文章 期刊
6卷1期系統識別號 14954篇
名雲南白藥對促進骨折癒合及其機轉的研究並列篇名
Yunnan Paiyao in Established Fractures: Therapeutic Efficacy and Possible Mechanisms of Action in Rabbits
作 者
王天美 (Teen-Meei Wang); 張書源 (Shu-Yuan Chang);張成國 (Chung-Gwo Chang);蔡長海 (Chang-Hai Tsai);史中 (Chung Shih);王宜萱(Yi-Hsuan Wang)
卷期／出版年月
6卷1期(2001/03)頁次 42-51
資料語文 中文摘要
背景
雖然雲南白藥具有止血癒傷、活血散瘀和破積通絡等功能為一種內服的臨床常用損傷要藥，稚近年來研究顯示該藥對骨折癒合具促進的效果。
方法 紐西蘭種雄性大白兔72隻，分成對照相和用藥組。以腓骨(fibula)切除0或6mm的骨折模式處理，並每天用藥連續到30、60或90天後分別犧牲之。
對照組再分為假性左側腓骨切除(sham，S)組和左側腓骨切除 (fracture F)組。
用藥組亦升為假性左側腓骨切除加內服雲南白藥(Yunnan Paiyao，Y)
每日0.25公克的S+Y組和左測排骨切除加內服雲南白藥的F+Y組。以血液生化學、顯微放射攝影學(microradiography)和骨組織形態學(histomorphometry)的技術來檢測和評估雲南白藥對促進骨折癒合的療效和機轉。
結果各組動物體手術處理30、60或90天後發現：
1) F與F+Y組I但情中驗性磷酸?濃度都較S和S+Y組增加，同時F + Y組的濃度亦較F組為高。
2)F組的顯微放射攝影像，在三個不同期間的骨折處，都未見有癒合的現象。而F+Y組則見有顯著癒合，且隨時間增加骨折處漸恢復成原有的外形。
3)F組的接觸性顯微放射攝影像，術後30天骨折處之外側，部分錨定骨痂形成，兩斷端的骨髓腔只有少量的封閉骨痂形成。在術後 60和90天，骨折處的骨痂量都較術後30天為多。
另在術後90天，兩斷端間雖可見微量的橋形骨痂和聯合骨痂的形成，惟仍有相當距離的骨折間隙、(fracture gap)存在。F+Y 組在術後30天，可見所有(四種)骨痂的形成，其量隨時間的增加而增加。在術後60和90天,兩斷端間先被封閉骨痂和聯合骨痂充滿，後因進行重塑。
(rmodeling)步驟，使原先充滿骨痂的骨髓牌幾近相通。4) F+ Y組的鬆質骨骨量和單位面績總骨量都分別較F組多，惟其增加最隨時間增加而相對減緩。5) F+Y組的活性骨生成表面和骨沉積速率都 較F組多，且其骨生成速率較F組快1.4至1.7倍。 結論內服雲南白藥對骨折處有增加造骨細胞的數目和活性，加快各種骨痂和骨量的生成以及骨化的過程，從而促進骨折癒合。
Background.
Although Yunnan-Paiyao CY) has been shown stop bleeding, increase wound healing, increase blood circulation and degrade clots, recent study results have highlighted the therapeutic efficacy of Y in healing bone fractures. Methods.
In our study, six rabbits were used in each group, the microradiographic and histomorphometric changes of the fibulae group between 0 mm- and 6 mm-operatedfracture (F) groups with and without oral treatment of 0.25g Y per day for30, 60 or 90 consecutive days were evaluated.
Serum levels of calcium, phosphorous and alkaline phosphatase (ALP) activities were also measured. Results. Increases in body weight, trabecular bone volume, total bone volume are, active bone formation surface, bone apposition rate and bone formation rate of the fracture in situ were observed at all times in the fibular fractures treated with Y (F+ Y) rabbits. All four kinds of callus, such as anchorage callus, sealing callus, bridging callus, and uniting callus were formed at 30-days in the- F+ Y group and significantly increased, at 60- and 90-days in the F+ Y groups. The progress of remodeling procedures of fracture healing was remarkable at 90-days in the -F+ Y group.
However, no union was monetary time in all F groups. Additionally, serum concentrations of ALP were significantly increased at 30,60- and 90-days in both F+Y and F groups when compared with the control group (S) and S treated with Y(s+ Y). However, serum concentrations of ALP were slightly, but not significantly higher, except for the group at 90-days, in the F+ Y group than in the F group.
These results indicate that callus formation and cancellus bone formation developed in the F+ Y group and that shortening of the inflame F+Y stage and promotion of reparative _and remodeling stages in the F+ Y group coincided with the maximal increase in bone formation.
Conclusions. Fracture healing of the rabbit fibulae was enhanced rapidly after using Y orally. Its possible mechanisms might be explained that Y caused and then increase the number and activity level of osteoblasts, thus, callus formation occurred in the fractured site, and induced bone formation. The method of operated fibular fracture.
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