引导骨再生技术结合补肾法修复大鼠股骨骨缺损  

Guided bone regeneration combined with kidney-tonifying therapy for repairing femoral bone defect in rats

作　　者：谢磊 张严 姜自伟[2] 申震 冯俊铭 郝成义 蔡杨庭 Xie Lei;Zhang Yan;Jiang Ziwei;Shen Zhen;Feng Junming;Hao Chengyi;Cai Yangting(Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510405,Guangdong Province,China)

机构地区：[1]广州中医药大学,广东省广州市510405 [2]广州中医药大学第一附属医院,广东省广州市510405 [3]广东省中医院,广东省广州市510405

出　　处：《中国组织工程研究》2020年第26期4106-4111,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金项目(81774337),项目负责人:姜自伟;广东省中医药局科研基金项目(20181080),项目负责人:蔡杨庭;广东省医学科学技术研究基金项目(B2018097),项目负责人:蔡杨庭。

摘　　要：背景:引导骨再生技术作为目前应用最广泛的骨缺损修复方法之一已广泛运用于口腔医学领域,但关于引导骨再生技术在长骨骨干骨缺损中应用的研究报道很少。目的:探究引导骨再生技术结合中药补肾治疗对大鼠股骨骨缺损修复的影响,评估其成骨效能,并探讨其作用机制。方法:将36只SD大鼠随机分为6组(n=6):空白组、引导骨再生组、补肾高剂量组、补肾中剂量组、补肾低剂量组、骨肽片(西药)组,建立大鼠股骨骨缺损模型,除空白组外,其余各组均给予引导骨再生治疗,采用引导骨再生技术植入自体骨及Bio-Gide胶原膜;补肾各剂量组分别给予0.216,0.108,0.054g/(kg·d)的强骨胶囊灌胃治疗8周;骨肽片组予以0.58 mg/(kg·d)骨肽片灌胃治疗8周。术后第12周,以X射线检查、骨组织苏木精-伊红染色及Masson染色为主要评价指标,评估成骨情况;采用实时荧光定量RT-PCR法检测骨组织中碱性磷酸酶、核心结合因子2、血管内皮生长因子及骨形态发生蛋白2 m RNA的表达。结果与结论:(1)X射线检查、骨组织苏木精-伊红染色及Masson染色结果显示,各治疗组Lane-Sandhu X射线评分与Huddleston组织学评分均显著高于空白组(P<0.001),其中补肾高剂量组和补肾中剂量组明显高于引导骨再生组(P<0.01);(2)RT-PCR检测结果显示,与空白组相比较,补肾高剂量组和补肾中剂量组对骨组织中碱性磷酸酶、核心结合因子2、血管内皮生长因子及骨形态发生蛋白2m RNA的表达有显著上调作用(P<0.01),且明显优于引导骨再生组(P<0.05);(3)提示引导骨再生技术结合中药补肾法治疗能明显促进大鼠股骨骨缺损修复、减少骨组织吸收并改善成骨效能。其作用机制可能是在膜屏障创造出骨组织优势生长的环境中,通过上调相关成骨因子及血管生成因子的表达,促进骨组织新生及血管形成。BACKGROUND:Guided bone regeneration technology,as a most widely used method for repairing bone defects,has been extensively used in the field of stomatology.However,there are few reports on the guided bone regeneration technology in long bone defects.OBJECTIVE:To explore the effects of guided bone regeneration combined with kidney-tonifying therapy on the repair of femoral bone defects in rats,and investigate its osteogenic efficacy and underlying mechanism.METHODS:Thirty-six Sprague-Dawley rats were randomly divided into six groups:blank group,guided bone regeneration group,high-,moderate-,and low-dose kidney-tonifying groups,and ossotide tablets group.The femur bone defect model of rats was established,and was treated by guided bone regeneration except for blank group.Bio-Gide collagen membrane combined with autologous bone was implanted by guided bone regeneration.The kidney-tonifying groups were given 0.216,0.108 and 0.054 g/(kg·d)Qianggu capsule via gavage for 8 weeks.The ossotide tablets group was given 0.58 mg/(kg·d)ossotide tablets via gavage for 8 weeks.At 12 weeks after surgery,the osteogenesis was evaluated by X-ray examination,hematoxylin-eosin staining and Masson staining of bone tissue.The mRNA expression levels of alkaline phosphatase,Runx-2,vascular endothelial growth factor and bone morphogenetic protein-2 in bone tissues were detected by quantitative real-time RT-PCR.RESULTS AND CONCLUSION:Results of X-ray examination and hematoxylin-eosin staining and Masson staining of bone tissue showed that the scores of Lane Sandhu and Huddleston in each group were significantly higher than those in the blank group(P<0.001).The scores in the high-and moderate-dose kidney-tonifying groups were significantly higher than those in the guided bone regeneration group(P<0.01).RT-PCR results showed that the mRNA expression levels of alkaline phosphatase,Runx-2,vascular endothelial growth factor and bone morphogenetic protein-2 in bone tissue in the high-and moderate-dose kidney-tonifying groups were significantly

关 键 词：股骨 骨缺损 引导骨再生技术 补肾法 Bio-Gide胶原膜 成骨效能 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]