壮筋续骨汤对骨折大鼠血清内源性生长因子水平的影响及意义

The Effect of Zhuangjin Xugu Decoction on Serum Levels of Endogenous Growth Factor in Femur Fracture Rats

目的：研究壮筋续骨汤对股骨骨折后大鼠血清中骨形态发生蛋白（BMP7）、胰岛素样生长因子-1（IGF-1）、碱性成纤维细胞因子（b FGF）和转化生长因子β1（TGFβ1）水平的影响,探讨其促进骨折愈合的机制。方法：成年健康雄性Wistar大鼠72只,随机数字表法分为假手术组、对照组、治疗组各24只。用低速牙科钻在股骨中段切断股骨制备骨折模型,应用壮筋续骨汤水煎液干预治疗7 d、14 d、21 d、28 d后取材观察,X线摄片观察骨折局部愈合情况,苏木精-伊红染色观察骨痂组织病理变化,酶联免疫吸附试验检测血清BMP-7、IGF-1、b FGF和TGFβ1水平。结果：骨折7 d骨折断端被纤维性组织填充;14 d纤维性骨痂开始形成,成骨细胞增多;至21 d有钙盐沉着,破骨细胞、成骨细胞活跃;至28 d骨性骨痂形成,大量骨小梁形成。治疗组大鼠骨折后7～21 d骨痂结构变化与对照组相应时间点比较无明显差异,但至28 d治疗组骨痂结构优于对照组,其皮质骨及髓腔可辨,成像更加清晰。血清BMP-7、IGF-1、b FGF和TGFβ1水平在骨折后7 d、14 d、21 d、28 d对照组和治疗组明显高于假手术组（t=20.46～21.07,P〈0.05）,在第28 d,治疗组明显高于对照组（t=12.92,P〈0.05）和假手术组（t=8.63,P〈0.05）。结论：壮筋续骨汤可能通过抑制内源性BMP7、IGF-1、b FGF和TGFβ1降解,增强其活性,发挥促进骨折愈合的作用。

ObjectiveTo investigate the effects of Zhuang Jin Xu Gu Decoction（＂ZJXG Decoction＂）-whichliterally means a decoction for strengthening tendons and bones-on serum levels of bone morphogenetic pro-tein-7（BMP-7） and insulin-like growth factor-1（IGF-1）,basic fibroblast growth factor（b FGF） and transform-ing growth factor β 1（TGF β 1）.MethodsSeventy-two male adult Wistar rats were randomly divided intosham-operated group,control group and treatment group,with 24 rats in each group.Femur fractures were gener-ated by cutting femur transversely at middle point.ZJXG Decoction was orally administered after sur-gery for 7～28 days,and fracture healing observed byX-ray,the pathological changes of the callus ob-served by collecting samples for hematoxylin-eosin staining.The serum levels of BMP-7 and IGF-1,b FGF andTGF β 1 were detected by enzyme-linked immunobsorbent assay（ELISA）.ResultsSeven days after fracture,the fracture gap was fully filled by fibrous tissue;in 14 days,fibrous callus formatted,osteoblasts increased;in21 days,calcium salt deposited,osteoclast formed and osteoblast activity increased;in 28 days,bony callusformed,a large amount of trabecular bone formatted.The callus of treatment group rats showed no significant dif-ference from that of the control group at the corresponding time points from 7 to 21 days after fracture,but in 28 days,the treatment group showed better callus than control group did,and the cortical bone and medullary cavi-ty could be identified with more clear image.ELISA results showed that the serum levels of BMP-7,IGF-1,b F-GF and TGF β 1 in the control group and the treatment group from 7 day to 28 days were significantly higherthan those in the sham-operated group（t=20.46～21.07,P 〈0.05）;in 28 days,the levels in the treatment groupbecame significantly higher than those in the control group（t=12.92,P 〈0.05） and sham-operated group（t=8.63,P 〈0.05）.ConclusionIt can be concluded that ZJXG Decoction could enhance the fracture healing byreducing the decomposition of BMP-7 and IGF-1,bFGF and TGFβ1 and enhancing their activities.