基于“瘀去-新生-骨合”理论研究富血小板血浆联合中药治疗股骨头坏死作用机制

Mechanism of Platelet-rich Plasma Combined with Chinese Medicine in the Treatment of Femoral Head Necrosis Based on the Theory of "Stasis Removal-Neogenesis and Bone Consolidation"

非创伤性股骨头坏死(ONFH)是一种由于血供受损导致股骨头坏死、塌陷的骨科疑难性疾病。以辨证论治为基础,运用化痰祛瘀中药内服治疗早期ONFH,往往能取得较好的疗效。此外,富血小板血浆(PRP)含有多种生长因子,具有强大的再生能力,在ONFH治疗中呈现巨大潜力。“瘀去-新生-骨合”理论是中医骨伤科关于骨修复的重要理论,其原本用于描述骨折愈合的持续、渐进过程,而股骨头坏死的血供破坏,必有血瘀,整个股骨头坏死修复过程需要良好的血供支持,瘀血不去,新血不生,新生则骨合,这与骨折修复的过程不谋而合,因此,本文将基于“瘀去-新生-骨合”理论,探讨PRP联合化痰祛瘀中药治疗早期非创伤性股骨头坏死的作用机制,为临床治疗本病提供一定的理论参考。

Non-traumatic osteonecrosis of the femoral head(ONFH) is a challenging orthopedic disease characterized by necrosis and collapse of the femoral head due to impaired blood supply.Based on the principle of syndrome differentiation and treatment,the internal use of phlegm-eliminating and stasis-dispelling Chinese medicines for early ONFH often yields good results.In addition,platelet-rich plasma(PRP),which contains a variety of growth factors,has significant regenerative potential and shows great promise in the treatment of ONFH.The theory of “stasis removal-neogenesis-bone consolidation” is an important concept in traditional Chinese medicine(TCM) orthopedics for bone repair.Originally used to describe the continuous and progressive process of fracture healing,this theory is relevant to ONFH as the impairment of blood supply leads to blood stasis.The entire repair process of ONFH requires adequate blood supply.Without the removal of blood stasis,new blood cannot form,and without new blood,bone consolidation cannot be achieved.This process aligns closely with the fracture repair process.Therefore,this paper explored the mechanism of PRP combined with phlegm-resolving and stasis-dispelling Chinese medicines in the treatment of early ONFH based on the “stasis removal-neogenesis-bone consolidation” theory,providing theoretical references for clinical treatment of this condition.