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目的探讨活血通络汤治疗激素性股骨头缺血性坏死的可能作用机制。方法 96只日本大耳兔随机分为预防+治疗组、治疗组、模型组、空白组,每组24只。采用臀部肌肉注射醋酸泼尼松龙8 mg/kg方法制备激素性股骨头缺血性坏死模型。从第2周开始,预防+治疗组喂服活血通络汤饲料,其余各组喂服普通饲料,每日1次,连续1周。从第3周开始,预防+治疗组和治疗组均喂服活血通络汤饲料,模型组、空白组均喂服等量普通饲料,每日1次,连续6周。采用免疫组织化学法测定兔股骨组织中碱性磷酸酶(AKP)、骨钙素(BGP)、碱性成纤维细胞生长因子(b FGF)、转化生长因子β1(TGF-β1)、骨形态发生蛋白2(BMP-2)及血小板源性生长因子B(PDGF-B)的表达情况。结果与空白组比较,模型组股骨组织TGF-β1、b FGF、BGP、BMP-2、PDGF-B含量明显降低,APK含量明显升高(P<0.05或P<0.01);与模型组比较,预防+治疗组、治疗组股骨组织TGF-β1、b FGF、BGP、PDGF-B含量明显升高,APK含量明显降低,预防+治疗组BMP-2含量明显升高(P<0.05或P<0.01)。结论活血通络汤可能通过上调骨组织中BGF、TGF-β1、b FGF、PDGF表达,下调APK表达,从而促进骨坏死的修复。
Objective To investigate the possible mechanism of action of Huoxuetongluo Decoction on steroid-induced avascular necrosis of femoral head. Methods Ninety-six Japanese large-eared rabbits were randomly divided into prophylaxis + treatment group, treatment group, model group and blank group, 24 rats in each group. A steroid model of avascular necrosis of the femoral head was prepared by intramuscular injection of prednisolone acetate 8 mg / kg into the buttocks. From the second week, the prophylaxis and treatment groups were fed with Huoxuetongluo decoction, and the rest groups were fed normal feed once a day for 1 week. From the third week onwards, the prevention + treatment group and the treatment group were fed with Huoxuetongluo decoction, the model group and the blank group were fed the same amount of ordinary feed, once daily for 6 weeks. Immunohistochemistry was used to measure the expression of AKP, BGP, bFGF, TGF-β1, bone morphogenetic protein Protein 2 (BMP-2) and platelet-derived growth factor B (PDGF-B) expression. Results Compared with the blank group, the contents of TGF-β1, bFGF, BGP, BMP-2 and PDGF-B in the femur tissue of the model group were significantly decreased and the APK content was significantly increased (P <0.05 or P <0.01) The contents of TGF-β1, bFGF, BGP and PDGF-B in the prevention and treatment groups and the treatment group were significantly increased, the content of APK was significantly decreased, and the levels of BMP-2 in the prevention and treatment groups were significantly increased (P <0.05 or P <0.01 ). Conclusion Huoxue Tongluo decoction may promote the repair of osteonecrosis by up-regulating the expression of BGF, TGF-β1, b FGF and PDGF in bone tissue and down-regulating the expression of APK.