活血止痛汤对硬膜外瘢痕组织中羟脯氨酸含量及其超微结构的影响  

Effect of Huoxue Zhitong decoction (活血止痛汤) on content of Hydroxyproline and ultrastructure of the epidural scar tissue

作　　者：夏志敏[1] 周辉[2] 赵万军[2] 韩勇[2] 张志敬[1] 

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]杭州市中医院

出　　处：《中国骨伤》2007年第8期532-535,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:评价活血止痛汤预防实验性椎板切除术后硬膜外瘢痕形成与粘连的疗效。方法:雄性SD大鼠90只随机分成空白对照组、透明质酸钠组、活血止痛汤组,每组30只。手术切除L4-L5腰椎椎板,造成0.25cm×1cm硬脊膜裸露区,透明质酸钠组于硬膜囊外均匀地涂抹一层透明质酸钠约0.3ml,其余2组以等量生理盐水处理。术后2周内活血止痛汤组予活血止痛汤2.5ml/kg灌胃;空白对照组和透明质酸钠组予等量生理盐水。术后第2、4、8周末处死动物,测定其硬膜外瘢痕组织中羟脯氨酸含量,按Rydell法评定粘连程度,透射电镜观察其超微结构。结果:第2周时,透明质酸钠组羟脯氨酸含量明显低于空白对照组(P<0.05),而活血止痛汤组虽然也较低,但差异无统计学意义(P>0.05);第4周时,与空白对照组相比,透明质酸钠组和活血止痛汤组羟脯氨酸含量均较低(P<0.05),但透明质酸钠组和活血止痛汤组的差异缺乏显著性。第8周时,活血止痛汤组羟脯氨酸含量不仅低于空白对照组(P<0.01),而且其与透明质酸钠组亦有显著性差异(P<0.05)。大体观察也发现透明质酸钠组和活血止痛汤组粘连程度明显降低(P<0.05)。各时相透明质酸钠组和活血止痛汤组瘢痕中成纤维细胞以及细胞内的细胞器数量均减少,胶原纤维的合成受到抑制。结论:活血止痛汤能降低硬膜外瘢痕中羟脯氨酸的含量,抑制瘢痕组织中成纤维细胞和胶原的代谢,减少硬膜外瘢痕的形成和粘连。Objective：To evaluate the effect of Huoxue Zhitong decoction on content of Hydroxyproline and uhrastructure of the epidural scar tissue. Methods： Ninety male SD rats were randomly divided into three groups, the control group （ A, n = 30） ,sodium hyaluronate group （B,n =30）,Huoxue Zhitong group（ C,n = 30）. 0. 25 cm × l cm dura mater uncovered area laminectomy was performed at L4 and L5, covered with 0. 2 ml sodium hyaluronate in group B, covered with same amount of saline in group A and C. During 2 weeks after operation,in group C,rats were fed with Huoxue Zhitong decoction （2. 5 ml/kg） by garage,and with same amount of saline in group A and B. The animals were sacrificed at 2,4 and 8 weeks after operation. The specimens were prepared for determination of the content of Hydroxyproline at scar tissue and the degree of scar adhesion according to Rydell method, and observed the uhrastructure changes of scar tissue with transmission electron microscope. Results： At 2 weeks after operation, compared with group A, the content of Hydroxyproline of group B was decreased （ P 〈 0. 05）, but group C compared with group A and B had no difference （ P 〉 0. 05 ）. At 4 weeks, compared with group A, the content of Hydroxyproline of group B and C were decreased （ P 〈 0. 05 ）. At 8 weeks, the content of Hydroxyproline of group C was significant decreased compared with not only group A （ P 〈 0. 01 ） but also with group B （ P 〈 0. 05 ）. In group B and group C, the dura mater adhesion was decreased （ P 〈 0. 05 ）, the proliferation of fibroblasts and fibroblastic function were inhibited （P 〈 0. 05）. Conclusion ：Huoxue Zhitong decoction inhibites the increase of Hydroxyproline and reduces the proliferation and collagen synthesis in fibroblast culture in the scar tissue.

关 键 词：椎板切除术 瘢痕 羟脯氨酸 活血止痛汤 

分 类 号：R681.5[医药卫生—骨科学]