微米中药功能衬材:活血及促进骨折愈合的作用

Micron traditional Chinese medicine functional lining material: activating blood circulation and promoting fracture healing

背景:课题组研制出一种新型医用骨科外固定材料——微米中药功能衬材,并证实该衬材具有促进碱性磷酸酶分泌,降低血钙,升高血磷和钙磷乘积,促进骨痂形成的作用。目的:进一步验证微米中药功能衬材促进骨折愈合的疗效。方法:取新西兰兔24只,造成右侧桡骨骨折模型后随机分组,微米组外敷微米中药功能衬材(微米三七粉混合骨碎补、红花等药物的有效成分)后加石膏外固定,中药对照组外敷普通中药功能衬材(普通三七粉)后加石膏外固定,衬材对照组外敷普通衬材(无菌脱脂棉)后加石膏外固定,模型对照组不予任何治疗。于造模前和造模后第2,4,6周行全血高切黏度、全血中切黏度、全血低切黏度和血浆黏度检测;造模后第6周末处死兔,取桡骨标本进行组织学观察。结果与结论:(1)血液流变学指标:微米组全血高切黏度、全血中切黏度、全血低切黏度和血浆黏度均低于同时期其余对照组,造模后第4,6周与模型对照组比较差异有显著性意义(P<0.05或0.01);(2)组织形态学观察:微米组可见大量成骨细胞,编织骨开始塑形,骨髓腔再通;中药对照组可见编织骨、软骨细胞和软骨内成骨共存,断端内、外骨痂相连,骨髓腔未再通;衬材对照组和模型对照组断端内、外骨痂大多尚未相连,骨髓腔未再通;(3)结果表明:微米中药功能衬材能够活血化瘀,改善微循环,促进成骨细胞增生,并进而促进骨折愈合。

BACKGROUND： As a new self-synthetized medical orthopedic fixation material, micron traditional Chinese medicine functional lining material can promote the secretion of alkaline phosphatase and callus formation, decrease serum calcium level, as well as increase serum phosphorus level and calcium-phosphorus product. OBJECTIVE： To further verify the therapeutic effect of micron traditional Chinese medicine functional lining material on fracture healing. METHODS： Twenty-four New Zealand rabbits were selected to prepare models of right radial fracture, and then were randomly allocated into four groups： rabbits in micron group were treated with micron traditional Chinese medicine functional lining material（micron Panax notoginseng powder mixed with active ingredients of Davallia divaricata and Carthamus tinctoriousplus） plus plaster external fixation; those in traditional Chinese medicine control group treated with ordinary Chinese medicine functional material plus plaster external fixation; those in lining material control group treated with ordinary lining material（sterile degreasing cotton） plus plaster external fixation; those in model control group received no treatment. The whole blood viscosity at high/middle/low shear rates and plasma viscosity were detected at 2, 4 and 6 weeks before and after modeling. Additionally, rabbits in each group were killed at 6 weeks after modeling, and radial samples were removed for histological observation. RESULTS AND CONCLUSION： The whole blood viscosity at high/middle/low shear rates and plasma viscosity in the micron group were all lower than those in the other three groups in the same period, and had significant differences from those in the model control group at 4 and 6 weeks after modeling（P 0.05 or 0.01）. A large number of osteoblasts could be found, woven bone began to form and the bone marrow cavity was recanalized in the micron group; in the traditional Chinese medicine group, woven bone, chondrocytes and endochondral ossification coexisted and there was a connection between calluses inside and outside of the broken end, but the bone marrow cavity was not recanalized. In contrast, neither connection between calluses inside and outside of the broken end, nor recanalized bone marrow cavity appeared in the lining material and model control groups. In conclusion, micron traditional Chinese medicine functional lining material can promote fracture healing by improving microcirculation and accelerating osteoblast proliferation.