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目的：基于成血管-成骨耦联机制和动物实验，探讨补肾复脉方对激素性股骨头坏死（steroid-induced avascular necrosis of the femoral head,SANFH）的作用机制。方法：采用甲泼尼龙琥珀酸钠联合脂多糖建造SANFH大鼠模型。以正常大鼠作为空白对照，将SANFH大鼠分为模型组、阳性组及中药低、中、高剂量组。对各组大鼠股骨头进行Micro-CT扫描观察其形态；H&E染色观察组织病理变化；免疫组化染色检测组织中CD31、Osterix、Runx2的表达；ELISA法检测血清中OPG、BALP、BGP、Runx2水平；Western blot及RT-qPCR检测组织中HIF-1α、VEGFA、VEGFR2、BMP2的蛋白及mRNA表达。结果：模型组股骨头表面结构被破坏。与模型组相比，中药低、中、高剂量组与阳性药组股骨头结构较完整，空骨陷窝率减少，各项指标的表达均呈剂量依赖性升高。结论：补肾复脉方能够通过促进骨与血管的形成来改善SANFH，其机制可能与上调HIF-1α/VEGFA/VEGFR2信号通路中相关因子的表达，从而增强成血管-成骨耦联作用有关。
Abstract：Objective: To explore the mechanism of Bushen Fumai Formula on steroid-induced avascular necrosis of the femoral head(SANFH) based on the vascularization-osteogenesis coupling mechanism and animal experiments. Methods: Methylprednisolone sodium succinate combined with lipopolysaccharide was used to establish SANFH rat model. The normal rats were used as the blank control, and SANFH rats were randomly divided into the model group, the positive group, and the low, medium and high dose groups of traditional Chinese medicine. Micro-CT scans were conducted to examine the structure of the femoral heads in each rat group, while H&E staining was utilized to detect histopathological alterations; Immunohistochemical staining was performed to detect the expression of CD31, Osterix, and Runx2 in the tissues; The levels of OPG, BALP, BGP, and Runx2 in serum were measured using ELISA, while Western blot and RT-qPCR techniques were used to identify the protein and mRNA presence of HIF-1α, VEGFA, VEGFR2, BMP2. Results: In the model group, the femoral head′s surface configuration was demolished. Compare to the model group, the femoral head was more intact, the rate of empty bone traps was reduced and the expression of all indices was increased in a dose-dependent manner in the low, medium and high dose categories of traditional Chinese medicine and the positive medicine group. Conclusion: Bushen Fumai Formula can improve the SANFH by promoting the formation of bone and blood vessels, and its mechanism may be related to the up-regulation of HIF-1α/VEGFA/VEGFR2 signaling pathway, thereby enhancing the bone-blood coupling mechanism.
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基本信息:
DOI：10.13210/j.cnki.jhmu.20250314.003
中图分类号:R285.5
引用信息:
[1]邱静,王世轩,赵双利,等.补肾复脉方治疗激素性股骨头坏死的作用机制研究[J].海南医科大学学报,2026,32(09):697-706.DOI:10.13210/j.cnki.jhmu.20250314.003.
基金信息:
国家中医药管理局全国名老中医药专家传承工作室建设项目[国中医药人教函（2022）75号]~~
2025-03-17
2025-03-17
2025-03-17