活血止痛汤对硬膜外瘢痕中TGF-β_1和TGF-β_2基因表达的影响  

Effec of Huoxue Zhitong recipe(活血止痛汤)on the expression of TGF-β_1 and TGF-β_2 of the epidural scar tissue

作　　者：周辉[1] 范希玲[2] 夏志敏[1] 郑悦亮[3] 韩勇[1] 张政宏[1] 

机构地区：[1]杭州市中医院骨伤科,浙江杭州310007 [2]浙江大学附属第一医院整形美容科 [3]浙江省人民医院急诊科

出　　处：《中国骨伤》2007年第10期674-678,共5页China Journal of Orthopaedics and Traumatology

基　　金：杭州市医药卫生科技项目资助课题(编号:2003A024)

摘　　要：目的:研究中药活血止痛汤对硬膜外瘢痕增生、粘连的预防作用,探讨其与硬膜外瘢痕形成过程中转化生长因子-β1(transforming growth factor,TGF-β1)和TGF-β2表达的关系,阐明其作用机制。方法:雄性SD大鼠90只随机分为空白对照组(A组)、透明质酸钠组(B组)、活血止痛汤组(C组),每组30只。手术切除L4,5腰椎椎板,造成0.25cm×1cm硬脊膜裸露区,B组于硬膜囊外均匀地涂上一层透明质酸钠(约0.3ml),其余2组以等量生量盐水处理。术后第1天开始,C组予活血止痛汤2.5ml.kg-1.d-1灌胃;A、B组予以等量生理盐水,连用14d。术后第2、4、8周末处死动物,逆转录酶链反应(reverse transcription polymerase chain reaction,RT-PCR)测定其硬膜外瘢痕组织中TGF-β1和TGF-β2的表达水平,按Rydell法评定粘连程度,透射电镜观察其超微结构。结果:第2、4、8周时,B、C组TGF-β1和TGF-β2的表达水平均明显低于A组(P<0.05),尤其在第8周时,C组TGF-β1和TGF-β2的表达水平与B组比较亦有统计学意义(P<0.05)。大体观察发现B、C组粘连程度明显减轻(P<0.05)。各时相B、C组瘢痕中成纤维细胞以及细胞内的细胞器的数量均减少,胶原纤维的合成受到抑制。结论:活血止痛汤能通过下调TGF-β1和TGF-β2的表达,减少成纤维细胞增殖和胶原等细胞外基质(extracellularmatrix,ECM)的沉积,达到预防硬膜外瘢痕增生、粘连的效果。Objective：To study the effect of Huoxue Zhitong recipe on the prevention of the epidural scar tissue adhesion and to explore the relationship with the expressions of transforming growth factor-β1（TGF-β1） and TGF-β2.Methods：Ninety male SD rats were randomly divided into three groups,the control group A（rats=30）,sodium hyaluronate group B（rats=30）,Huoxue Zhitong recipe group C（rats=30）.Laminectomy were performed at L4,5to expose a 0.25 cm×1 cm area of spinal dura,which were covered by 0.3 ml sodium hyaluronate in group B,or covered by same amount of saline in group A and C.At first day after operation,Rats were fed with Huoxue Zhitong recipe（2.5 ml·kg^-1·d^-1y gavag in group C,and with same amount of saline in group A and B（continuous application for 14 d）.The animals were sacrificed at the 2nd,4th and 8th weeks after operation.The specimens were prepared for determination of the expression of TGF-β1 and TGF-β2 at scar tissue and the degree of scar adhesion according to Rydell method.The ultrastructure of scar tissue was absened with transmission electron microscope（TEM）.Results：At the 2nd,4th,8th weeks after operation,the expression of TGF-β1 and TGF-β2 of group B and C were lower than that of group A（P〈0.05）.At the 8th week,the expression of the two cytokines in group C was significant decreased than that of group B（P〈0.05）.The duramater adhesion in group B and group C was less than that of group A（P〈0.05）.In group B and C,the amount of fibroblasts and intracellular organelle decreased,synthesis of collagen fiber was inhibited in different periods（P〈0.05）.Conclusion：Huoxue Zhitong recipe can decrease the expression of TGF-β1 and TGF-β2and reduce proliferation of fibroblast and sedimentation of extracellular matrix,soit can prevent hyperplasia and adhesion for the scar tissue.

关 键 词：瘢痕组织 转化生长因子-Β 中草药 大鼠 

分 类 号：R681.53[医药卫生—骨科学]