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目的探讨中药“骨愈合剂”熏蒸对糖尿病兔骨折愈合过程中骨形态发生蛋白(BMP)表达的影响。方法实验兔随机分为四组,每组12只:A、B组为正常兔胫骨骨折模型组;A1、B1组为糖尿病兔胫骨骨折模型组。A、A1组采用“骨愈合剂”熏蒸;B、B1组为非熏蒸对照。术后2、4、6、8周采血,检测BMP2、转化生长因子β1(TGF-β1)、碱性成纤维细胞生长因子(bFGF)、类胰岛素生长因子(IGF)和血小板衍生因子(PDGF)含量。X射线片检查,比较骨痂出现的时间及骨痂量的差异、骨折线的变化、骨性愈合及髓腔再通的情况。于术后8周取兔胫骨标本,进行组织学检查。结果术后4、6、8周,A1组BMP2、TGF-β、IGF高于B1组(P<0.05)。术后8周,A、B组成熟骨小梁及骨髓形成,A组的髓腔再通优于B组。A1组成熟骨小梁、骨髓形成良好。结论 “骨愈合剂”能够有效促进糖尿病兔骨折BMP2和骨生长相关因子的表达,促进骨折愈合。
Objective To investigate the effect of traditional Chinese medicine “bone healing agent” fumigation on bone morphogenetic protein (BMP) expression during the process of fracture healing in diabetic rabbits. Methods Rabbits were randomly divided into four groups (n = 12): group A and group B were normal tibia fracture models; group A1 and group B1 were model tibia fractures of diabetic rabbits. A, A1 group with “bone healing agent” fumigation; B, B1 group for fumigation control. Blood samples were taken at 2, 4, 6 and 8 weeks after operation to detect the expression of BMP2, TGF-β1, bFGF, IGF and PDGF, content. X-ray examination to compare the callus time and callus volume differences, changes in fracture line, bone healing and recanalization. Rabbit tibia specimens were taken at 8 weeks postoperatively for histological examination. Results At 4, 6 and 8 weeks after operation, the levels of BMP2, TGF-β and IGF in group A1 were significantly higher than those in group B1 (P <0.05). At 8 weeks after operation, the mature trabecular and the bone marrow were formed in A and B groups, and the recanalization of marrow cavity in A group was better than that in B group. A1 group mature trabecular bone, bone marrow formation is good. Conclusion “Bone healing agent” can effectively promote the expression of BMP2 and bone growth-related factors in diabetic rabbit fracture and promote fracture healing.