身痛逐瘀汤疏通淋巴管瘀滞促进骨修复的实验研究

Experimental study on Shentong Zhuyu Decoction accelerating fracture healing via promoting lymphatic drainage

目的 观察身痛逐瘀汤对胫骨骨折小鼠的骨修复作用。方法 将6~8周龄雄性C57BL/6小鼠随机分为生理盐水组和身痛逐瘀汤组,每组20只。当两组小鼠成功建立右侧胫骨骨折复合髓内固定模型半小时后,身痛逐瘀汤组给予浓度1.375 g/mL身痛逐瘀汤药液0.2 mL/d,生理盐水组给予同体积0.9%NaCl溶液,两组均连续灌胃5 d。造模后,活体监测小鼠的后肢淋巴管回流功能、骨折断端软组织肿胀度和足底热敏痛阈;造模14 d后取材,检测骨痂形态计量学;造模后28 d后取材,检测骨折愈合生物力学性能。结果 (1)造模后第1天(P<0.001)和第7天(P<0.001),身痛逐瘀汤组的淋巴管清除率优于生理盐水组。(2)造模后第2~7天,身痛逐瘀汤组后肢软组织肿胀度明显低于生理盐水组。(3)造模后第1天,身痛逐瘀汤组的足底热敏痛阈明显低于生理盐水组(P<0.01)。(4)胫骨Micro-CT重建显示,身痛逐瘀汤组小鼠比生理盐水组的骨痂量更多,骨小梁更致密,骨折线更模糊;定量分析发现身痛逐瘀汤组骨痂的BV/TV(P<0.01)和Tb.N(P<0.05)优于生理盐水组。(5)身痛逐瘀汤最大应力(P<0.001)和屈服应力(P<0.001)高于生理盐水组。结论 身痛逐瘀汤能促进淋巴管回流,减轻骨折后肿痛症状,促进骨折愈合。

Objective To observe the pharmacological efficacy of Shentong Zhuyu Decoction on the healing of open tibial fracture in mice. Methods male C57 BL/6 mice, aged from 6 to 8 weeks, were randomly divided into saline group and Shentong Zhuyu Decoction(STZY) group, with 20 mice in each group. Half an hour after establishment of right tibial fracture model combined with intramedullary fixation in two groups, STZY group was gavage administered at a concentration of 1.375 g/mL, 0.2 mL per day, and saline group was given the same volume of 0.9% NaCl solution for 5 days. Lymphatic drainage function of hind limbs, soft tissue swelling at fracture sides and plantar thermal pain threshold were monitored in vivo. Harvested hind limbs were taken to detect the morphometry of callus at 14day of fracture and were measured for biomechanical properties at at 28day of fracture. Results(1)On the 1day(P<0.001) and 7day(P< 0.001) after modeling, the lymphatic clearance of STZY group was higher than saline group.(2)On the 2to 7day after modeling, the soft tissue swelling degree of hindlimb in STZY group was significantly lower than saline group.(3)On the 1day after modeling, the plantar thermal pain threshold of STZY group was significantly lower than saline group(P<0.01).(4) Micro-CT reconstruction for tibial callus showed that STZY group had more callus, denser bone trabeculae and blurred fracture line than saline group;Quantitative analysis showed that BV/TV(P < 0.01) and Th.N of callus in STZY group(P < 0.05) was higher than saline group.(5)The ultimate stress(P < 0.001) and yield stress(P<0.001) of STZY group were higher than saline group. Conclusion Shentong Zhuyu Decoction reduces soft tissue swelling and pain and accelerates fracture healing via promoting lymphatic drainage.