The Study Of Bushen Huoxue Decoction Combining With Surgical Treatment In Pilon Fracture And Its Molecular Mechanism

ObjectiveBy using unique dialectical thinking and the basic theory of traditional Chinese medicine, the use of stem cell technology to explore and research of traditional Chinese medicine treatment of Bushen Huoxue Decoction and to promote the fracture repair and reconstruction of rat MSCs migration in the process of the molecular mechanisms, on the other hand, to develop Bushen Huoxue Decoction with internal fixation of Pilon fractures of postoperative clinical observation, so as to provide strong theoretical basis for the Chinese medicine treatment of fractures, and to guide clinical service.Methods1. Experimental Study Prepared SD rats with femoral fracture, including the normal group, the model group, the calcium group, high dose group, middle dose group, low dose group. At 7th day,14th day,21th day, cultivate MSCs from the fracture sit, and observed the cellular morphology by optical microscopy, osteogenic differentiation by Alizarin red staining and adipogenic differentiation by oil red 0, Western Blot detected the CXCR4 expression on membranes of the MSCs;Immunohistochemical detected the CCL12 secretion in fracture sit.2. Clinical Research According to random number table method of 40 patients with Pilon fractures (kidney deficiency and blood stasis type) were randomly divided into treatment group and control group. After 2 weeks,4 weeks, 8 weeks,16 weeks and 24 weeks observed callus growth situation with X-ray, determining the fracture clinical time, and evaluating the ankle recovery function.Results1. The expression of CCL12 and CXCR4 was high an 7th day after fracture; The groups of traditional Chinese medicine could inhibit CCL12 and CXCR4 expression at 14th day, showing a decreasing trend, and high dose reduced significantly; Chinese traditional medicine could promote CCL12 and CXCR4 expression at 21th day, high dose effect changed obviously.2. Callus growth situation of treatment group was better than control group, the bone fracture clinical healing time is lower than the control group, with statistical significance (P＜0.05);Treatment group on Mazur ankle score was higher than the control group, but there was no statistically significant difference (P＞0.05).Conelusion1. In the early and late, Bushen Huoxue Decoction could improve expression of CCL12 and CXCR4 in the fracture sit so that it could promote the migration of MSCs to the fracture sit, with low concentration changing most at early stage, high concentration at late stage;Bushen Huoxue Decoction could limit CCL12 and CXCR4 expression at the middle stage and suppress MSCs migration, with high concentration changing obviously.2. Bushen Huoxue Decoction could promote the Pilon fractures in patients with fracture callus growth, shorten fracture healing time, improve the clinical effect.