加味青娥丸对非创伤性股骨头坏死患者脂联素信号转导通路相关受体和饥饿素表达的影响

Effects of Modified Qing'e Pill on the Expression of Adiponectin,Adiponectin Receptors and Ghrelin in Patients with Nontraumatic Osteonecrosis of the Femoral Head

目的:观察加味青娥丸对非创伤性股骨头坏死患者脂联素信号转导通路相关受体和饥饿素表达的影响,以探讨加味青娥丸治疗非创伤性股骨头坏死的机制。方法:招募临床诊断为非创伤性股骨头坏死患者,随机分为治疗组及对照组,治疗组给予加味青娥丸及补钙治疗,对照组给予模拟剂及补钙治疗,疗程均为6个月,两组患者适当限制运动及负重。另招募60例健康体检者作为健康组。抽取两组患者治疗前后及健康组静脉血,采用ELISA法检测患者治疗前后血浆脂联素和饥饿素的水平;RTPCR方法检测患者治疗前后脂联素、脂联素受体1和受体2mRNA的表达。同步观察患者治疗前后股骨骨密度、髋部X线片及髋关节功能评分(Harris评分),比较两组患者上述指标的差异。结果:治疗后6个月,治疗组患者血浆脂联素、饥饿素及脂联素受体1和受体2mRNA的表达水平显著高于治疗前;治疗组髋关节Harris评分高于对照组;两组患者髋部X片影像学观察及骨密度无明显差异。结论:中药加味青娥丸可能通过调节非创伤性股骨头坏死患者脂联素信号通路相关受体mRNA及饥饿素水平,改善脂质代谢状态而对股骨头坏死疾病起到一定的治疗作用。

Objective：To observe the regulation of modified Qing＇e pill on the expression level of adiponectin,adiponectin receptors and ghrelin in patients with nontraumatic osteonecrosis of the femoral head （ONFH）, for providing an experi- mental base of its clinical application. Methods.. All 60 patients with nontraumatic ONFH were randomly divided into the treatment group and the control group. The treatment group was treated by modified Qing＇e pill while the control group was treated with simulated pill. All patients were also given Caltrate D oral. They were treated for six months. Another 60 cases of healthy people accepted heath examination were as healthy group. Serum adiponectin and ghrelin were measured by enzyme-linked immunosorbent assay （ELISA） method, and the expression of adiponectin, adiponectin receptor 1 and adiponectin receptor 2 mRNA were detected by fluorescent real-time quantitative polymerase chain reaction （RT-PCR） in patients with ONFH before and after the treatment and healthy control group. While X-ray examination of the hip,bone mineral density （BMD） of the femoral head and Harris score were measured in patients with ONFH before and after treat- ment. Results：The levels of serum adiponectin and ghrelin in patients with ONFH were significantly different from healthy controls. The expression of adiponectin and AdipoR1/2 in patients with ONFH were significantly lower than that in healthy controls. After six months treatment,levels of serum adiponectin and ghrelin, the expression of adiponectin, Adi- poR1/2 in treatment group were significantly higher than baseline. Harris score in the treatment group were significantly higher than that in the control group. BMD of the hip and X-ray examination of the hip were no significant difference between treatment group and control group after treatment. Conclusion： Modified Qing＇e pill may play a protective role a-gainst nontraumatic ONFH by regulating the adiponectin signaling pathway and ghrelin.