Effects of electroacupuncture combined with rehabilitation exercise training on hemorheology and TLR4/MyD88/NF-κB signaling pathway in peripheral blood monocytes of patients with knee osteoarthritis
Objective To explore the effects of electroacupuncture combined with rehabilitation exercise training on hemorheology and toll-like receptors 4(TLR4)/myeloid differentiation factor 88(MyD88)/nuclear factor-κB(NF-κB)signaling pathway in peripheral blood monocytes of patients with knee osteoarthritis(KOA).Methods 90 patients with KOA were randomly divided into a control group and a study group according to the order of admission,with 45 cases in each group.The control group received rehabilitation exercise training,and the study group was treated with electroacupuncture on the basis of the control group.The clinical symptom scores,hemorheology indexes and related indicators of TLR4/MyD88/NF-κB signaling pathway in peripheral blood monocytes were compared between the two groups.Results After 1 month of treatment,the visual analogue scale(VAS)score,Western Ontario and McMaster University Osteoarthritis Index(WOMAC)score and Lysholm knee function score were all improved in both groups compared with those before treatment;the study group had VAS score of(1.93±0.41)points and WOMAC score of(17.34±2.28)points,which were lower than(2.82±0.39)and(34.39±3.17)points in the control group;the study group had higher Lysholm knee function score of(84.73±6.34)points than(72.69±5.22)points in the control group(P<0.05).After 1 month of treatment,the whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and erythrocyte aggregation index were decreased in both groups compared with those before treatment;in the study group,the whole blood high shear viscosity was(3.14±0.28)mPa·s,the whole blood low shear viscosity was(6.21±0.75)mPa·s,the plasma viscosity was(1.35±0.21)mPa·s and the erythrocyte aggregation index was(2.73±0.31),which were lower than(4.26±0.32)mPa·s,(8.24±1.21)mPa·s,(2.07±0.23)mPa·s and(4.21±0.42)and in the control group(P<0.05).After 1 month of treatment,TLR4 mRNA,MyD88 mRNA and NF-κB mRNA in both groups were decreased compared with those before treatment;the study group had TLR4 mRNA of(2.16±0.19),MyD88 mRNA of(2.21±0.73)and NF-κB mRNA of(2.36±0.47),which were lower than(3.08±0.23),(3.67±0.84)and(3.42±0.53)in the control group(P<0.05).Conclusion Electroacupuncture combined with rehabilitation exercise training can improve the clinical symptoms and hemorheology of KOA patients,and its mechanism of action can be played by regulating TLR4/MyD88/NF-κB signaling pathway in peripheral blood monocytes.
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