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目的探索补肾活血方对兔胫骨截骨延长术后延长区域骨组织形态及骨密度的作用及机制。方法 24只新西兰大白兔完全随机方法分为假手术组、模型组和补肾活血方组,每组8只大白兔,假手术组和模型组均予以生理盐水灌胃,补肾活血组予以补肾活血方灌胃。干预8周后处死,观察各组兔骨延长区域骨组织形态、骨密度、骨组织形态计量学及TGF-β2基因表达水平。结果补肾活血方组延长区骨组织形态相比模型组,胫骨外侧的骨皮质结构连续完整,内外层骨皮质间的骨质明显增多、增厚,骨小梁较粗且排列整齐、均匀,破裂程度较低,血管数量增多,网状新骨生成明显。假手术组兔胫骨延长区骨密度高于模型组和补肾活血方组(P<0.05),补肾活血方组兔胫骨延长区骨密度要高于模型组,差异具有统计学意义(P<0.05);假手术组兔胫骨延长区骨小梁面积百分数、骨小梁数量和骨小梁厚度均要大于模型组和补肾活血方组,骨小梁分离度小于模型组和补肾活血方组,差异具有统计学意义(P<0.05);补肾活血方组兔胫骨延长区骨小梁面积百分数、骨小梁数量和骨小梁厚度骨要大于模型组,骨小梁分离度小于模型组,差异具有统计学意义(P<0.05);模型组和补肾活血方组TGF-β2基因表达水平均要高于假手术组,差异具有统计学意义(P<0.05);而模型组TGF-β2基因表达水平低于补肾活血方组,差异具有统计学意义(P<0.05)。结论补肾活血方可能通过刺激TGF-β2的表达,增加骨延长区的成骨作用,促进骨的矿化,以保证截骨延长区的顺利愈合。
Objective To explore the effect of “Bushen Huoxue Decoction” on bone morphology and bone mineral density (BMD) in lengthening of tibial osteotomy in rabbits. Methods Twenty-four New Zealand white rabbits were randomly divided into sham-operated group, model group and Bushen Huoxue prescription group. Eight rabbits in each group were given normal saline intragastrically. Rats in Bushen Huoxue group were treated with Bushen Huoxue Recipe Gavage. The rats were killed after 8 weeks of intervention. The morphological changes of bone tissue, bone mineral density, bone histomorphometry and TGF-β2 gene expression in the rabbit lengthening area were observed. Results Compared with the model group, the cortical bone structure of Bushen Huoxue Fang group extended continuously. The structure of cortical bone outside the tibia was continuous and complete. The bone mass between the cortical and cortical bone was obviously increased, thickened, and the trabecular was thick and arranged neatly, evenly To a lesser degree, the number of blood vessels increased, and the formation of reticular neovascularization was obvious. Compared with model group and Bushen Huoxue Decoction group, the BMD of tibia extension group was significantly higher in sham operation group (P <0.05) ; Sham operation group rabbit tibial extension area trabecular area percentage, trabecular number and trabecular thickness should be greater than the model group and Bushen Huoxue Fang group, trabecular separation is less than the model group and Bushen Huoxue Fang group differences with (P <0.05). The area of trabecular area, the number of trabecular and the trabecular thickness in the area of tibial extension of Bushen Huoxue prescription group were greater than the model group, the trabecular separation was less than that of the model group, the difference was statistically significant (P <0.05). The TGF-β2 gene expression in model group and Bushen Huoxue prescription group was higher than that in sham operation group (P <0.05), while the expression of TGF-β2 gene in model group was lower In Bushen Huoxue prescription group, the difference was statistically significant (P <0.05). Conclusion Bushen Huoxue Prescription can increase the osteogenesis of bone extension area and promote the mineralization of bone by stimulating the expression of TGF-β2 to ensure the smooth healing of the osteotomy extension area.