Clinical And Experimental Research On The Effect Of The Treatment Of Bushenhuoxuetang For Tibial Plateau Fracture Healing

ObjectiveTo provide the evidence of clinical practice about treatment of tibial plateau fracture by observing the clinical effects of using BSHXT (BuShenHuoXueTang) to treat the same kind of fracture that we study. The study also aimed to explore drug target of BSHXT and to provide theoretical foundation and innovative thinking of accelerating fracture healing with traditional Chinese medicine. We research the active components, optimum concentration and mechanism of BSHXT to promote migratory of rat’s BMSCs to accomplish this objective.MethodsClinical observation:36 patients from the inpatient department of the third affiliated hosipital of Guangzhou university of TCM (Orthopedics hospital affiliated) with fracture of tibial plateau (deficiency of the kidney and stasis of blood pattern) that need operation were randomly divided into the treatment group and the control group. The treatment group was demanded to take BSHXT while the control group didn’t, and both groups were under conventional treatment. The pain score (preoperation and 3 weeks after operation), the fracture healing time and the knee functional score were observed to evaluate the curative effect.Experimental study:BMSCs of rat were isolated, cultured, differentiated and identified, and the P3 generation of BMSCs was selected to do the subsequent study. BSHXT was extracted with petroleum ether, ethyl acetate, absolute alcohol and water respectively through Soxhlet extraction method. Transwell assay was used to examine the migration of BMSCs influenced by the extracts from BSHXT while western blot and immunocytochemistry was used to examine the expression of IGF2R influenced by the active components of BSHXT.ResultsClinical observation:On the perspective of the pain score, there has no statistical significance in the difference between the two groups while there is statistical significance in the difference before and after treatment in control group and treatment group respectively. Beyond that, the other two index showed that the treatment group with BSHXT has obvious advantage over the control group.Experimental study:The result of transwell assay showed that all the extracts, except for the 10μg/mL and 50μg/mL of ethyl acetate, have statistical significance in the difference between the blank group. The group which has the highest activity was 100μg/mL of petroleum ether. There is statistical significance in the difference between the different concentration (such as 10μg/mL and 50μg/mL)of the different active components(such as ethyl acetate).All results above also can be read in immunofluorescence pictures. The result of western blot and immunocytochemisty revealed that there is statistical significance in the difference between two groups on the expression of IGF2R.ConelusionBSHXT has the function of accelerating tibial plateau fracture healing and improving patient’s clinical comprehensive curative effect with the addition of lower cost and less side-effect, which is deserved to apply to clinical. The petroleum ether, ethyl acetate, absolute alcohol and water can be the active component of BSHXT at the specific concentration and the level of activity is related to the concentration. The mechanism that need to further exploration may be involved in inducing the directed migration of BMSCs and up-regulating the expression of IGF2R.