为探讨激光穴位照射联合丹参川芎嗪关节腔内给药治疗膝关节骨性关节炎(KOA)的疗效，将KOA患者96例随机分为对照组（n＝48, 丹参川芎嗪关节注射）和观察组（n＝48, 激光穴位照射＋丹参川芎嗪关节内给药），比较两组临床疗效及治疗前后膝关节疼痛程度、膝关节功能、膝关节活动度及白细胞介素-1β（IL-1β）、C反应蛋白(CRP)、软骨寡聚基质蛋白（COMP）及基质金属蛋白酶-3（MMP-3）血浆水平。结果表明: 观察组治疗总有效率（93.75%）高于对照组（77.08%）（P＜0.05）； 与治疗前比较，两组治疗后VAS评分及IL-1β、CRP、COMP、MMP-3水平降低（P＜0.05），Lysholm评分、膝关节活动度增高（P＜0.05），但观察组以上指标改善优于对照组（P＜0.05）。研究认为激光穴位照射联合丹参川芎嗪关节腔内给药治疗膝关节骨性关节炎的疗效满意。

In this paper, optical coherence tomography (OCT) and surface-enhanced Raman spectroscopy (SERS) were used to characterize normal knee joint (NKJ) tissue and knee osteoarthritis (KOA) tissue ex vivo. OCT images show that there is a clear hierarchical structure in NKJ tissue, including surface layer, transitional layer, radiation layer and cartilage matrix calcification layer tissue structure, while the hierarchical structure of KOA tissue is not clear and unevenly distributed, and the pathological tissues at different stages also show significant differences. SERS shows that NKJ tissue and mild osteoarthritic knee cartilage (MiKOA) tissue have strong characteristic Raman peaks at 964, 1073 (1086), 1271, 1305, 1442, 1660 and 1763cm?1. Compared with the Raman spectrum of NKJ tissue, the Raman characteristic peaks of MiKOA tissue have some shifts, moving from 1073cm?1 to 1086cm?1 and from 1542cm?1 to 1442cm?1. There is a characteristic Raman peak of 1271cm?1 in MiKOA tissue, but not in NKJ tissue. Compared with NKJ tissue, severely degenerated cartilage (SdKOA) tissues show some new SERS peaks at 1008, 1245, 1285, 1311 and 1321cm?1, which are not seen in SERS spectra of NKJ tissue. Principal component analysis (PCA) was used to analyze the Raman spectra of 1245–1345cm?1 region. The results show that PCA can distinguish NKJ, MiKOA and SdKOA tissues and the accuracy is about 90%. These results indicate that OCT can clearly distinguish NKJ, MiKOA, moderate osteoarthritic knee cartilage (MoKOA) and SdKOA tissue, while SERS can provide further judgment basis. The results also prove that the contents of protein and polysaccharide in knee tissue are changed during the pathological process of knee tissue, which is the cause of pain caused by poor friction in knee joint during movement.In this paper, optical coherence tomography (OCT) and surface-enhanced Raman spectroscopy (SERS) were used to characterize normal knee joint (NKJ) tissue and knee osteoarthritis (KOA) tissue ex vivo. OCT images show that there is a clear hierarchical structure in NKJ tissue, including surface layer, transitional layer, radiation layer and cartilage matrix calcification layer tissue structure, while the hierarchical structure of KOA tissue is not clear and unevenly distributed, and the pathological tissues at different stages also show significant differences. SERS shows that NKJ tissue and mild osteoarthritic knee cartilage (MiKOA) tissue have strong characteristic Raman peaks at 964, 1073 (1086), 1271, 1305, 1442, 1660 and 1763cm?1. Compared with the Raman spectrum of NKJ tissue, the Raman characteristic peaks of MiKOA tissue have some shifts, moving from 1073cm?1 to 1086cm?1 and from 1542cm?1 to 1442cm?1. There is a characteristic Raman peak of 1271cm?1 in MiKOA tissue, but not in NKJ tissue. Compared with NKJ tissue, severely degenerated cartilage (SdKOA) tissues show some new SERS peaks at 1008, 1245, 1285, 1311 and 1321cm?1, which are not seen in SERS spectra of NKJ tissue. Principal component analysis (PCA) was used to analyze the Raman spectra of 1245–1345cm?1 region. The results show that PCA can distinguish NKJ, MiKOA and SdKOA tissues and the accuracy is about 90%. These results indicate that OCT can clearly distinguish NKJ, MiKOA, moderate osteoarthritic knee cartilage (MoKOA) and SdKOA tissue, while SERS can provide further judgment basis. The results also prove that the contents of protein and polysaccharide in knee tissue are changed during the pathological process of knee tissue, which is the cause of pain caused by poor friction in knee joint during movement.

通过比较分析正常大鼠与膝骨关节炎模型（KOA）大鼠血清、 膝关节肌肉和滑膜组织的表面增强拉曼光谱(SERS), 为KOA生物学改变提供实验基础。 同条件下饲养普通级健康雄性SD大鼠20只, 随机分为正常对照组（简称“正常组”）和KOA模型组（简称“模型组”）, 每组10只。 采用左膝关节腔内注射0.03 mol·L-1的L-半胱氨酸与4%木瓜蛋白酶混合物方法制备KOA模型, 并于复制成功4周后取材。 采用银纳米基底液检测大鼠血清和膝关节肌肉、 滑膜组织中的表面增强拉曼谱峰, 应用NGLabSpec软件比较两组拉曼频移和特征峰的差异, 应用OriginPro 8.5软件分析拉曼光谱图。 结果: 在血清中, 拉曼频移400～2 000 cm-1区间内, 正常组特征峰有12个, 模型组有14个, 且模型组大部分特征峰强度低于正常组, 两组在495, 883和1 447 cm-1等处出现较为显著的差异性特征峰; 在膝关节肌肉组织中, 正常组特征峰有12个, 模型组有13个, 二者的同质性特征峰的拉曼强度存在显著差异, 模型组以950和1 237 cm-1为代表的多处同质性特征峰的峰强显著升高; 在滑膜组织中, 正常组特征峰有10个, 模型组有15个, 两组共性特征峰的峰强变化多不明显, 但在655, 950, 1 335和1 447 cm-1处的同质性特征峰表现出峰强的明显差异, 在655和950 cm-1峰为模型组显著升高, 而1 335和1 447 cm-1两峰相对强度为模型组显著降低。 结果表明: KOA模型导致血清、 膝关节肌肉和滑膜组织的同质性特征峰数量显著减少, 差异性物质增多, 物质代谢平衡被严重打破, SERS是一种快速准确的检测方法, 可以用于KOA模型的检测。

目的: 观察并比较骨关节炎复合激光穴位照射治疗与针刺联合特定电磁波治疗器(TDP)照射两种方法的差异性。方法: 以10.6 μm及650 nm复合激光照射和针刺联合TDP为手段, 选取犊鼻穴治疗膝关节骨关节炎, 开展随机、对照临床试验。采用WOMAC问卷结合患者疗效自评进行评价。结果: 复合激光照射组治疗后2 周及6 周与治疗前比较, 疼痛、僵硬和功能程度积分均有显著改善(P值＜0.001), 对照针刺联合TDP照射组治疗前后同节点相应指标均无统计学差异(P值＞0.050)。结论: 犊鼻穴激光照射对膝关节骨关节炎确有一定疗效, 这一效应和针刺联合TDP照射无明显差异性。