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目的研究不同时间段骨折处X线摄片评分和C反应蛋白(CRP)、纤维蛋白原(FIB)及血管内皮细胞生长因子(VEGF)在血液中的表达情况,探讨早期应用疏风清热合剂促进骨折愈合的机制。方法建立家兔双侧桡骨骨折模型,将造模成功后的33只家兔按随机数字表法分为模型对照组、生理盐水组和疏风清热合剂组,每组11只,另设空白对照组11只。疏风清热合剂组和生理盐水组于造模后10天内分别给予疏风清热合剂[10 mL/(kg·d)]和等体积的生理盐水灌胃。造模后第28、42天检测双侧桡骨进行X线摄片,第1、3、7、14天检测血液中CRP、FIB表达,第7、14、28天检测血液中VEGF表达情况。结果(1)与模型对照组比较,疏风清热合剂组第28、42天骨折部位X线评分较高(P<0.01),且高于生理盐水组(P<0.05)。(2)与本组造模后第3天比较,模型对照组、生理盐水和疏风清热合剂组第7天CRP、FIB均表达较低(P<0.05)。与空白对照组比较,模型对照组第1、3、7天血浆CRP、FIB表达水平均升高(P<0.01);与模型对照组比较,疏风清热合剂组第3、7天时间点CRP、FIB表达降低(P<0.05,P<0.01);与生理盐水组比较,疏风清热合剂组在第3、7天时间点CRP、FIB表达降低(P<0.01)。(3)与本组造模后第14天比较,模型对照组、生理盐水和疏风清热合剂组第7、28天VEGF表达降低(P<0.05,P<0.01)。与空白对照组比较,模型对照组第7、14、28天VEGF表达均升高(P<0.01);与模型对照组比较,疏风清热合剂组第7、14、28天VEGF表达较高(P<0.01),且高于生理盐水组(P<0.01)。结论早期应用疏风清热合剂可以促进新西兰家兔桡骨骨折的愈合,其作用机制可能是通过降低急性相蛋白CRP、FIB表达以及促进血液中VEGF的高表达实现。
Objective To study the expression of X-ray and C-reactive protein (CRP), fibrinogen (FIB) and vascular endothelial growth factor (VEGF) in blood at different fracture stages and to explore the effect of Shufeng Qingre Hemorherapy Fracture healing mechanism. Methods Rabbits bilateral radius fracture model was established, the 33 rabbits after successful modeling were divided into model control group, saline group and Shufeng Qingrensi group according to random number table method, with 11 rabbits in each group and blank control Group 11 only. Shufeng Qingre Mixture group and saline group were given Shufeng Qingre Mixture [10 mL / (kg · d)] and normal saline intragastrically for 10 days after modeling. On the 28th and 42nd days after operation, the bilateral radial radiographs were detected by X-ray. CRP and FIB were detected in the blood on the 1st, 3rd, 7th and 14th days. The VEGF expression in the blood was detected on the 7th, 14th and 28th day. Results (1) Compared with the model control group, the scores of X-ray at fracture site of Shufeng Qingre Mixture group on the 28th and the 42nd day were higher than that of the normal control group (P <0.05). (2) Compared with the third day after modeling, the expression of CRP and FIB in the model control group, NS and Shufeng Qingre Mixture group was lower on the 7th day (P <0.05). Compared with the blank control group, the levels of plasma CRP and FIB in the model control group were increased on the 1st, 3rd, 7th day (P <0.01). Compared with the model control group, the CRP (P <0.05, P <0.01). Compared with the normal saline group, the expression of CRP and FIB in Shufeng Qingre Mixture group decreased at the 3rd and 7th day (P <0.01). (3) Compared with the 14th day after modeling, the VEGF expression of model control group, NS and Shufeng Qingre Mixture group decreased on the 7th and 28th day (P <0.05, P <0.01). Compared with the blank control group, the expression of VEGF increased on the 7th, 14th and 28th days in the model control group (P <0.01). Compared with the model control group, VEGF expression was higher on the 7th, 14th and 28th days in Shufeng Qingre Mixture group P <0.01), and higher than the saline group (P <0.01). Conclusion Shufeng Qingre Mixture can promote the healing of radius fractures in New Zealand rabbits. The mechanism may be through reducing the expression of CRP and FIB and promoting the expression of VEGF in blood.