摘要:目的:观察关节内注射参麦注射液治疗家兔膝骨关节炎的疗效。方法:以40只健康SPF级新西兰家兔为研究对象,随机分为正常对照组、模型组、参麦注射液组(以下称参麦组)、利多卡因组和参麦注射液+利多卡因组(以下称参麦+利多组)5组,每组8只,除正常对照组外,其余4组采用木瓜蛋白酶所致兔膝骨关节炎模型。正常对照组、模型组分别予关节内注射0.4mL的注射用生理盐水,参麦组注射0.4mL参麦注射液,利多卡因组注射0.4mL利多卡因,参麦+利多组注射二者混合液0.4mL,每周1次,连续8次,观察家兔步态、膝关节周径及关节液中炎症因子浓度。结果:造模后2周家兔步态除正常对照组外,其余4组造模前后步态均有明显变化(P=0.018<0.05),参麦组与参麦+利多组给药4次后步态与造模前无明显差异(P=0.021、0.012<0.05);给药8次后膝关节周径变化与正常对照组比较,模型组膝关节周长增大,差异有统计学意义(P=0.0049<0.05),参麦组有所增大,差异无统计学意义(P=0.13>0.05),利多卡因组明显增大,差异有统计学意义(P=0.029<0.05),参麦+利多组减小,但差异无统计学意义(P=0.77>0.05);局部炎症因子水平结果与正常对照组比较,模型组IL-1β、IL-6、TNF-α水平均升高,差异有统计学意义(P=0.023,0.001,0.014<0.05),参麦组有所升高,差异无统计学意义(P=0.061,0.13,0.527>0.05),利多卡因组明显升高,差异有统计学意义(P=0.031,0.008,0.025<0.05),参麦+利多组有所升高,但差异无统计学意义(P=0.087,0.17,0.18>0.05)。结论:关节内注射参麦注射液能明显改善模型兔步态,消除膝关节肿胀,同时可以降低关节液的炎症因子如IL-1β、IL-6、TNF-α水平。%Objective:To evaluate the safety and efficacy of intra articular injection of shenmai injection in treating knee osteoarthritis.Methods:40 healthy SPF new zealand rabbits were induced into the knee-osteoarthritis models by papain and randomly and equally divided into 5 groups:the normal group,the model group,the shenmai injection group(the shenmai group),the lidocaine group and the shenmai injection and lidocaine group(the shenmai + droperidol group).The normal group and the model groups were given intra-articular injection of normal saline(0.4 mL),the Shenmai group were given injection of Shenmai of shenmai and droperidol(0.4 mL),1 time a week for 8 weeks for above groups,observing their gait,the knee circumference and the inflammation factor concentration in the synovial fluid.Results:2 weeks after modeling,the rabbit gait but that of the normal group changed obviously(P= 0.018<0.05).The gait of the shenmai injection group and the shenmai+droperidol group had no obvious change after 4 times of administration than that before modeling(P=0.021,0.012<0.05).The knee circumference of the model group enlarged after 8 times of administration compared with the normal group,the difference being statistically significant(P=0.0049<0.05),that of the shenmai group also enlarged,having no significant difference(P=0.13>0.05),that of the lidocaine group increased obviously,the difference being statistically significant(P=0.029<0.05),but that of the shenmai+droperidol group decreased,the difference being not statistically significant(P=0.77>0.05). As for the local inlfammatory factor levels compared with the normal group,IL-1 β,IL-6,TNF-α levels of the model group increased,the difference being statistically signiifcant(P=0.023,0.001,0.014<0.05),of the shenmai group a little increased,without significant difference(P=0.061,0.13,0.527>0.05),of the lidocaine group increased significantly,the difference being statistically significant(P=0.031,0.008,0.025<0.05),and of the shenmai+droperidol group increased,but the difference being not statistically significant(P=0.087,0.17,0.18>0.05). Conclusion:Intra articular injection of shenmai injection could obviously improve the gait of rabbit model,eliminate the knee joint swelling,and reduce the level of inlfammatory factors in the synovial lfuid such as IL-1β,IL-6 and TNF-α.