三七总皂苷促进腱骨愈合的实验研究

目的：研究三七总皂苷对腱骨愈合的影响。方法：取20只成年新西兰大白兔,随机分为PNS组及空白对照组,每组10只。两组动物均切断双侧膝关节前交叉韧带,以趾长伸肌腱重建前交叉韧带,制作腱骨愈合模型。PNS组骨隧道内注射三七总皂苷注射液,干预腱骨愈合。空白对照组不予干预措施。术后4周及8周每组各处死5只新西兰大白兔,获取腱骨愈合标本。通过肉眼、组织学切片观察两组腱骨愈合的变化及差异。结果：顺利完成所有手术,20只大白兔无死亡及关节感染。大体观察,两组动物4周时腱骨界面为纤维连接,8周时腱骨间隙已不容易辨认。组织学观察,PNS组腱骨界面细胞成熟度更高,sharphy纤维生长更加密集,间质钙化程度更高,新骨形成量更多。8周时界面组织形态分类,两组分布差异有统计学意义。结论：三七总皂苷能够促进腱骨界面细胞成熟,促进腱骨界面胶原生长,促进新骨形成,加快腱骨愈合速度,提高腱骨愈合质量。但本研究尚未对各项指标进行定量测量,三七总皂苷促进腱骨愈合的详细机制尚未完全明确。

Effect of Panax Notoginseng Saponins on autograft tendon healing in bone tunnel:interface histological characteristics

Objective: To investigate the effect of Panax Notoginseng Saponins(PNS) on tendon healing in bone tunnel. Methods: The experiment was performed in the animal laboratory,Wangjing hospital from April to August,2010. All the experiment procedures were accorded with the animal ethical requirements. Twenty New Zealand rabbits were randomly divided into blank control group and PNS group with 10 animals in each group. Anterior cruciate ligament reconstruction with toe extensor tendon was done in knee joints of rabbits by suspend fixation model. PNS was injected in bone tunnel of rabbits in PNS group,and nothing was given to blank group. Specimens were collected at 4 and 8 weeks after surgery. Sections were stained with HE stain to observe the changes of interface tissue between bone tunnel and tendon graft. Interface types were classified according to Yamakado method. Results: At 4 weeks after surgery,the interface was filled with connective tissue in both groups,while at 8 weeks,there was not obvious gap between bone and tendon graft in both groups under macrography. Under microscope,there were more fibroblasts in the PNS group,fibroblasts were more mature in the PNS group,and there were more Sharphey fibers in the PNS group. There was larger new bone formation area in PNS group. The classification on the Yamakado type was significantly different between two groups(P<0.05). Conclusion: PNS can enhance tendon-bone healing in bone tunnel,and promote the connection between tendon and bone. The study lacks quantitative analysis of those criteria,and the mechanics of the promotion of tendon-bone healing has not been totally clear.