression in the knee synovium of rabbits with sports traumatic arthritis.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(11):2047-2050(China)
[www.zglckf.com/zglckf/ejournal/upfiles/08-11/11k-2047(ps).pdf]