复方四黄液联合Ag_(2)O-TiO_(2)-NTs调控TLRs信号通路对骨折术后感染炎性反应的实验研究  

Influence of Compound Sihuang Liquid Combined with Ag_(2)O-TiO_(2)-NTs on Inflammatory Reaction of Infection after Fracture Surgery by Regulating TLRs Signaling Pathway

作　　者：曾展鹏[1] 赖昌荣 关信潮[1] 郑伟杰[1] 陈镇文 ZENG Zhan-peng;LAI Chang-rong;GUAN Xin-chao;ZHENG Wei-jie;CHEN Zhen-wen(Department of Orthopedics,Panyu Hospital of Chinese Medi cine,Guangzhou Guangdong 511400;Department of Anesthes:iology,The Eighth People's Hospital of Panyu District,Guangzhou Guangdong 511450)

机构地区：[1]广东省广州市番禺区中医院骨伤四科,广东广州511400 [2]广州市番禺区第八人民医院麻醉科,广东广州511450

出　　处：《世界中西医结合杂志》2023年第12期2391-2396,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：广东省中医药局科研项目资助(20222162);广州市科技计划项目(202201010832)。

摘　　要：目的探讨复方四黄液联合Ag_(2)O-TiO_(2)-NTs通过调控TLRs信号通路,对骨折术后感染的炎性反应的调控作用。方法将32只SPF级新西兰大白兔建立闭合性骨折内固定术后感染模型,按随机数字法分为对照组、Ag_(2)O-TiO_(2)-NTs组、复方四黄素溶液组、Ag_(2)O-TiO_(2)-NTs溶液+复方四黄素溶液组。于骨折部位注入表面葡萄球菌悬液。注射菌液当天及注射1 d、5 d、10 d、15 d后记录所有大白兔肛温、CRP、ESR及PCT,并取钢板周围滑膜组织进行TLR2和4的免疫组化及Western blot检测。结果复方四黄液以及Ag_(2)O-TiO_(2)-NTs均可以降低CRP、ESR及PCT的表达,二者合用时,效果更为明显。复方四黄液对术后感染的体温升高,具有较好的控制作用。复方四黄液和Ag_(2)O-TiO_(2)-NTs两组的TLR2及TLR4均较对照组降低,而合用后降低更为明显,说明二者具有抑制TLRs信号通路始动环节TLR2和TLR4的作用。结论应用复方四黄液,并联合Ag_(2)O-TiO_(2)-NTs治疗兔子闭合性骨折内固定术后感染,明确复方四黄液及Ag_(2)O-TiO_(2)-NTs能有效抑制TLR2及TLR4相关信号传导的启动,并降低下游的炎症指标表达的作用。Objective This study aims to explore the regulatory effect of compound Sihuang Liquid combined with Ag_(2)O-TiO_(2)-NTS on the inflammatory reaction of infection after fracture surgery by regulating the TLRs signal pathway.Methods A total of 32 SPF-level New Zealand white rabbits were selected to establish infection models after internal fixation of closed fractures and were randomly divided into Ag_(2)O-TiO_(2)-NTS group,compound tetraflavin solution group,Ag_(2)O-TiO_(2)-NTS solution+compound tetraflavin solution group,and control group.Surface staphylococcus suspension was injected at the fracture site.The anal temperature,CRP,ESR,and PCT of all white rabbits were recorded on the day of injection and on the 1st,5th,10th,and 15th days after injection.The synovial tissue around the plate was taken for immunohistochemical and Western blot detection of TLR2 and 4.Results Compound Sihuang Liquid and Ag_(2)O-TiO_(2)-NTS can reduce the expression of CRP,ESR,and PCT,and the effect is better when they are used together.Compound Sihuang Liquid has a good control effect on the temperature rise of postoperative infection.The TLR2 and TLR4 of the two groups of compound Sihuang Liquid and Ag_(2)O-TiO_(2)-NTS were lower than those of the control group,and the decrease was more obvious after combined use,indicating that compound Sihuang Liquid and Ag_(2)O-TiO_(2)-NTS had the effect of inhibiting TLR2 and TLR4,the initiating links of the TLRs signaling pathway.Conclusions Compound Sihuang Liquid and Ag_(2)O-TiO_(2)-NTS were used to treat infection after internal fixation of closed fracture in rabbits.It was clear that compound Sihuang Liquid and Ag_(2)O-TiO_(2)-NTS could effectively inhibit the activation of TLR2 and TLR4-related signal transduction and reduce the expression of downstream inflammatory indicators.

关 键 词：装载了纳米氧化银颗粒的钛纳米管 复方四黄液 闭合性骨折内固定术后感染 

分 类 号：R285.5[医药卫生—中药学]