补肾方对激素性股骨头坏死大鼠的骨修复作用

目的:观察补肾方对激素性股骨头坏死(SONFH)大鼠股骨头骨修复的作用。方法:雄性Wistar大鼠随机分为正常组,模型组,补肾方高、中、低剂量组和阳性药健骨生丸组。除正常组外其余各组臀肌注射21 mg·kg-1甲泼尼龙琥珀酸钠,1 d 1次,连续3 d,建立单纯性糖皮质激素股骨头坏死模型。各给药组从第4天开始,分别给予5.3,10.6,21.2 g·kg-1的补肾方和1.68 g·kg-1健骨生丸,给药6周后取血和股骨头,HE染色观察股骨头组织的病理学改变,Micro-CT扫描观察股骨头骨形态变化并进行骨计量学分析,ELISA检测血清骨形成标志物骨钙素(BGP)和降钙素(CT)含量。结果:模型组大鼠股骨头表现出大量空骨陷窝和脂肪细胞、骨小梁变窄或断裂、骨髓腔内血细胞减少、可见大量坏死区等组织病理学改变;还可见股骨头塌陷、骨质减少、骨小梁稀疏等影像学改变,骨体积分数、骨小梁厚度、骨小梁模式因子、骨小梁数量、骨密度等骨计量学参数降低而骨小梁分离度升高,血清BGP和CT含量也显著降低;与模型组比较,补肾方中、高剂量组能明显改善大鼠股骨头组织病理学改变程度,补肾方高、中、低剂量组均显著抑制骨坏死程度,中、高剂量组还显著升高血清BGP和CT的含量(P0.05,P0.01);健骨生丸组的作用与补肾方中剂量组的作用相当。结论:补肾方组能明显改善SONFH大鼠股骨头组织病理学和影像学改变,增加血清中BGP及CT的含量,这一促进骨修复的作用可能是其防治激素引起的股骨头骨坏死的机制之一。

Bone Repair Effect of Bushen Formula on Rats with Steroid-induced Osteonecrosis of Femoral Head

Objective: To investigate the bone repair effect of Bushen formula on rats with steroid-induced osteonecrosis of the femoral head(SONFH). Method: Male Wistar rats were randomly divided them into 6 groups:control group, model group, high-dose Bushen formula, mid-dose Bushen, low-dose Bushen groups, and Jiangusheng pills group. Then gluteal injection with methylprednisolone sodium succinate by 21 mg·kg^-1 into all rat groups except for control group, once a day, for 3 consecutive days was conducted to establish the model of SONFH. Since the fourth day, low-dose Bushen, Mid-dose Bushen, High-dose Bushen groups and Jiangusheng group were give 5.3, 10.6, 21.2 g·kg^-1 Bushen formula and 1.68 g·kg^-1 Jiangusheng pills respectively. Six weeks later, their blood and femoral head were collected to observe the histopathological changes of femoral head by HE staining. Micro-CT scanning was used to observe femoral bone morphogenetic changes and analyze the bone morphometry. Bone metabolism markers osteocalcin(bone gla-protein, BGP) and calcitonin(CT) content were detected by ELISA. Result: The femoral head of model group rats showed many histopathological changes, such as more empty lacunae, more fat cells, narrowed or broken bone trabecula, the bone marrow cavity cytopenia, massive necrosis zones. Besides, femoral head collapse, osteopenia, trabecular thinning and other imagological changes can also be observed. According to the bone metrological parameters, bone volume fraction, trabecular thickness, trabecular bone pattern factor, trabecular number and bone density decreased, but trabecular separation increased in model group rats. BGP and CT content in serum significantly reduced in model group rats. Compared with the model group, mid-dose and high-dose Bushen can significantly improve the pathological changes in femoral head of rats. The three dose Bushen groups showed significant inhibition of bone necrosis. Mid-dose and high-dose Bushen can remarkably increase BGP and CT content in serum. The Jiangusheng group had a similar effect with mid-dose Bushen group. Conclusion: Bushen formula can significantly improve the histopathological and imagological changes of rats with SONFH and increase BGP and CT content in serum. This effect in promoting bone repair may be one of its mechanisms of preventing steroid-induced femoral head osteonecrosis.