| BackgroundOsteonecrosis of the femoral head is a progressive and difficult orthopaedic disease.In the early stage of osteonecrosis of the femoral head,due to the pain in the hip,the patient is afraid to move the hip joint,which causes the patient to have joint mobility impairment.In the absence of intervention,symptoms such as pain and limitation of activity continue to worsen,resulting in loss of labor and a sharp decline in quality of life.Therefore,how to actively and effectively relieve the above symptoms in the early stage,delay the development of femoral head necrosis,and meet the patients’ demands for a high-quality life is of great social significance.Visual needle-knife is based on the MR/CT image fusion technology to visualize the traditional needle-knife.On the basis of retaining the advantages of less trauma and less bleeding,it makes up for the blind operation of the traditional acupotomy,the curative effect is not fixed,and the operation is difficult to repeat.Clinical studies have also confirmed that compared with traditional needle-knife,visual needle-knife has obvious therapeutic advantages,but its mechanism is still unknown and needs scientific evidence to support it.ObjectiveVisual needle-knife was used to release the lesioned soft tissue around the hip joint.To observe the effect of visual needle on the myofascial trigger points of osteonecrosis of the femoral head model in Beagle dogs,the morphological changes of surrounding soft tissue,the inflammatory factors of IL-1β,IL-6,TNF-α,and the vasomotor factors of ET-1,HIS,NA,NO,and CGRP in serum,to explore the mechanism of visual needle knife to improve the pain of osteonecrosis of the femoral head,and to provide a theoretical basis for the clinical application of Traditional Chinese Medicine external therapy in the treatment of osteonecrosis of the femoral head.MethodEstablishment of the myofascial trigger points of osteonecrosis of the femoral head model in Beagle dogs by liquid nitrogen freezing and centrifugal exercise,and they were randomly divided into the sham group,the model group,the traditional needle-knife group and the visual needle-knife group.Animals in Sham group and model group were kept and moved normally.Traditional needle-knife group:At the 13th week after modeling,traditional needle-knife treatment was given,once a week,three times a course of treatment,for a total of three weeks.Visual needle-knife group:At the 13th week after modeling,visual needle-knife treatment was given,once a week,three times a course of treatment,for a total of three weeks.At the three time points before the experiment,the 12th week(after modeling)and the 15th week(after treatment),the general activities,dietary changes,mental state,posture,barking and hip joint activities of beagles in each group was observed by the same experimenter.The tissue around the hip joint was observed by hematoxylin-eosin staining.Elisa method was used to detect the expression of inflammatory factors such as IL-1β,IL-6,and TNF-α in serum and the expression of vasomotor factors such as ET-1,HIS,NA,NO and CGRP.Results1.Study on behavior and histomorphology of the myofascial trigger points of osteonecrosis of the femoral head model in beagle Dogs by visual needle-knifeBy observing the general activities,diet changes,mental state,posture,barking and hip joint activities of the four groups of beagle dogs at three time points(the start of the experiment,at the end of the modeling,after the end of the treatment).the results were obtained:the Sham group were active,had normal diet,coordination of limbs,no obvious resistance when passively moving the hip joint,and no obvious pain response.The model group showed mental fatigue,showed a state of high alert,and had a certain aggressiveness.They showed that the affected limb could not kick the ground,had difficulty walking,and the pain response was obvious.The traditional needle-knife group and the visual needle-knife showed the same performance as the model group at the end of the modeling.The condition improved after intervention treatment,and the performance tended to be the same as the Sham group,and the effect of visual needle-knife is better than that of traditional needle knife.The hematoxylin-eosin stained sections of the tissue around the hip joint were observed under a light microscope,and it was found that:in the Sham group,the cytoplasm was evenly stained,and the nuclei were neatly arranged;the muscle fibers were tightly arranged,the gap was small,and there was no muscle fiber rupture,abundant blood vessels were seen,there was no obvious inflammatory cell infiltration and cellular edema.Model group:the arrangement of nuclei is disordered;the muscle fibers are loose,the gap is large,the muscle striated is blurred,and the muscle fibers are broken;local connective tissue hyperplasia.Traditional needle-knife group:the arrangement of nuclei is slightly disordered;muscle fiber gaps can be seen,and local muscle striated lines are blurred;connective tissue is slightly hyperplasia.Visual needle-knife group:cells were stained evenly,nuclei were arranged neatly;muscle fibers were closely arranged;blood vessels were abundant,and no obvious connective tissue hyperplasia was seen.2.The effect of visual needle-knife on inflammatory factors of the myofascial trigger points of osteonecrosis of the femoral head model in Beagle Dogs(1)Comparison of the contents of inflammatory factors in each group before treatment:Compared with the Sham group,the contents of IL-1β,IL-6,and TNF-αin the model group,the traditional group and the visualization group were significantly increased(P<0.05);Compared with the model group,there was no significant difference in the contents of IL-1β,IL-6 and TNF-α in the traditional group and the visualization group(P>0.05);compared with the traditional group,the contents of IL-1β,IL-6 and TNF-α in the visualization group There was no significant difference(P>0.05).(2)Comparison of the contents of inflammatory factors in serum before and after visual needle-knife treatment:compared with before treatment,the levels of IL-1β,IL-6 and TNF-α on the 7th and 21th days after treatment were significantly different(P<0.05);compared with the 7th day after treatment,there were significant differences in L-1β,IL-6 and TNF-α contents on the 21th day after treatment(P<0.05).(3)Comparison of serum inflammatory factor contents before and after traditional acupuncture treatment:compared before treatment,there were significant differences in IL-1β and IL-6 levels on the 7th and 21th day after treatment(P<0.05),but there was no significant difference in TNF-α levels on the 7th day after treatment(P>0.05).Compared with the 7th day after treatment,the L-1β and IL-6 levels on the 21th day after treatment were significantly different(P<0.05),the TNF-α content on the 21th day after treatment was not statistically significant(P>0.05).(4)Comparison of the contents of inflammatory factors between the visualization group and the traditional group after treatment:After treatment,the contents of IL-1β,IL-6 and TNF-α in the visualization group were lower than those in the traditional group,and the differences were statistically significant(P<0.05).3.The effect of visual needle-knife on vasomotor factors of the myofascial trigger points of osteonecrosis of the femoral head model in Beagle Dogs(1)Comparison of the contents of vasomotor factors in the samples of each group before treatment:compared with the Sham group,the contents of ET-1 and NA in the model group,the traditional group and the visualization group were significantly increased(P<0.05),and the contents of HIS,NO and CGRP were significantly significantly decreased(P<0.05);Compared with the model group,there was no significant difference in the contents of ET-1,HIS,NA,NO and CGRP in the traditional group and the visualization group(P>0.05);Compared with the traditional group,the contents of ET-1β HIS,NA,NO and CGRP in visualization group had no significant difference(P>0.05).(2)Comparison of the contents of vasomotor factors in serum before and after visual needle-knife treatment:compared with before treatment,the ET-1,HIS,NA,NO and CGRP levels were significantly different on the 7th and 21th day after treatment(P<0.05).Compared with the 7th day after treatment,the content of ET-1,HIS,NA,NO and CGRP on the 21th day after treatment was significantly different(P<0.05).(3)Comparison of the content of vasomotor factors in serum before and after traditional needle-knife treatment:compared with before treatment,there were statistically significant differences in the content of ET-1,HIS,NA,NO and CGRP on the 7th and 21th day after treatment(P<0.05);Compared with the 7th day after treatment,the content of ET-1,HIS,NA,NO and CGRP at the 21th day after treatment were significantly different(P<0.05).(4)Comparison of the contents of vasomotor factors between the visualization group and the traditional group after treatment:after treatment,the contents of ET-1 and NA in the visualization group were lower than those in the traditional group,and the contents of NO,HIS,CGRP and HIS were higher than those in the traditional group,the differences were statistically significant(P<0.05).Conclusions1.Needle-knife therapy is helpful to alleviate the pain and activity limitation symptoms of the myofascial trigger points of osteonecrosis of the femoral head model in Beagle Dogs,and the effect of visual needle-knife is better than that of traditional needle knife.2.Needle-knife therapy can improve the pathological changes of the myofascial trigger points of osteonecrosis of the femoral head model in Beagle Dogs,and the effect of visual needle-knife is better than that of traditional needle-knife.3.Needle-knife therapy can reduce the expression levels of inflammatory factors IL-1β,IL-6 and TNF-α in the peripheral venous blood of the myofascial trigger points of osteonecrosis of the femoral head model in Beagle Dogs,and the visual needle-knife effect is better than the traditional needle-knife.4.Needle-knife therapy can reduce the vasomotor factors ET-1,NA and increase the expression level of NO,HIS and CGRP in the peripheral venous blood of the myofascial trigger points of osteonecrosis of the femoral head model in Beagle Dogs,and the visual needle-knife effect is better than the traditional needle-knife. |
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