医用臭氧注射疗程对大鼠颞下颌关节骨关节炎及其疼痛作用的影响

doi:10.13591/j.cnki.kqyx.2024.05.008

摘要/Abstract

摘要：

目的探讨医用臭氧注射疗程对SD大鼠颞下颌关节骨关节炎及其疼痛作用的影响。方法按随机数字表法将54只大鼠分为对照组、模型组、医用臭氧组,每组18只。对照组在造模时仅注射生理盐水;模型组仅注射碘乙酸钠造模;医用臭氧组关节上腔注射碘乙酸钠造模1周后关节内注射医用臭氧进行干预,注射频率为1次/周,共5次。注射医用臭氧1周(造模后2周)、3周(造模后4周)、5周(造模后6周)后,各组分别处死6只大鼠。处死大鼠前检测各组大鼠机械缩头阈值,处死后检测各组大鼠关节液中白介素-1β(interleukin-1β,IL-1β)表达水平,并对各组大鼠颞下颌关节软骨大体观进行Pelletier 评分和软骨苏木精-伊红染色后进行改良Mankin’s评分。结果同一时间内:模型组相比于对照组,1、3、5周,大鼠颞下颌关节骨关节机械痛阈值减小(P<0.01),大鼠颞下颌关节液中IL-1β表达水平升高(P<0.01),颞下颌关节软骨Pelletier 评分以及软骨改良Mankin’s评分增高(P<0.01);医用臭氧组相比于模型组,注射医用臭氧3周和5周,大鼠颞下颌关节骨关节机械痛阈值升高(P<0.01),大鼠颞下颌关节液中IL-1β表达水平和颞下颌关节软骨Pelletier 评分以及软骨改良Mankin’s评分降低(P<0.01),大鼠颞下颌关节腔内注射医用臭氧1周各检测指标虽有变化但无显著性 (P>0.05)。同一组内:医用臭氧组3周和5周相比于医用臭氧组1周,大鼠颞下颌关节机械痛阈值增加(P<0.01),大鼠颞下颌关节液中IL-1β表达水平降低(P<0.01),关节软骨Pelletier 评分以及软骨改良Mankin’s评分无统计学意义(P>0.05)。医用臭氧组3周相比于医用臭氧组5周,大鼠颞下颌关节机械痛阈值、大鼠颞下颌关节液中IL-1β表达水平、关节软骨Pelletier 评分和软骨改良Mankin’s评分无统计学意义(P>0.05)。结论医用臭氧治疗3周以上可改善大鼠颞下颌关节骨关节炎及其疼痛。

关键词: 颞下颌关节, 骨关节炎, 疼痛, 医用臭氧, 疗程

Abstract:

Objective To investigate the effect of medical ozone injection therapy on temporomandibular joint (TMJ) osteoarthritis and its pain in SD rats. Methods Fifity-four rats were randomly assigned according to a random number table into three groups: control group, model group, and medical ozone group, with 18 rats in each group. In the control group, only physiological saline was injected during modeling; in the model group, only sodium iodoacetate was injected for modeling; in the medical ozone group, after injecting sodium iodoacetate into the joint cavity for modeling for one week, medical ozone was then injected into the joint cavity for intervention at a frequency of once a week, totaling 5 times. One week (week 2 after modeling), 3 weeks (week 4 after modeling), and 5 weeks (week 6 after modeling) after medical ozone injections, 6 rats from each group were euthanized. Mechanical withdrawal threshold of rats in each group was assessed before euthanasia, and the expression levels of interleukin-1β (IL-1β) in joint fluid of rats in each group were measured after euthanasia. Gross observation and modified Mankin’s scoring were performed on TMJ cartilage of rats in each group after stained with Pelletier score and Safranin O-Fast Green. Results During the same time period, compared to the control group, the model group showed a significant decrease in the mechanical pain threshold of the TMJ in rats at 1 week, 3 weeks, and 5 weeks (P<0.01). The expression levels of IL-1β in the TMJ fluid increased (P<0.01), and the Pelletier score and modified Mankin’s score of TMJ cartilage increased (P<0.01). In comparison to the model group, the medical ozone group exhibited a significant increase in the mechanical pain threshold of the TMJ in rats after 3 weeks and 5 weeks of medical ozone injections (P<0.01). The expression levels of IL-1β in the TMJ fluid decreased (P<0.01), and the Pelletier score and modified Mankin’s score of TMJ cartilage decreased (P<0.01). However, there were no statistically significant difference in the measured parameters in the TMJ cavity after 1 week of medical ozone injection (P>0.05).Within the medical ozone group, compared to the 1-week treatment, the mechanical pain threshold of the TMJ increased (P<0.01) and the expression levels of IL-1β in the TMJ fluid decreased at 3 weeks and 5 weeks (P<0.01). However, there was no statistically significant difference in the Pelletier score and modified Mankin’s score of TMJ cartilage (P>0.05) between different treatment duration.Additionally, there were no statistically significant differences in the mechanical pain threshold of the TMJ, expression levels of IL-1β in the TMJ fluid, Pelletier score, and modified Mankin’s score of TMJ cartilage between the medical ozone group at 3 weeks and 5 weeks (P>0.05). Conclusion Medical ozone treatment for more than 3 weeks can improve temporomandibular joint osteoarthritis and its associated pain in rats.

Key words: temporomandibular joint, osteoarthritis, pain, medical ozone, treatment duration

中图分类号:

R782.63

鲁彩霞, 张思敏, 尼格阿依·艾合麦提, 李雪儿, 陈泽源, 买买提吐逊·吐尔地. 医用臭氧注射疗程对大鼠颞下颌关节骨关节炎及其疼痛作用的影响[J]. 口腔医学, 2024, 44(5): 362-368.

LU Caixia, ZHANG Simin, Nigeayi·AIHEMAITI , LI Xueer, CHEN Zeyuan, Maimaitituxun·TUERDI . Effect of medical ozone injection therapy on temporomandibular joint osteoarthritis and its pain in rats[J]. Stomatology, 2024, 44(5): 362-368.

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组别	1周	3周	5周
对照组	0.00±0.00	0.00±0.00	0.17±0.41
模型组	1.33±0.52^**	2.50±0.55^**▲▲	3.00±0.71^**▲▲
医用臭氧组	1.17±0.41^**	1.33±0.52^**##	1.50±0.55^**##

组别	1周	3周	5周
空白组	0.17±0.41	0.17±0.41	0.33±0.52
模型组	5.67±0.82^**	8.83±0.75^**▲▲	9.40±0.89^**▲▲
医用臭氧组	5.17±0.75^**	5.50±1.05^**##	5.83±0.75^**##