探“先天、后天”理论在促进去卵巢小鼠骨质疏松性骨折愈合中的作用

Effects of innate and postnatal theory on promoting the healing of osteoporotic fracture in ovariectomized mice

目的:研究补肾、健脾法促进去卵巢小鼠骨质疏松性骨折愈合的作用,探讨中医"先天之本""后天之本"理论在骨质疏松性骨折防治中的运用。方法:建立骨质疏松性骨折小鼠模型,随机分为生理盐水组、健脾组、补肾组,分别给予0.9%氯化钠溶液、健脾方、补肾方灌胃治疗,在术后治疗7、14、28d分别处死小鼠、取材,进行相关指标检测,包括血清雌二醇(E_2)和影像学检测。结果:血清E2检测发现,与生理盐水组比较,补肾组在术后28d可明显提高去卵巢小鼠血清E2含量(P<0.05);X-Ray线检测和Micro-CT扫描三维重建结果显示,补肾组和健脾组都能增加骨痂的形成,促进骨质疏松性骨折的愈合;Micro-CT定量分析结果显示,与生理盐水组比较,补肾组7d时骨痂BMD of BV,14d时BV/TV、Conn.D.、BMD of BV、BMD of TV均明显增加(P<0.05),健脾组7、14d时骨痂BV/TV、BMD of TV亦明显增加(P<0.05)。表明补肾方和健脾方都能提高骨痂的骨量。结论:补"先天"通过雌激素样作用,养"后天"可能通过提供血液濡养和促进药物吸收,加速骨质疏松性骨折愈合。

Objective: To study the effects of methods of tonifying kidney and strengthening spleen on promoting the healing of osteoporotic fracture in ovariectomized mice, and explore theinfluence of TCM theory of the ‘innate foundation and postnatal foundation' in the prevention and treatment of osteoporosis and osteoporotic fractures. Methods: The mice model of osteoporotic fracture in tibia was established. Then, the mice were randomly divided into 3 groups: normal saline group, strengthening spleen group, toni-fying kidney group, 0.9% sodium chloride solution, strengthening spleen compound formula and tonifying kidney compound formula were correspondingly administrated by gavage. The mice were sacrificed after 7, 14 and 28 days of treatment. Then, the serum estradiol(E2) levels and imageology were measured. Results: The ovariectomized mice showed a significant decreased serum E_2 levels, but which were obviously reversed by the treatment of tonifying kidney compound formula for 28 days(P<0.05). But, there were no significant differences in the serum estradiol levels between the model group and strengthening spleen compound formula group. The results of X-ray and 3D reconstruction of Micro-CT showed that both of the administration of tonifying kidney and strengthening spleen increased the porosis and promoted the healing of osteoporotic fracture. Quantitative analysis results of Micro-CT showed that the callus' BMD of BV was increased by the treatment of tonifying kidney compound formula for 7 days, and the callus' BV/TV, Conn.D, BMD of BV and BMD of TV were significantly increased by the treatment of tonifying kidney compound formula for 14 days when compared with the model group(P<0.05). Meanwhile, the callus' BV/TV and BMD of TV were significantly increased by the treatment of strengthening spleen compound formula for 7 and 14 days(P<0.05). Therefore, the quantitative analysis results of Micro-CT indicated that both of the treatment of tonifying kidney and strengthening spleen significantly increased the bone mass of the callus. Conclusion: Tonifying kidney medicine may accelerate the healing of osteoporotic fracture by tonifying the innate foundation that play the estrogenic-like roles, and strengthening spleen medicine may provide blood and nutrition to promote the healing of osteoporotic fracture.