淫羊藿配合髓芯减压术治疗兔激素性股骨头坏死的实验研究

Study of Epimedium Combined with Core Decompression for Steroid- induced Femoral Head Necrosis in Rabbits

目的观察淫羊藿配合髓芯减压术对兔激素性股骨头坏死的治疗效果并探讨其作用机制。方法用改进的马血清加甲基泼尼松龙的方法诱导制备兔激素性股骨头坏死动物模型。将动物分为正常对照组、模型组、手术组(髓芯减压术)、中药组(淫羊藿)、综合组(髓芯减压术+淫羊藿)。治疗后对各组股骨头的骨密度、病理组织学、IGF1、BMP2 mRNA和蛋白的表达进行检测。结果与对照组相比,模型组骨密度明显下降,中药组、手术组、综合组均有所改善,综合组改善效果最好。HE染色综合组骨小梁饱满,排列规则整齐,骨细胞基本正常,造血细胞丰富,脂肪细胞较少。IGF1mRNA和蛋白水平,模型组高于对照组。BMP-2 mRNA和蛋白水平,模型组较对照组明显下降。IGF1、BMP-2 mRNA和蛋白的表达,中药组与综合组,手术组与模型组相比均无明显差异;而在中药组和综合组的表达显著高于模型组和手术组,且IGF1与BMP-2 mRNA及蛋白在股骨头的表达呈明显正相关。结论淫羊藿可上调成骨相关蛋白IGF1和BMP-2的表达,其与髓芯减压术相结合可有效促进兔激素性股骨头坏死的损伤修复。

Objective To study the effect and the mechanism of epimedium combined with core decompression for steroid-induced femoral head necrosis in rabbits.Methods The rabbit models of steroid-induced femoral head necrosis were established by the modified method of horse serum plus methylprednisolone and rabbits were divided into control,model,operation （core decompression）,Chinesemedicine（epimedium） and integration group（core decompression ＋ epimedium）.After treatment,the bone mineral density,pathological changes,mRNAs and proteins expressions of IGF1,BMP-2 of femoral head were examined.Results Compared with model group,the bone mineral density of the femoral head were improved in operation,Chinese medicine,integration group,and the improvement in integration group was much better than other two groups.Results of HE staining showed that in integration group bone trabecula was plump and in regular arrangement,osteocyte tend to be normal,hematopoietic cells were abundant and fat cells were less.Compared with control group,in model group,the expressions of IGF1 mRNA and protein were increased and the expressions of BMP-2 mRNA and protein were decreased.The expressions of IGF1,BMP-2 mRNA and protein in integration and Chinese medicine group were higher than those in model and operation group,and had no obvious difference between integration and Chinese medicine group,model and operation group.In addition,there was a positive correlation between IGF1 and BMP-2 in femoral head.Conclusion Epimedium could up-regulate the expressions of IGF1 and BMP-2.It combined with core decompression plays an important role in the reparation of steroid-induced femoral head necrosis.