消肿接骨散外敷治疗桡骨远端骨折的作用及其机制研究

Effect and mechanism of external application of Xiaozhong Jiegu Powder for distal radial fracture

目的:观察消肿接骨散对大鼠桡骨远端骨折的消肿、接骨疗效,并初步探讨其对成骨因子骨钙素(bone gla protein,BGP)、骨碱性磷酸酯酶(bone alkaline phosphatase,BALP)及骨形态发生蛋白2(bone morphogenetic protein 2,BMP-2)的影响。方法:采用SD大鼠复制桡骨远端骨折模型,分为正常组,模型组,双氯芬酸二乙胺乳胶剂(扶他林)组,消肿接骨散低、中、高剂量组(0.441、0.882、1.323 g·kg^(-1)),测量大鼠患肢肿胀程度,检测血清BGP、BALP水平,HE染色检测骨折愈合和修复程度,免疫组化检测桡骨骨组织中BMP-2表达。结果:与模型组比较,消肿接骨散中、高剂量组大鼠患肢肿胀程度明显降低(P<0.05,P<0.01),血清中BGP及BALP的水平明显升高(P<0.05,P<0.01),并能促进模型大鼠骨折处的纤维增生、骨痂形成,缩短骨折愈合周期,上调骨组织中BMP-2表达(P<0.05,P<0.01)。结论:消肿接骨散具有消肿接骨、促进骨折愈合的疗效,其机制可能与升高血清中BGP、BALP水平,上调骨组织BMP-2表达有关。

OBJECTIVE To explore the effects of Xiaozhong Jiegu Powder(XJP)on detumescence and bone grafting of distal radial fracture in rats and explore its effect on osteogenic factors of bone gla protein(BGP),bone alkaline phosphatase(BALP)and bone morphogenetic protein 2(BMP-2).METHODS Sprague-Dawley(SD)rats were utilized for mimicking the model of distal radial fracture.The animals were assigned into six groups of normal control,model,diclofenac diethylamine emulsion(voltaren)and XJP low/middle/high-dose(0.441/0.88/1.323 g·kg^(-1)).Swelling degree of affected limb was measured,serum level of BGP/BALP detected,degree of fracture healing and repair detected by hematoxylin-eosin(HE)stain and the expression of BMP-2 in radius quantified by immunohistochemistry.RESULTS As compared with model group,swelling degree of affected limbs declined markedly in middle/high-dose XJP group(P<0.05)while serum level of BGP/BALP spiked obviously(P<0.05,P<0.01).It could also promote fibrous proliferation and callus formation at fracture site of model rats,shorten fracture healing cycle and up-regulate the expression of BMP-2 in bone tissue(P<0.05,P<0.01).CONCLUSION XJP has the effects of reducing swelling,enhancing bone union and promoting fracture healing.And its mechanism may be correlated with elevated serum level of BGP/BALP and an up-regulation of BMP-2 expression in bone tissue.