| ObjectiveThe study aimed to investigate the therapeutic principle of fracture;and analysis the rationality and feasibility of the treatment of strengthen kidney and activating the circulation the blood to treat fracture;and explore the influence factors of fracture healing and analysis the clinical effects based on reviewing literature related to the inner treatment combination of the external treatment, the kidney-tonifying, blood-activating and strengthen kidney and activating the circulation the blood to treat proximal humeral fractures;and observe the clinical effect of kidney-tonifying and blood-activating recipes;To study influence of the kidney-tonifying, blood-activating and the kidney-tonifying combination of blood-activating Chinese herbal medicine on the proliferation of the bone marrow mesenchymal stem cells(BMSCs) under the guidance of taditional Chinese medical theory(TCM).MethodsThree parts of theory inquiry, clinical observation and cell experiment.1. Theoretical studiesThe literatures of proximal humeral fractures and Influencing factors for fracture healing and Strengthen Kidney and Activating The Circulation The Blood were overviewed, generaliaed and summarized to analysis the feasibility of the treatment of kidney-tonifying and blood-activatin to treat fracture.2.Clinical studiesThe clinical study of the effect of BuShenHuoXueFang(BSHXF) on proximal humeral fractures.59subjects enrolled in this clinical study were randomly divided into the treatment group and the control group. The clinical symptom (fracture healing time and the pain scores) and Bone metabolize chemistry indexs (Ca2+, ALP and OCN) improvement were observed.3.Experimental studiesBMSCs were isolated from SD rat bone marrow by density gradient centrif-ugation, then cultured in vitro. The serum containing Chinese herbal medicine were collected. The BMSCs cultured with conditioned media, different groups (Bushenhuoxuefang, Huoxuefang, Bushenfang and control group), different conce-Ntrations of serum containing kidney-tonifying and blood-activatin chinese herbal medicine(KBCHF) or blood-activatin chinese herbal medicine(BCHF) or chinese herbal medicine kidney-tonifying(KCHF). The proliferation of BMSCs were detected with MTT assay.Results1.Theoretical studiesAccording to Orthopedic theory of TCM, many scholars research and reports, We screened Chinese herbs to establishe kidney-tonifying and blood-activatin recipes to treat fractures and fracture-related diseases, provide reference and basis for the clinical treatment of fractures.2.Clinical studiesThe results of BSHXF affected bone metabolic indexrs of the proximal humeral fractures’patients and compared with the results of control group. The outcome manifest the patients’serum ALP and serum OCN content rise after being cured by taking BSHXF. There was a statistically significant difference, comparison with the standard control groups has statistical significance. Clinical symptoms(fracture healing time, the pain scores and Shoulder joint function scores) in the treatment group was significantly improved, Significant efficiency compared with control group, there were statistically significant.3.Experimental studies(1) BMSCs isolation, culture, amplification, identification and determ-ination of cell cycleThe results show that the cytoplasm was stained red, nuclei were stained blue, CD44could be determined, the positive rate of about40%. Antigen expression of CD34hardly was found. The results of the cell cycle was detected by flow cytometry show that BMSCs has. strong proliferation.(2) BSHXF and its Demolition party serum containing of different concentrations effect on cell proliferation of BMSCs There were KBCHF group, KCHF group, BCHF group and control group, Different concentrations of each group containing serum cultured BMSCs, at48hours and72hours, cell proliferation was measured by MTT. The first three results were compared with the control group, there was significant only with the high concentrations of KBCHF group (P<0.05) at48hours.Conclusion1. There are Clinically feasible and reasonable with kidney-tonifying and blood-activating recipes treat fracture.2. BSHXF beneficial effects on bone metabolism indexs; and promotes the proliferation of osteoblasts;and improves clinical symptoms. Due to BSHXF’s Significant efficacy and safety, could be the prospective medicine to treat fractures.3. The Serum containing high concentrations KBCHF Chinese herbal medicine have cytoprotection function and can promote the proliferation. |
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