兔激素性股骨头坏死早期骨组织细胞功能改变及外敷中药的治疗作用观察

Cell function changes of bone tissue in early glucocorticoid-induced femoral head necrosis and the therapeutic effects of external application of Chinese medicines

目的探讨激素性股骨头坏死(GANFH)过程中骨组织细胞功能改变的临床意义及中药"促骨塑膏"对GANFH的防治作用。方法64只健康成年新西兰兔随机分为正常对照组、激素造模组、中药治疗组、中药预防组(n=16),分别于处理的0、2、4、6、8、12周测定血清中骨特异性碱性磷酸酶(BALP)、骨钙素(BGP)的含量及抗酒石酸酸性磷酸酶(TRACP)的活性,并于第4、6、8、12周分批处死动物,取双侧股骨头进行常规病理组织学检查。结果与正常对照组比较,激素造模组BALP在第4周及第6周升高,TRACP从第2周开始升高,BGP从第4周开始降低(P<0.05);中药预防组BALP从第8周开始、TRACP从第2周开始升高(P<0.05),而BGP与正常对照组比较无显著性差异。在第12周时,与激素造模组及同组8周时比较,中药治疗组BALP、BGP水平升高,TRACP活性降低,成骨细胞增多,破骨细胞减少(P<0.05)。结论激素通过损伤骨组织细胞导致的骨塑形及骨重建破坏引起GANFH,骨组织细胞功能改变的特异性指标检测对于GANFH的早期诊断具有重要参考价值。外敷中药"促骨塑膏"促进成骨细胞增殖并抑制破骨细胞增殖,可有效预防兔激素性GANFH。

Objective To investigate the clinical significance of cell function changes of bone tissue in glucocorticoid-induced avascular necrosis of femoral head （GANFH）, and the preventive and therapeutic effects of ＂Cugusugao＂ ointment, a mixture of traditional Chinese medicines, on GANFH. Methods Sixty-four New Zealand white rabbits were randomly divided into four groups （16 each）： control group, model group, therapy group and prevention group. The contents of bone-specific alkaline phosphatase （BSAP） and bone gla protein （BGP）, and the activity of tartrate-resistant acid phosphatase （TRAP） in serum were determined at the 0, 2nd, 4th, 6th, 8th and 12th week after treatment. Meanwhile, rabbits were sacrificed at the 4th, 6th, 8th and 12th week, and bilateral femoral heads were obtained for histopathological examination. Results Compared with control group, the contents of serum BSAP were elevated at the 4th and 6th week, while TRAP elevated from the 2nd week and BGP lowered from the 4th week in model group （ P〈0. 05）. The contents of serum BSAP were elevated from the 8th week and TRAP from the 2nd week in prevention group （ F〈0. 05）, while serum BGP had no obvious change At the 12th week, the contents of BSAP and BGP were elevated, the activity of TRAP declined, and the number of osteoblast increased, while of osteoclast decreased in therapy group compared with those in model group and in the group per se at 8th week. Conclusions Cell functional changes of bone tissues caused by glucocorticoid usually result in destructive effects of bone moulding and remodeling, which lead to GANFH. External application of ＂Cugusugao＂ ointment can promote osteoblast and inhibit ostcoclast proliferation, thus effectively prevent GANFH occurring.