| Objective To study the Tradition Chinese Medicine mechanism of Jiegu paste in promoting fracture healing.Methods New Zealand rabbits were used to establish the model of radial fracture of left forelimb,which was divided into Jiegu paste group,Yunnan Baiyao group,celecoxib group,model control group and normal control group,6 New Zealand rabbits in each group,New Zealand rabbits in the Jiegu paste Group and Yunnan Baiyao Group were treated with external application of medicine for 4 weeks and external fixation with splint,Celecoxib group,model control group and normal control group without without external application of drugs,only fixed with a splint of the same size,the splint replacement time is the same as that of Jiegu paste group and Yunnan Baiyao group;New Zealand rabbits in celecoxib group were given celecoxib capsule by oral administration;the effects of Yunnan Baiyao on fracture healing were studied by x-ray examination,serum calcium and phosphorus determination,ELISA detection of serum Interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),Osteocalcin(OC),vascular endothelial growth factor A(VEGFA),N-terminal peptide of type I procollagen(PINP),basic fibroblast growth factor(bFGF),alkaline phosphatase(ALP),tartaric acid phosphatase 5(ACP5),HE staining detection of fracture healing process,Immunohistochemistry(IHC)detection of bFGF expression in fracture site.Results The results of X-ray examination showed that the fracture healing degree of celecoxib group was the worst,the fracture healing degree of Jiegu paste Group was better than that of model group in the same time,and the fracture healing speed of Yunnan Baiyao group was the fastest.In Yunnan Baiyao group,Jiegu paste group and celecoxib group,the serum calcium reached the peak at the first week and then decreased,the serum phosphorus increased after modeling,and the product of serum calcium and phosphorus increased at first and then decreased after modeling.but from the second week after modeling,the content of serum calcium,phosphorus and the product of calcium and phosphorus in Yunnan Baiyao group were higher than those in other groups,and the difference was statistically significant when compared with the celecoxib group(P < 0.05)and not statistically significant when compared with the bone-setting cream group(P >0.05).The concentrations of TNF-α and IL-6 in serum of all groups were the highest on the day of modeling,and then showed a decreasing trend until the lowest at the 4th week,which was close to the concentration of normal control group,and the lowest in celecoxib group,there was no significant difference between the two groups,but the concentration of Jiegu paste group was higher than that of Yunnan Baiyao group(p <0.05).The concentrations of serum OC,PINP and ALP in celecoxib group,Jiegu paste group and Yunnan Baiyao group have been on an upward trend,at the 4th week,the concentration of serum OC and ALP in Yunnan Baiyao group was higher than that in Jiegu paste group,and the serum PINP concentration is lower than that of the Jiegu paste group;there was no significant difference in serum OC and ALP between Yunnan Baiyao group and Jiegu paste group(P > 0.05),but there was significant difference between Yunnan Baiyao group and celecoxib group(P < 0.05);there were significant differences in serum PINP concentration among Yunnan Baiyao group,Jiegu paste group and celecoxib group(P < 0.05).The serum levels of VEGFA and bFGF in the model control group,Jiegu paste group,and Yunnan Baiyao group have been on an upward trend,by week 4,the serum concentrations of VEGFA and bFGF in the Yunnan Baiyao group were the highest compared to the Jiegu paste group;the serum levels of VEGFA and bFGF in the celecoxib group have been consistently decreasing,by week 4,the serum VEGFA concentration was lower than that of the normal control group;there was no statistically significant difference in serum VEGFA and bFGF concentrations between the Yunnan Baiyao group and the Jiegu paste group(P>0.05),there was no statistically significant difference in serum bFGF concentration between the celecoxib group and the normal group(P>0.05),there were statistically significant differences in serum VEGFA and bFGF concentrations among the other groups(P<0.05).The serum ACP5 concentration of celecoxib group,Jiegu paste group and Yunnan Baiyao group reached the highest in the first week,and then decreased gradually,at the first week,the serum ACP5 concentration of celecoxib group was higher than that of Yunnan Baiyao group and Jiegu paste group,at the 4th week,the serum ACP5 concentration of Yunnan Baiyao group was the highest,and the serum ACP5 concentration of celecoxib group was slightly lower than that of celecoxib group.There was significant difference in serum ACP5 concentration among the three groups(P < 0.05).HE staining showed that HE staining in celecoxib group showed that chondrocytes were positively transformed into callus,but the bone marrow cavity produced by celecoxib group had smaller pore diameter and less number than that in model group,and a small part of bone began to calcify;in the Jiegu paste group,HE staining showed that chondrocytes were positively transformed into callus,resulting in a large pore size and a large number of bone marrow cavities,and even part of the bone marrow cavities had been formed,Yunnan Baiyao group has completed the transformation from cartilage to callus,the bone marrow cavity is all formed,part of the bone marrow cavity is connected with each other and arranged in an orderly manner,and more bones begin to calcify and produce tiny blood vessels.Detection of bFGF expression in osteoblasts at fracture site by IHC,the average positive area ratio of five visual fields in Jiegu paste group,Yunnan Baiyao group and celecoxib group were 4.69%,1.81% and 0.153%,respectively.there were significant differences among the groups(P < 0.05).Conclusion Jiegu paste can promote the healing of radius fracture in New Zealand rabbits. |
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