中药胶剂修复半月板损伤的实验研究

Meniscal repair using a Chinese herbal medicinal gel:an experimental study in rabbits

目的 观察中药胶剂促进半月板损伤修复的效果 ,并探讨其作用机理。方法 选用同样条件饲养 ,体重 3kg左右的健康成年日本大耳白兔 80只 ,雌雄不拘 ,每组 40只 ,均采用左右侧自身对照 ,侧别由掷币法随机决定。一组动物为空白对照 ,即一侧半月板裂伤植入中药胶剂 ,另一侧裂伤不做任何处理 ;另一组动物为实验对照 ,即一侧裂伤植入中药胶剂 ,另一侧裂伤植入物理性状与该中药胶剂相似的明胶。在日本大耳白兔双侧下肢内侧半月板前 1/ 3处横行切断造成半月板损伤模型 ,一侧植入中药胶剂 ,另一侧为对照组。术后 6周、12周、2 4周分批处死动物取材。标本用于大体观察、光镜下组织学观察、扫描电镜观察和生物力学测试。结果 实验组裂伤部很快被肉芽样修复组织完全填充 ,有血管长入 ,创缘有软骨细胞增殖现象 ,随后修复组织逐渐演变为正常半月板的纤维软骨组织。结论 实验证明该中药胶剂能够诱导血管和修复细胞进入半月板裂伤部 ,包括原来并无血运的区域 ,激发修复反应 ,有效地促进半月板损伤的修复 ,而且较之其它方法更为简便易行。其机理在于该中药胶剂能够有效地改善损伤局部的血液供应状态 ,刺激半月板纤维软骨细胞增殖 ,并为新生血管和修复细胞提供修复支架。

Objective [HT5”SS]To study the effect of a Chinese herbal gel on repair of meniscal injury,in order to find an easy and effective way to promote the repair of this injury,especially those in the avascular portion.[HT5”H]Methods [HT5”SS]Eight healthy adult white rabbits with big ears,3kg weight or so without limitation in sex were fed in the same conditions.The animals were randomly divided into two groups:the control and gelatin control groups.In gelatin group,Chinese herbal medicinal gel was implanted into one side of meniscal lesion while no management was done in the contralateral side of the uninjuried meniscus.In gelatin control group,Chinese herbal medicinal gel was implanted into one side of lesion and gelatin(Sigma.Co.TAPE B)whose physical properties were similar with the Chinese medicinal gel was implanted into other side.The gelatin control was established so as to prove the repairing effect of the Chinese herbal gel depending not only on it’s physical action,but to a larger extent on it’s pharmacological action.The meniscus were cut transversely at the anterior 1/3 of medial meniscus.Models in both sides were established and Chinese herbal medicinal gel was implanted into one side of lesion.The other side served as the control group.The animals were sacrificed at 6th,12th and 24th weeks respectively after operation.The specimens were removed for gross observation,histological and scanning microscope observations and biomechanical testing.[HT5”H]Results [HT5”SS]The meniscal lesions of the experimental side were quickly filled with granular-like repairing tissue.The newly developed vessels could be seen growing into the repairing tissue with the chondrocytes proliferating at the peripheral margin of the lesion.Then the repairing tissue gradually developed into the fibrocartilagineous components resembling normal meniscus.[HT5”H]Conclusion [HT5”SS]The Chinese herbal gel can induce the growth of vessels and repairing cells into the meniscal lesion including the former avascular portion and stimulate the repairing response and thus promote the repair of meniscal lesions effectively.This method is easier to be carried out in comparison with other methods.The Chinese herbal gel’s mechanism of promoting the repair of meniscal injuries lies in the fact that the Chinese herbal ingredients can improve the status of blood supply of the injured area effectively,stimulate the proliferation of meniscal chondrocytes and provide the scaffold for the newly developed vessels and the repairing cells. [WT5”HZ]