基于Micro-CT评价温阳补肾方对兔激素性股骨头坏死模型股骨头微结构的影响

To Evaluate the Effect of Wenyang Bushen Recipe on the Microstructure of Femoral Head in Rabbit Model of Steroid-induced Femoral Head Necrosis Based on Micro-CT

目的:通过Micro-CT图像评价温阳补肾方对兔激素性股骨头坏死模型股骨头骨量的影响。方法:选取健康雄性新西兰大白兔6只,分成空白组、模型组、中药组(温阳补肾方临床等效剂量组)。用马血清加甲基强的松龙的方法建立兔激素性股骨头坏死模型,同时正常组等量注射生理盐水。造模结束后,正常组与模型组予生理盐水灌胃,治疗组则给予温阳补肾方灌胃,第四周处死所有兔子取材双侧股骨头,用Micro-CT扫描图像进行分析和评价。结果:大体形态观察:模型组股骨头破损变薄,骨质脆弱,软骨面颜色苍白,表面粗糙;中药组与模型组相比,股骨头破损程度较降低,软骨面颜色较白,骨质较硬,与正常组相比,光泽度较弱。Micro-CT图像显示:模型组股骨头变形,骨皮质不连续且较正常组薄弱,骨质密度不均,“星芒征”消失;软骨面可见剥脱裂纹,骨小梁排列紊乱,甚至断裂;中药组各个骨组织形态与正常组接近;与模型组相比,股骨头外形饱满;骨小梁的排列趋于规则,软骨层增厚,骨皮质连贯。结论:糖皮质激素的大量运用会导致股骨头形态发生改变,主要表现为外形塌陷、骨皮质连续性破坏、骨密度降低、软骨面剥脱、骨小梁紊乱等;温阳补肾方的应用可扭转激素性股骨头坏死的骨组织形态变化,使已变形塌陷的股骨头外形趋于饱满、紊乱的骨小梁排列整齐、恢复骨皮质连续性、增厚薄弱的软骨层。从直观的影像学角度,证明了温阳补肾方在治疗激素性股骨头坏死方面的显著作用。

Objective:To evaluate the effect of Wenyang Bushen Decoction on the bone mass of femoral head in a rabbit model of steroid-induced osteonecrosis of the femoral head by Micro-CT images.Methods:A total of 8 healthy male New Zealand white rabbits were randomly divided into control group,model group and TCM group(Wenyang Bushen Decoction clinical equivalent dose group).The rabbit model of steroid-induced osteonecrosis of the femoral head was established by horse serum and methylprednisolone,and the normal group was injected with the same amount of normal saline.At the end of modeling,the normal group and the model group were given normal saline by gavage,and the treatment group was given WenyangBushen decoction by gavage.At the fourth week after the beginning of treatment,all rabbits were sacrificed,and the bilateral femoral heads were taken for analysis and evaluation by Micro-CT scanning.Results:In model group,the femoral head was damaged and thin,the bone was fragile,the cartilage surface was pale,and the surface was rough.Compared with the model group,the degree of femoral head damage in the Chinese medicine group was lower,the cartilage surface color was white,the bone was harder,and the glossiness was weaker than that in the normal group.Micro-CT images showed that in the model group,the femoral head was deformed,the bone cortex was discontinuous and weaker than that in the normal group,the bone density was uneven,and the"star"sign disappeared.Exfoliation cracks were observed on the cartilage surface,and the bone trabeculae were arranged disorderly or even broken.In the Chinese medicine group,the morphology of bone tissue was similar to that of the normal group.Compared with the model group,the femoral head was plump in shape.The arrangement of bone trabeculae tended to be regular,the cartilage layer thickened,and the cortical bone was coherent.Conclusion:The extensive use of glucocorticoids can lead to morphological changes of the femoral head,mainly manifested as shape collapse,cortical bone continuity destruction,bone mineral density reduction,cartilage surface exfoliation,and trabecular bone disorder.The application of Wenyang Bushen recipe can reverse the morphological changes of the bone tissue of steroid-induced osteonecrosis of the femoral head,make the shape of the deformed and collapsed femoral head tend to be full,the disordered bone trabeculae are arranged in order,the continuity of the bone cortex is restored,and the thin and weak cartilage layer is thickened.From the visual imaging point of view,it is proved that Wenyang Bushen recipe has a significant effect on the treatment of steroid-induced osteonecrosis of the femoral head.