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目的研究健脾补肾方促进骨质疏松性骨折愈合的疗效机制,探讨“脾肾相关”、“先后天之本”中医理论在骨质疏松性骨折防治中的运用。方法建立去卵巢骨质疏松性骨折小鼠模型,随机分为7、14、28d 3个时间点,每个时间点分生理盐水、健脾补肾方2组。于骨折术后第2天给予相应药物灌胃治疗,分别于治疗3个时间点后处死小鼠,取材,进行影像学观察和病理组织学染色。结果 X-ray、Micro-CT结果显示,健脾补肾组7、14、28d均可促进骨痂形成及骨折愈合;Micro-CT定量分析显示,健脾补肾组7、14d骨痂BV/TV、Conn.D、mean/density of TV、mean/density of BV均明显高于生理盐水组(P<0.05);有限元分析结果提示,健脾补肾组28d骨折部位刚度、弹性模量结果均高于生理盐水组(P<0.05);HE染色、ABH/OG染色结果显示,健脾补肾方可以促进骨折部位早、中期膜内成骨和软骨内成骨,加速骨折愈合;免疫组化染色结果显示,健脾补肾方能增加骨痂部位β-catenin、Runx2的表达,促进骨折愈合。结论健脾补肾方可以促进骨质疏松性骨折的愈合,其机制可能与增加β-catenin、Runx2的表达相关。
Objective To study the therapeutic mechanism of invigorating the spleen and kidney in promoting osteoporotic fracture healing and to explore the application of traditional Chinese medicine theory in prevention and treatment of osteoporotic fractures related to spleen and kidney. Methods The mouse model of osteoporotic fracture of ovariectomy was established and randomly divided into 3 groups at 7, 14 and 28 days. The rats in each group were divided into normal saline group and Jianpi Bushen recipe group. On the second day after the fracture surgery, the rats were given the corresponding drugs for gavage treatment. The mice were sacrificed at 3 time points after the fracture, and the materials were taken for imaging observation and histopathological staining. Results The results of X-ray and Micro-CT showed that callus formation and fracture healing were promoted at 7, 14 and 28 days after spleen and kidney invigorating group. Micro-CT quantitative analysis showed that BV / TV, The mean value of Conn.D, mean / density of TV and mean / density of BV were all significantly higher than that of saline group (P <0.05). The results of finite element analysis showed that the stiffness and elastic modulus of 28 d (P <0.05). The results of HE staining and ABH / OG staining showed that Jianpi Bushen Prescription could promote the early and middle period of osteogenesis and endochondral ossification in the fracture site and accelerate the healing of fracture. The results of immunohistochemical staining , Spleen and kidney can increase callus parts β-catenin, Runx2 expression, promote fracture healing. Conclusion Jianpi Bushen Prescription can promote the healing of osteoporotic fractures, which may be related to the increase of β-catenin and Runx2 expression.