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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 effect of Huoxuetongluo Decoction on pathological changes of steroid-induced avascular necrosis of femoral head (SANFA). Methods: Forty rabbits of 6 months old were selected and divided into normal group (n = 8) and modeling group (n = 32). 32 rabbits in model group were subjected to SANFA modeling. The model group consisted of model group, low dose group, medium dose group and high dose group, each with 8 rats. The model group and the normal group were fed distilled water, and the rest were fed different doses of Huoxuetongluo Decoction for 6 weeks, After 8 weeks, the levels of endothelin (ET) and osteocalcin (BGP) in rabbits’ ears were measured. The rats were drawn for 8 weeks and the pathological changes were observed. Results: Compared with the normal group, ET in the 6th week and 8th week of the model group was lower, with statistical significance (P <0.05). Compared with the model group, ET in the low, medium and high dose groups was significantly decreased, with (P <0.05). Compared with normal group, the levels of BGP in the 6th week and the 8th week of the model group were higher than those in the normal group (P <0.05) (P <0.05). Compared with the model group, BGP in low, medium and high dose groups were significantly increased (P <0.05); compared with low, medium and high dose groups, BGP Statistical significance (P <0.05). In the normal group, the intact femoral trabecular bone and the trabecular bone were found in the normal group, and the empty lacuna was found occasionally. In the model group, the trabecular bone became thinner and disordered, and there was bone fragments with empty lacuna. Beam structure disorder, thickening of collagen fibers; trabecular arrangement in the middle dose group relatively neat, fibroblasts increased; high dose group visible trabecular arranged in neat, new bone formation. Conclusion: Huoxue Tongluo Decoction can promote the repair of femoral head tissue in rabbits with steroid-induced avascular necrosis of the femoral head, and restrain the progression of the disease. The curative effect is closely related to the dose and duration.