目的 :为临床应用“关节炎Ⅲ号”穴位贴敷治疗类风湿性关节炎时选择最佳配穴处方提供依据。方法 :大鼠足跖皮内注射福氏完全佐剂诱导关节炎模型

观察自制“关节炎Ⅲ号”不同组合穴位涂敷对模型大鼠关节炎指数、左右后肢跖围的动态变化和关节的病理变化

以及血清、脾、关节浸液中的白细胞介素 1 β(IL 1 β)与前列腺素E2 (PGE2 )的浓度变化的影响。结果 :各治疗组大鼠的关节炎指数、跖围与模型组大鼠比较均有显著降低

其中系统取穴组见效最快

远道取穴组次之

局部取穴组见效最慢。造模后大鼠关节有明显的病理改变

经治疗各组炎症级别有所下降

以系统取穴组最明显。造模后大鼠各样本的IL 1 β浓度均上升

各治疗组IL 1 β浓度与模型组比较有一定差异

但以关节浸液中的IL 1 β浓度的降低为明显

并以远道取穴的效果较好 ;不同组合穴位涂敷均能降低模型大鼠关节浸液中升高的PGE2 浓度

以局部取穴为好。结论 :“关节炎Ⅲ号”穴位涂敷对大鼠佐剂性关节炎有效与对IL 1 β和PGE2 的调节有关 ;不同组合的穴位涂敷表现出不同的疗效

其中整体疗效以系统取穴最佳

远道取穴免疫调节作用较强

局部取穴抗炎作用较好Objective:To observe the therapeutic effects of external application of "Arthritis-Ⅲ" (a Chinese medicinal herbal ointment ) to different acupoint groups in the treatment of adjuvant arthritis in the rat. Methods:Arthritis rats model was established by subcutaneous injection of complete Freund's adjuvant (CFA

0.1 mL) into the right paw. Fifty SD rats were randomly divided into remote + local acupoint group

remote acupoint group

local acupoint group

model group

and normal control group

with 10 cases in each one. Self-prepared "Arthritis-Ⅲ" ointment containing Leigongteng (Tripterygium Wilfordii) etc. was applied to "Dazhui" (GV 14)

"Shenshu" (BL 23) and "Taixi "(KI 3) for 5 min every time

twice daily

continuously for 14 days. Arthritis index (AI) was tested using Wood's method

and the plantar circumference of the hind legs of the rats was measured from the 19th day on after injection

once every 3 days. The anatomical changes of rats' paw tissues were observed based on Mosakazu's method after staining with HE technique. IL-1β and Prostaglandin (PG) E 2 concentrations in the serum and spleen and joint fluid were assayed separately. Results: On the 33rd day after injection of CFA

AI values of the 3 acupoint groups

particularly that of remote +local acupoint group

were significantly lower than that of model group (P<0.05～0.01). From the 22nd day to 31st day after injection of CFA

the plantar circumference values (right limb) of the normal control group and the 3 treatment groups (in remote acupoint group

from 25th day on

and in local acupoint group

from 31st day on) were all markedly lowered than those of model group (P<0.05～0.01). The inflammation degree of the 3 treatment groups

especially that of remote+ local acupoint group

was significantly lighter than that of model group (P<0.05). IL-1β concentrations in serum

spleen supernate and the left joint infusion of model group were higher than those of normal control group

and majority of those of the 3 treatment groups were considerably lower than those of model group (P<0.05～0.01); only those of remote acupoint group were close to those of control group (P>0.05). PGE 2 concentration value of serum in model group was considerably lower than that of normal control group

and those of the 3 treatment group were higher or apparently higher than that of model group (P<0.05). On the contrary

PGE 2 concentration value in the joint infusion of model group was markedly higher than that of control group

and those of the 3 treatment groups were all significantly lower than that of model group (P<0.01)

only PGE 2 levels (serum and joint infusion) of the local acupoint group were close to those of normal control group (P>0.05). Conclusion: External application of "Arthritis-Ⅲ" to acupoints is effective in relieving symptoms and signs of arthritis

reducing inflammation reaction

and regulating IL-1β and PGE 2 levels of the tissues. Among them

the effects of improvement of symptoms and signs and pathological changes in remote +local acupoint group are the best

the effect of immunoregulation in remote acupoint group is stronger

and the anti-inflammation action of local acupoint group is better.