CAJ | 학술논문

目的：观察中药外敷超微粉体对大鼠骨折后骨痂形成和改建的影响。方法：将60只3月龄 SD 雌性大鼠制成左侧胫骨骨折模型，并以克氏针固定。造模结束后将大鼠随机分为超微组、散剂组和对照组，每组20只。自术后第1天开始，超微组和散剂组大鼠分别采用中药外敷超微粉体和中药外敷散剂外敷骨折部位，每天2次，共28 d，对照组不进行干预。分别于术后7 d、14 d、21 d 和28 d 每组各处死5只大鼠，取左侧胫骨分别进行 X 线、组织学及 Micro-CT 检查。结果：①X 线检查结果。超微组和散剂组术后28 d 时骨折处外骨痂密度增加，骨折线模糊，均接近愈合，其中超微组大鼠骨折处外骨痂更致密；对照组术后28 d 时仍可看到骨折线。②组织学观察结果。术后7 d 骨折处主要为纤维骨痂，3组无明显差别；术后14 d 和21 d 时，软骨骨痂开始取代纤维性骨痂；术后28 d 时软骨骨痂周围不断有原始骨小梁出现，骨折断端表面出现破骨细胞，原始骨小梁不断改建成为成熟骨小梁，其中以超微组骨小梁最多。③Micro-CT 检查结果。术后7 d 时 Micro-CT 检查，3组均未见到明显骨痂。术后14 d 时3组大鼠骨折部位骨痂体积和骨痂密度组间比较，差异均有统计学意义[（20.2±2.3）mm3，（16.4±1.7）mm3，（14.4±1.3）mm3，F =13.286， p =0.001；（184.6±9.3）mg·m ﹣3，（162.8±5.7）mg·m ﹣3，（148.2±6.8）mg·m ﹣3，F =30.649，p =0.001]；超微组的骨痂体积和密度均高于散剂组和对照组（p =0.000，p =0.000；p =0.000，p =0.000），散剂组骨痂体积和密度均高于对照组（p =0.001，p =0.001）。术后21 d 时3组大鼠骨折部位骨痂体积和骨痂密度组间比较，差异均有统计学意义[（25.6±3.6）mm3，（21.2±0.8） mm3，（17.6±1.8）mm3，F =41.517，p =0.000；（248.2±16.0）mg·m ﹣3，（222.6±7.8）mg·m ﹣3，（197.8±9.0）mg·m ﹣3，F =23.834，p =0.000]；超微组的骨痂体积和密度均高于散剂组和对照组（p =0.000，p =0.000；p =0.000，p =0.000），散剂组骨痂体积和密度均高于对照组（p =0.000，p =0.000）。术后28 d 时3组大鼠骨折部位骨痂体积和骨痂密度组间比较，差异均有统计学意义[（30.2±0.8）mm3，（23.4±1.1）mm3，（21.4±1.1）mm3，F =96.727，p =0.000；（292.2±10.9）mg·m ﹣3，（256.8±6.5） mg·m ﹣3，（222.8±4.4）mg·m ﹣3，F =98.826，p =0.000]；超微组的骨痂体积和密度均高于散剂组和对照组（ p =0.000，p =0.000；p =0.000，p =0.000），散剂组骨痂体积和密度均高于对照组（p =0.000，p =0.000）。结论：中药外敷超微粉体能够促进大鼠骨折后软骨骨痂向骨性骨痂转化，提高骨痂密度，促进骨折愈合，其效果优于中药外敷散剂。目的：觀察中藥外敷超微粉體對大鼠骨摺後骨痂形成和改建的影響。方法：將60隻3月齡 SD 雌性大鼠製成左側脛骨骨摺模型，併以剋氏針固定。造模結束後將大鼠隨機分為超微組、散劑組和對照組，每組20隻。自術後第1天開始，超微組和散劑組大鼠分彆採用中藥外敷超微粉體和中藥外敷散劑外敷骨摺部位，每天2次，共28 d，對照組不進行榦預。分彆于術後7 d、14 d、21 d 和28 d 每組各處死5隻大鼠，取左側脛骨分彆進行 X 線、組織學及 Micro-CT 檢查。結果：①X 線檢查結果。超微組和散劑組術後28 d 時骨摺處外骨痂密度增加，骨摺線模糊，均接近愈閤，其中超微組大鼠骨摺處外骨痂更緻密；對照組術後28 d 時仍可看到骨摺線。②組織學觀察結果。術後7 d 骨摺處主要為纖維骨痂，3組無明顯差彆；術後14 d 和21 d 時，軟骨骨痂開始取代纖維性骨痂；術後28 d 時軟骨骨痂週圍不斷有原始骨小樑齣現，骨摺斷耑錶麵齣現破骨細胞，原始骨小樑不斷改建成為成熟骨小樑，其中以超微組骨小樑最多。③Micro-CT 檢查結果。術後7 d 時 Micro-CT 檢查，3組均未見到明顯骨痂。術後14 d 時3組大鼠骨摺部位骨痂體積和骨痂密度組間比較，差異均有統計學意義[（20.2±2.3）mm3，（16.4±1.7）mm3，（14.4±1.3）mm3，F =13.286， p =0.001；（184.6±9.3）mg·m ﹣3，（162.8±5.7）mg·m ﹣3，（148.2±6.8）mg·m ﹣3，F =30.649，p =0.001]；超微組的骨痂體積和密度均高于散劑組和對照組（p =0.000，p =0.000；p =0.000，p =0.000），散劑組骨痂體積和密度均高于對照組（p =0.001，p =0.001）。術後21 d 時3組大鼠骨摺部位骨痂體積和骨痂密度組間比較，差異均有統計學意義[（25.6±3.6）mm3，（21.2±0.8） mm3，（17.6±1.8）mm3，F =41.517，p =0.000；（248.2±16.0）mg·m ﹣3，（222.6±7.8）mg·m ﹣3，（197.8±9.0）mg·m ﹣3，F =23.834，p =0.000]；超微組的骨痂體積和密度均高于散劑組和對照組（p =0.000，p =0.000；p =0.000，p =0.000），散劑組骨痂體積和密度均高于對照組（p =0.000，p =0.000）。術後28 d 時3組大鼠骨摺部位骨痂體積和骨痂密度組間比較，差異均有統計學意義[（30.2±0.8）mm3，（23.4±1.1）mm3，（21.4±1.1）mm3，F =96.727，p =0.000；（292.2±10.9）mg·m ﹣3，（256.8±6.5） mg·m ﹣3，（222.8±4.4）mg·m ﹣3，F =98.826，p =0.000]；超微組的骨痂體積和密度均高于散劑組和對照組（ p =0.000，p =0.000；p =0.000，p =0.000），散劑組骨痂體積和密度均高于對照組（p =0.000，p =0.000）。結論：中藥外敷超微粉體能夠促進大鼠骨摺後軟骨骨痂嚮骨性骨痂轉化，提高骨痂密度，促進骨摺愈閤，其效果優于中藥外敷散劑。
목적：관찰중약외부초미분체대대서골절후골가형성화개건적영향。방법：장60지3월령 SD 자성대서제성좌측경골골절모형，병이극씨침고정。조모결속후장대서수궤분위초미조、산제조화대조조，매조20지。자술후제1천개시，초미조화산제조대서분별채용중약외부초미분체화중약외부산제외부골절부위，매천2차，공28 d，대조조불진행간예。분별우술후7 d、14 d、21 d 화28 d 매조각처사5지대서，취좌측경골분별진행 X 선、조직학급 Micro-CT 검사。결과：①X 선검사결과。초미조화산제조술후28 d 시골절처외골가밀도증가，골절선모호，균접근유합，기중초미조대서골절처외골가경치밀；대조조술후28 d 시잉가간도골절선。②조직학관찰결과。술후7 d 골절처주요위섬유골가，3조무명현차별；술후14 d 화21 d 시，연골골가개시취대섬유성골가；술후28 d 시연골골가주위불단유원시골소량출현，골절단단표면출현파골세포，원시골소량불단개건성위성숙골소량，기중이초미조골소량최다。③Micro-CT 검사결과。술후7 d 시 Micro-CT 검사，3조균미견도명현골가。술후14 d 시3조대서골절부위골가체적화골가밀도조간비교，차이균유통계학의의[（20.2±2.3）mm3，（16.4±1.7）mm3，（14.4±1.3）mm3，F =13.286， p =0.001；（184.6±9.3）mg·m ﹣3，（162.8±5.7）mg·m ﹣3，（148.2±6.8）mg·m ﹣3，F =30.649，p =0.001]；초미조적골가체적화밀도균고우산제조화대조조（p =0.000，p =0.000；p =0.000，p =0.000），산제조골가체적화밀도균고우대조조（p =0.001，p =0.001）。술후21 d 시3조대서골절부위골가체적화골가밀도조간비교，차이균유통계학의의[（25.6±3.6）mm3，（21.2±0.8） mm3，（17.6±1.8）mm3，F =41.517，p =0.000；（248.2±16.0）mg·m ﹣3，（222.6±7.8）mg·m ﹣3，（197.8±9.0）mg·m ﹣3，F =23.834，p =0.000]；초미조적골가체적화밀도균고우산제조화대조조（p =0.000，p =0.000；p =0.000，p =0.000），산제조골가체적화밀도균고우대조조（p =0.000，p =0.000）。술후28 d 시3조대서골절부위골가체적화골가밀도조간비교，차이균유통계학의의[（30.2±0.8）mm3，（23.4±1.1）mm3，（21.4±1.1）mm3，F =96.727，p =0.000；（292.2±10.9）mg·m ﹣3，（256.8±6.5） mg·m ﹣3，（222.8±4.4）mg·m ﹣3，F =98.826，p =0.000]；초미조적골가체적화밀도균고우산제조화대조조（ p =0.000，p =0.000；p =0.000，p =0.000），산제조골가체적화밀도균고우대조조（p =0.000，p =0.000）。결론：중약외부초미분체능구촉진대서골절후연골골가향골성골가전화，제고골가밀도，촉진골절유합，기효과우우중약외부산제。
Objective:To observe the effect of traditional Chinese drug(TCD)ultramicro-powder for external application on the forma-tion and reconstruction of bony callus after fracture in rats. Methods:Sixty 3-month-old female SD rats were made into the left tibia fracture models and the fractures were fixed with kirschner wires. Then the rats were randomly divided into ultramicro-powder group,pulvers group and control group,20 cases in each group. The rats in ultramicro-powder group and pulvers group were treated with TCD ultramicro-powder for external application and pulvers for external application at fracture sites respectively on the first day after operation,twice a day for 28 consecutive days,while rats in the control group were not be treated. At 7,14,21 and 28 days after the operation,5 rats were selected from each group and were executed,and their left tibiaes were fetched out for X-ray examination,histology examination and micro-CT examina-tion. Results:At the 28th day after operation,the density of external callus increased at fracture site of ultramicro-powder group and pulvers group,moreover,the fracture lines were fuzzy and the fracture approached clinic healing. The density of external callus of ultramicro-powder group was more dense,while the fracture line can still be seen in control group at the 28th day after operation. At the 7th day after opera-tion,the fiber calluses were found at fracture sites and there was no obvious difference between the 3 groups. At the 14th and 21th day after operation,the fiber calluses began to be replaced by cartilage callus. At the 28th day after operation,original bone trabeculas appeared con-stantly around the cartilage callus,and the osteoclasts were also found on fracture sites. The original bone trabeculas converted to mature bone trabeculas constantly,and the bone trabeculas were the most in ultramicro-powder group. The micro-CT examination showed that no visible bony callus were found in the 3 groups at the 7th day after operation. There were statistical difference in volume and density of bony callus at fracture sites between the 3 groups at the 14th day after operation(20. 2 +/﹣ 2. 3,16. 4 +/﹣ 1. 7,14. 4 +/﹣ 1. 3 mm(3),F =13. 286,p = 0. 001;184. 6 +/﹣ 9. 3,162. 8 +/﹣ 5. 7,148. 2 +/﹣ 6. 8 mg/ m(3),F = 30. 649,p = 0. 001). The volume and density of bony callus were higher in ultramicro-powder group compared with pulvers group and control group(p = 0. 000,p = 0. 000;p = 0. 000,p =0. 000),and were higher in pulvers group compared with control group(p = 0. 001,p = 0. 001). There were statistical difference in volume and density of bony callus at fracture sites between the 3 groups at the 21th day after operation(25. 6 +/﹣ 3. 6,21. 2 +/﹣ 0. 8,17. 6 +/﹣ 1. 8 mm(3),F = 41. 517,p = 0. 000;248. 2 +/﹣ 16. 0,222. 6 +/﹣ 7. 8,197. 8 +/﹣ 9. 0 mg/ m(3),F = 23. 834,p = 0. 000). The volume and density of bony callus were higher in ultramicro-powder group compared with pulvers group and control group(p = 0. 000,p = 0. 000;p =0. 000,p = 0. 000),and were higher in pulvers group compared with control group(p = 0. 000,p = 0. 000). There were statistical difference in volume and density of bony callus at fracture sites between the 3 groups at the 28th day after operation(30. 2 +/﹣ 0. 8,23. 4 +/﹣ 1. 1, 21. 4 +/﹣ 1. 1 mm(3),F = 96. 727,p = 0. 000;292. 2 +/﹣ 10. 9,256. 8 +/﹣ 6. 5,222. 8 +/﹣ 4. 4 mg/ m(3),F = 98. 826,p = 0. 000). The volume and density of bony callus were higher in ultramicro-powder group compared with pulvers group and control group(p = 0. 000,p =0. 000;p = 0. 000,p = 0. 000),and were higher in pulvers group compared with control group(p = 0. 000,p = 0. 000). Conclusion:The TCD ultramicro ﹣ powder for external application can promote the transformation of cartilage callus into osseous callus in rats after fracture and raise the bony callus density. Therefore,it can promote fracture healing. Moreover,its therapeutic effect is better than that of TCD pul-vers for external application.