【目的】 观察针刺“阳陵泉”“足三里”对膝骨关节炎大鼠的治疗作用及机制。【方法】 从40只雄性SD大鼠中随机选取 10只作为正常组，其余 30只构建膝骨关节炎模型。共有 27只大鼠建模成功。将造模成功的大鼠随机分为模型组、针刺组 （针刺阳陵泉、足三里穴）、针刺+自噬抑制剂（3-MA）组（针刺阳陵泉、足三里穴，腹腔注射3-MA），每组9只。干预后，观 察各组大鼠软骨组织病理学形态，进行软骨Mankin’s评分，计算软骨细胞凋亡率，酶联免疫吸附分析（ELISA）检测炎性因子 [环氧化酶2（COX-2）、白细胞介素1β（IL-1β）、肿瘤坏死因子α（TNF-α）]，氧化损伤指标[一氧化氮（NO）、超氧化物歧化酶 （SOD）、丙二醛（MDA）、谷胱甘肽过氧化物酶（GSH-Px）]、基质金属蛋白酶3（MMP-3）、基质金属蛋白酶抑制剂1（TIMP-1） 含量，DHE 探针检测活性氧（ROS）水平，聚合酶链反应（PCR）法检测软骨组织PTEN诱导激酶1（PINK1）、帕金蛋白（Parkin）、 微管相关蛋白1轻链3-Ⅱ（LC3-Ⅱ） mRNA表达量，Western Blot法检测软骨组织PINK1、Parkin、LC3-Ⅱ蛋白表达量。【结果】 与正常组比较，模型组软骨 Mankin’s 评分，细胞凋亡率，COX-2 水平，IL-1β、TNF-α 水平，NO、MDA 水平，MMP-3、 TIMP-1水平，ROS含量升高，SOD、GSH-Px水平，PINK1、Parkin、LC3-Ⅱ mRNA和蛋白表达量降低，差异均有统计学意 义（P＜0.05）；与模型组比较，针刺组软骨 Mankin’s 评分，细胞凋亡率，COX-2 水平，IL-1β、TNF-α 水平，NO、MDA 水 平，MMP-3、TIMP-1水平，ROS含量降低，SOD、GSH-Px水平，PINK1、Parkin、LC3-Ⅱ mRNA和蛋白表达量升高，差异 均有统计学意义（P＜0.05）；与针刺组比较，针刺+3-MA组软骨Mankin’s评分，细胞凋亡率，COX-2水平，IL-1β、TNF-α 水平，NO、MDA 水平，MMP-3、TIMP-1水平，ROS 含量升高，SOD、GSH-Px 水平，PINK1、Parkin、LC3-Ⅱ mRNA 和蛋白表达量降低，差异均有统计学意义（P＜0.05）。【结论】 针刺“阳陵泉”“足三里”可通过激活PINK1/Parkin介导的线粒体自 噬抑制膝骨关节炎大鼠软骨细胞凋亡，改善病情。

Objective To observe the therapeutic effects and mechanisms of acupuncture at “Yanglingquan” （GB34） and “Zusanli”（ST36） on knee osteoarthritis（KOA） rats，focusing on the regulation of PTEN-induced kinase 1/Parkin （PINK1/Parkin）-mediated mitophagy in chondrocytes. Methods Ten out of 40 male SD rats were randomly selected as the normal group，and the remaining 30 rats were used to construct a KOA model. A total of 27 rats were successfully modeled. The successfully modeled rats were randomly divided into a model group，an acupuncture group （acupuncture at Yanglingquan and Zusanli），and an acupuncture + autophagy inhibitor （3- MA） group （acupuncture at Yanglingquan and Zusanli combined with intraperitoneal injection of 3-MA）， with 9 rats in each group. After intervention，the morphology of cartilage tissue in each group was observed，and the Mankin’s score of cartilage was assessed. The apoptosis rate of chondrocytes was calculated. Enzyme-linked immunosorbent assay （ELISA） was used to detect inflammatory factors [cyclooxygenase 2（COX-2），interleukin 1β （IL-1β），and tumor necrosis factor α（TNF-α）]，oxidative damage indicators [nitric oxide （NO），superoxide dismutase （SOD），malondialdehyde （MDA），and glutathione peroxidase （GSH-Px）]，and the levels of matrix metalloproteinase 3（MMP-3） and tissue inhibitor of metalloproteinase 1（TIMP-1）. The DHE probe was used to measure reactive oxygen species （ROS） level. Polymerase chain reaction （PCR） was used to detect the mRNA expression levels of PTEN-induced kinase 1（PINK1），Parkin，and microtubule-associated protein 1 light chain 3-Ⅱ（LC3-Ⅱ） in cartilage tissue. Western blot was used to measure the protein expression levels of PINK1，Parkin， and LC3-Ⅱ in cartilage tissue. Results Compared with the normal group， the model group showed increased Mankin’s score，apoptosis rate，COX-2 level，IL-1β and TNF-α levels，NO and MDA levels，MMP-3 and TIMP-1 levels， and ROS content， as well as decreased SOD and GSH-Px levels， and reduced mRNA and protein expressions of PINK1，Parkin and LC3-Ⅱ，with statistically significant differences （P＜0.05）. Compared with the model group，the acupuncture group showed decreased Mankin’s score，apoptosis rate，COX-2 level， IL-1β and TNF- α levels， NO and MDA levels， MMP-3 and TIMP-1 levels， and ROS content， as well as increased SOD and GSH-Px levels，and elevated mRNA and protein expressions of PINK1，Parkin and LC3-Ⅱ， with statistically significant differences （P＜0.05）. Compared with the acupuncture group，the acupuncture + 3- MA group showed increased Mankin’s score，apoptosis rate，COX-2 level，IL-1β and TNF-α levels，NO and MDA levels，MMP-3 and TIMP-1 levels，and ROS content，as well as decreased SOD and GSH-Px levels，and mRNA and protein expressions of PINK1， Parkin and LC3-Ⅱ ， with statistically significant differences （P＜ 0.05）. Conclusion Acupuncture at “Yanglingquan” and “Zusanli” can inhibit chondrocyte apoptosis by activating PINK1/Parkin-mediated mitophagy，thus improving the condition of KOA rats.

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福建省自然科学基金资助项目（编号：2021J011258）