消肿止痛胶囊治疗兔急性软组织损伤的作用机制研究

Study on the function mechanism of XIAOZHONG ZHITONG capsule on acute soft tissue injury in rabbits

目的:探讨消肿止痛胶囊对急性软组织损伤的治疗作用及可能的作用机制。方法:将30只健康新西兰兔随机分为正常组、模型组、治疗组,每组10只。除正常组外,其余2组建立兔急性损伤性血肿模型。正常组及模型组按4 mL.kg-1体质量以生理盐水灌胃,治疗组按4 mL.kg-1体质量以20 mg.mL-1消肿止痛胶囊混悬液灌胃。造模后第5天肉眼观察伤肢损伤处的变化并参照冯芳军等的标准进行评分,同时测定血清白细胞介素-1β、白细胞介素-6水平及血液黏度,并在光镜下观察其组织形态及炎性细胞的浸润情况。结果:①软组织损伤评分。治疗组软组织损伤评分低于模型组(t=8.760,P=0.000)。②白细胞介素-1β。各组血清白细胞介素-1β含量比较,差异有统计学意义(F=84.380,P=0.000)。组间两两比较,治疗组、模型组含量高于正常组(P=0.001,P=0.000),治疗组低于模型组(P=0.000)。③白细胞介素-6。各组血清白细胞介素-6含量比较,差异有统计学意义(F=118.781,P=0.000)。组间两两比较:正常组、治疗组低于模型组(P=0.000,P=0.000);治疗组与正常组比较,差异无统计学意义(P=0.838)。④血液黏度。3组间全血高切黏度、中切黏度、低切黏度及血浆黏度比较,差异有统计学意义(F=106.650,P=0.000;F=169.403,P=0.000;F=145.910,P=0.000;F=23.972,P=0.000)。组间两两比较,治疗组、模型组全血高切黏度、中切黏度、低切黏度及血浆黏度均高于正常组(P值均为0.000),而治疗组各指标均低于模型组(P值均为0.000)。⑤组织形态学观察。正常组肌纤维形态较一致,肌细胞呈束状平行紧密排列,细胞呈长梭形,胞浆丰富;模型组有的可见部分肌纤维肿胀,有的可见白细胞呈弥漫性浸润;治疗组肌纤维间质白细胞浸润不明显,肌纤维形态大致正常。治疗组创伤病灶中炎性细胞浸润密度低于模型组(t=14.655,P=0.000)。结论:消肿止痛胶囊能够明显减轻急性软组织损伤部位的肿胀、瘀血,减少炎性细胞浸润,降低全血黏度、血浆黏度及血清白细胞介素-1β和白细胞介素-6水平。其治疗急性软组织损伤的机制可能是降低血液黏度,并抑制炎性细胞因子白细胞介素-1β及白细胞介素-6的释放。

Objective ： To explore the curative effects and possible function mechanism of XIAOZHONG ZHITONG capsule on acute soft tissue injury. Methods：Thirty healthy New Zealand rabbits were randomly divided into normal group, model group and treatment group, 10 cases in each group. Rabbits models with acute traumatic hematomas were built for all the groups except for normal group. Rabbits in the normal group and model group were lavaged with physiological saline, while the others in the treatment group were lavaged with XIAOZHONG ZHITONG suspension（20 mg. mL-1 ） ,the dosage of each solution mentioned above was 4 mL . kg-1. Five days after the modeling, the injury changes of the wounded limbs were observed by naked eyes and the resuhs were scored according to the standards formulated by Feng Fang-jun. In the meantime,the levels of interleukin-lbeta （IL-1 β）and interleukin-6 （IL-6）of blood serum and the blood viscosity were evaluated, and their histomorphometric situations and infiltratins of inflammatory cells were observed under light microscope. Results ： （1）Scores of soft tissue injury： the scores of treatment group were lower than those of the model group （ t = 8. 760, P = 0. 000）. （2）IL- 1β ：there was statistical difference in IL-1β content of blood serum among the 3 groups（ F = 84. 380,P = 0.000）. IL-1β contents of treatment group and model group were higher than those of normal group respectively （P = 0. 001, P = 0. 000） , while the contents of treatment group were lower than those of model group（ P = 0. 000）. （2）IL-6 ： there was statistical difference in IL-6 content of blood serum among the 3 groups（F = 118. 781, P = 0. 000）. IL-6 contents of normal group and treatment group were lower than those of model group respectively （P = 0. 000, P = 0. 000 ） , while there was no statistical difference between treatment group and normal group（ P = 0. 838 ）. （4）Blood viscosity ： there were statistical difference in the high shear viscosity of whole blood, medium shear viscosity of whole blood, low shear viscosity of whole blood and the plasma viscosity among the 3 groups （ F = 106. 650, P = 0. 000 ; F = 169. 403, P = 0. 000 ; F = 145.910, P = 0. 000 ; F = 23. 972, P = 0. 000 ）. The high shear viscosity of whole blood, medium shear viscosity of whole blood, low shear viscosity of whole blood and the plasma viscosity of treatment group and model group were higher than those of normal group respectively （ P = 0. 000 ） , while all index above of treatment group were lower than model group（P = 0. 000）. （5）Histomorphometric observation：such situations as unanimous shape of muscle fibers, tightly aligned parallel myocyte in sarciniform,fusiform cells and rich cells plasma were found in normal group;part of the muscle fiber swelling and diffuse infiltration of white blood cells were showed partly in model group ; unconspicuous infiltration of muscle interstitial leukocyte and roughly normal shape of muscle fiber were found in treatment group. Infiltration density of inflammatory cells in the focus of traumatic lesions in the treatment group were lower than those of the model group （ t = 14. 655, P = 0. 000）. Conclusion ： XIAOZHONG ZHITONG capsule can obviously relieve the situations of swelling and blood stasis for the parts of acute soft tissue injury, decrease the occurrence of infiltration for the inflammatory cells and lower down the blood viscosity, plasma viscosity and the levels of IL-1β, and IL-6 in blood serum. The mechanism of XIAOZHONG ZHITONG capsule on acute soft tissue injury maybe rely on the decrease of blood viscosity and the inhibition of the release of such inflammatory cytokines as IL-1β and IL-6.