补肾通络方调控软骨下骨骨重塑保护关节软骨的机制研究  

Therapeutic Mechanism of Bushen Tongluo Prescription in Regulating Subchondral Bone Remodeling and in Protecting Articular Cartilage

作　　者：李钊[1] 梁祖建[1] 张百挡[1] 张还添[2] 何铭涛[1] 陈宇[2] 

机构地区：[1]广州中医药大学附属骨伤科医院,广东广州510240 [2]广州中医药大学第三临床医学院,广东广州510405

出　　处：《新中医》2010年第8期120-123,共4页New Chinese Medicine

基　　金：广东省自然科学基金资助项目(编号:7004817);广东省医师学会骨科医师科研基金资助项目(编号:200606);广州中医药大学创新基金课题(编号:2007C082;09CX088)

摘　　要：目的:探讨补肾通络方调控软骨下骨骨重塑保护关节软骨的作用机制。方法:取30只SPF级雌性SD大鼠,采用改良的Hulth模型的方法建立骨关节炎动物模型,分为Sham组、模型组和中药组。术后第4周中药组开始灌服补肾通络方,模型组、Sham组灌服等量的生理盐水,分别于术后8、12、16周取材,采用骨关节炎软骨国际骨关节炎研究学会(OARSI)软骨组织病理学评分系统,以免疫组化方法评估关节软骨中蛋白多糖和Ⅱ型胶原的含量及对软骨下骨进行骨形态计量学分析。结果:术后8、12、16周,模型组病理改变OARSI评分及甲苯胺蓝、Ⅱ型胶原免疫组化染色灰度值与Sham组比较,差异均有非常显著性意义(P<0.01);术后12、16周中药组3项指标与模型组比较,差异均有非常显著性意义(P<0.01)。软骨下骨组织形态计量学参数测量结果显示,术后12、16周模型组骨小梁面积百分数(%Tb.Ar)、骨小梁宽度(Tb.Th)、骨小梁数量(Tb.N)、骨小梁分离度(Tb.Sp)、每毫米破骨细胞数(Oc.N/mm)、单位骨小梁面积破骨细胞数(Oc.N/mm2)、荧光周长百分率(%L.Pm)、矿化沉积率(MAR)、骨形成率/骨小梁面积(BFR/BV)、骨形成率/周长(BFR/BS)与Sham组、中药组分别比较,差异均有非常显著性意义(P<0.01)。结论:软骨下骨在骨关节炎发生发展中起重要作用,补肾通络方可通过调控软骨下骨生物力学性能,防止软骨破裂,延缓或修复软骨病损。Objective: To explore the therapeutic mechanism of Bushen Tongluo Prescription (TBP) in regulating subchondral bone remodeling and in protecting articular cartilage. Methods: Thirty SPF SD rats were randomized into 3 groups: sham-operation group,model group and TBP group. The rat models of osteoarthritis were induced by modified Hulth method. Four weeks after the operation,TBP was given to the rats in TBP group by gastric gavage,and the rats in other two groups were given the same volume of normal saline. Contents of proteoglycan and collagen type Ⅱin the articular cartilage were detected with immunohistochemical assay,and the morphometry of the subchondral bone was analyzed by applying criteria established by the Osteoarthritis Research Society International (OARSI) 8,12 and 16 weeks after the operation. Results: OARSI score in the sham-operation group and TBP group differed from that in the model group ( P < 0. 05 ) 8,12 and 16 weeks after the operation. The loss of proteoglycan and collagen type Ⅱ,subchondral bone formation and sclerotin hardening were obvious in the model group compared with those in the sham-operation group. In the model group,the bone trabecula area percent,trabecula thichness,trabecula number,trabecula separation,and osteoclast number in per millimeter differed from those in the sham-operation group and TBP group ( P < 0. 01).The fluorescence perimeter percent,mineralization sedimentation rate and bone formation were lower in the model group than those in the sham-operation group and TBP group ( P < 0. 01 ).Conclusion: Subchondral bone plays an important role in the development of osteoarthritis,and TBP can prevent chondroclasis,and can delay and relieve chondropathy in osteoarthritis patients by regulating the biomechanics property of subchondral bone.

关 键 词：骨性关节炎 软骨下骨 中医疗法 补肾通络方 动物实验 大鼠 

分 类 号：R684.3[医药卫生—骨科学]