活血通络汤对激素性股骨头缺血性坏死病理形态学的影响

Effect of Huoxue Tongluo Decoction on Pathological Morphology for Steroid Induced Avascular Necrosis of Femoral Head

目的:探讨活血通络汤对激素性股骨头缺血性坏死(SANFA)病理形态学的影响。方法:选取月龄为6个月的大白兔40只,分为正常组(8只)和造模组(32只),对造模组32只兔子进行SANFA造模,采用数字随机对照表将造模组分为模型组、低剂量组、中剂量组、高剂量组,各8只,其中造模组和正常组灌服蒸馏水,其余均灌服不同剂量的活血通络汤,6周、8周后均取家兔耳缘静脉血测定内皮素(ET)和骨钙素(BGP)水平,持续给药8周后取材,观察病理形态变化。结果:与正常组对比,模型组给药第6周、8周ET均较低,具有统计学意义(P<0.05);与模型组对比,低、中、高剂量组ET均显著降低,具有统计学意义(P<0.05);低、中、高剂量组组间对比,具有统计学意义(P<0.05);与正常组对比,模型组给药第6周、8周BGP均较高,具有统计学意义(P<0.05);与模型组对比,低、中、高剂量组BGP均显著升高,具有统计学意义(P<0.05);低、中、高剂量组组间对比,具有统计学意义(P<0.05)。正常组可见完整股骨头骨小梁及骨小梁中骨细胞,偶见空骨陷窝;模型组骨小梁变细,排列紊乱,且存在骨碎片,存在空骨陷窝;低剂量组骨小梁结构紊乱,胶原纤维增粗;中剂量组骨小梁排列相对整齐,成纤维细胞增多;高剂量组可见骨小梁排列整齐,有新骨形成。结论:活血通络汤能促使激素性股骨头缺血性坏死大白兔股骨头组织修复,抑制病情发展,且疗效与用药剂量、持续时间密切相关。

Objective： To investigate the pathological morphological changes of Huoxue Tongluo Decoction in the treatment of steroid induced avascular necrosis of the femoral head（ SANFA）. Methods： 40 rabbits of 6 month-old were selected and divided into normal group（ n = 8） and modeling group（ n = 32）. SANFA modeling was carried out in the 32 rabbits in the modeling group. According to the random number table method,the modeling group were divided into the model group,low dose group,medium dose group and high dose group, with 8 rabbits in each group. The modeling and the normal group were drenched with distilled water. The rest were drenched with different doses of Huoxue Tongluo Decoction. 6 and 8 weeks later,the ear vein blood of the rabbits was collected to determine the levels of endothelin（ ET） and bone gla protein（ BGP）. 8 weeks of continuous administration later,the materials were collected. The pathological morphological changes were observed. Results：Compared with the normal group,ET of the model group in the 6th week and 8th week of administration was lower（ P〈0. 05）;Compared with the model group,ET of the low,medium and high dose groups were significantly lower（ P〈0. 05）; the differences between the low,medium and high dose group were statistically significant（ P〈0. 05）; compared with the normal group,BGP of the model group in the 6th week and 8th week of administration were higher（ P〈0. 05）; compared with the model group,BGP of the low,medium and high dose group were significantly higher（ P〈0. 05）; the differences between the low,medium and high dose group were statistically significant（ P〈0. 05）. In the normal group,there were visible complete femoral head bone trabecula and bone trabecular metatarsal cells and occasionally visible empty bone lacunae; the bone trabecula of the model group thinned,disorganized and there existed bone fragments and empty bone lacuna; the structure of bone trabecula of the low dose group was disorganized and the collagen fiber thickened; the arrangement of the trabecular bone in the middle dose group was relatively neat and the fibroblasts increased; the arrangement of the trabecular bone in the high dose group was also neat and new bone formed. Conclusion： Huoxue Tongluo Decoction can promote the repair of femoral head tissues in rabbits with steroid induced avascular necrosis of the femoral head and inhibit the development of the disease. Besides,the curative effect is closely related to the dosage and duration of drug use.