目的 观察伤科九味健骨片对骨折大鼠骨愈合的促进作用及对TGF-β/Smad通路的调控机制。方法 制备SD大鼠右侧胫骨闭合性骨折模型，按随机数字表法分为模型组、伤科接骨片组和伤科九味健骨片低、高剂量组，每组8只，另取8只未经处理的动物作为对照组。造模后第2天开始，伤科接骨片组ig伤科接骨片0.39 g/kg，伤科九味健骨片低、高剂量组分别ig伤科九味健骨片0.43、0.86 g/kg，对照组ig生理盐水，1次/d，共28 d。解剖观察右侧胫骨骨折愈合情况和组织形态病理学情况；采用ELISA法检测血清中促炎症因子白细胞介素（IL）-1β、IL-6、肿瘤坏死因子-α（TNF-α）；以及骨形成因子碱性磷酸酶（ALP）、骨钙素（BGP）的水平；利用Image J软件进行组织形态计量学分析Smad 1/5/9、Smad 6、转化生长因子β（TGF-β）、骨形态发生蛋白2（BMP2）蛋白的表达。结果 伤科九味健骨片组大鼠骨折侧胫骨愈合恢复良好，边缘整齐，平滑无隆起，无明显骨折痕迹；病理结果显示，伤科九味健骨片组骨折侧大鼠胫骨骨密质结构紧密，骨细胞及骨基质形态正常，内膜平整。与模型组比较，伤科九味健骨片能显著降低骨折大鼠血清中IL-1β、IL-6、TNF-α水平，显著升高骨折大鼠血清中ALP、BGP水平（P＜0.05、0.01）；并能显著上调胫骨组织中BMP2、Smad 1/5/9、TGF-β蛋白的表达，下调Smad 6蛋白的表达（P＜0.05、0.01）。结论 伤科九味健骨片具有促进骨折愈合的作用，其机制可能与降低血清中炎症因子水平，升高骨形成因子水平，以及上调TGF-β、BMP2、Smad 1/5/9蛋白表达、下调Smad 6蛋白的表达有关。

Objective To observe the promoting effect of Shangke Jiuwei Jiangu Tablets on bone healing, and the regulatory mechanism of TGF-β/Smad pathway in fracture rats. Methods The model of closed fracture of the right tibia of SD rats was prepared, and the successfully constructed animals were divided into model group, Shangke Jiegu Tablets group, Shangke Jiuwei Jiangu Tablets low-dose and high-dose groups, with 8 animals in each group according to the random number table method, and 8 untreated animals were selected as control group. Starting from the second day after modeling, the Shangke Jiegu Tablets group was given 0.39 g/kg, the Shangke Jiuwei Jiangu Tablets low and the high-dose groups were given 0.43 and 0.86 g/kg Shangke Jiuwei Jiangu Tablets, respectively, and the control group was given normal saline, once daily for 28 d. The fracture union and histopathology of the right tibia were observed by anatomy. The pro-inflammatory cytokines IL-1β, IL-6, TNF-α, and levels of bone forming factors ALP and BGP were detected by ELISA method. The expressions of Smad 1/5/9, Smad6, TGF-β, and BMP2 were analyzed by histomorphometric analysis using Image J software. Results The fracture-side tibia of the Shangke Jiuwei Jiangu Tablets group was well healed, with neat edges, smooth edges, and no obvious fracture traces. The pathological results showed that the tibial bone density structure was tight, the bone cells and bone matrix were normal and the intima was smooth in the Shangke Jiuwei Jiangu Tablets group. Compared with model group, Shangke Jiuwei Jiangu Tablets group could significantly reduce the levels of IL-1β, IL-6, and TNF-α in serum of fractured rats, and significantly increase the levels of ALP and BGP in serum of fractured rats (P < 0.05, 0.01). The expression of BMP2, Smad1/5/9, and TGF-β in tibia tissue was significantly up-regulated, while the expression of Smad 6 protein was down-regulated (P < 0.05, 0.01). Conclusion Shangke Jiuwei Jiangu Tablets has the effect of promoting fracture healing, and its mechanism may be related to reducing the level of inflammatory factors in serum, increasing the content of bone formation factors, up-regulating the expression of TGF-β, BMP2, Smad1/5/9 protein, and down-regulating the expression of Smad6 protein.

R285.5

广东省中医药局科研项目（20212253）