文献类型：期刊文献

中文题名：生骨再造丸联合髓芯减压术对激素性股骨头缺血性坏死模型兔血脂水平及骨小梁结构的影响

英文题名：Effect of Shenggu Zaizao Wan combined with myeloid drilling core decompression in treating steroid induced avascular necrosis of the femoral head on blood lipid level and trabecular architecture in model rabbit

作者：郭成龙[1];何玲[2];郭小荣[1];曹林忠[2];杨小锋[2];张虎林[1];张晓刚[1]

第一作者：郭成龙

机构：[1]甘肃中医药大学附属医院脊柱外科;[2]甘肃中医药大学中医临床学院

第一机构：甘肃中医药大学第二附属医院

年份：2018

卷号：35

期号：1

起止页码：18

中文期刊名：甘肃中医药大学学报

外文期刊名：Journal of Gansu University of Chinese Medicine

基金：兰州市科技局2014立项课题(2014-1-25)

语种：中文

中文关键词：激素性股骨头缺血性坏死;兔;生骨再造丸;髓芯减压术;实验研究

外文关键词：steroid femoral head necrosis ; rabbit ; Shenggu Zaizao Wan ; myeloid drilling core decomposition ;experimental study

摘要：目的观察生骨再造丸联合髓芯减压术对激素性股骨头缺血性坏死模型兔血脂水平及骨小梁结构的影响,探讨生骨再造丸联合髓芯减压术治疗激素性股骨头缺血性坏死的作用机制。方法将60只雄性28周龄青紫蓝兔随机分为空白组、模型组、生骨再造丸组、手术组、综合治疗组5组,其中空白组组8只,其余4组各13只。除空白组外,其余4组通过耳缘静脉注射大肠杆菌内毒素(LPS)及臀肌注射甲基强的松龙(MP)进行造模。造模成功后,生骨再造丸组以4.6 mL/(kg·d)剂量灌胃生骨再造丸浓缩液,手术组给予髓芯减压术,综合治疗组在髓芯减压术的基础上灌胃生骨再造丸浓缩液,空白组及模型组给予等量生理盐水灌胃。干预8周后,观察各组兔一般情况,检测并比较各组血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,取股骨头标本切片,行HE染色,观察并比较各组兔骨小梁结构及密度、骨细胞形态、髓腔脂肪细胞数目。结果模型组骨小梁排列散乱、稀疏,部分骨小梁萎缩、断裂,周围无成骨细胞,骨髓内造血细胞和脂肪细胞坏死,骨髓腔扩大;生骨再造丸组、手术组、综合治疗组骨小梁均较模型组密集,脂肪细胞逐次减少,造血细胞增多,有利于骨坏死的修复,综合治疗组尤为明显。与空白组比较,模型组血清TG,TC,LDL-C水平明显升高(P<0.01),HDL-C水平明显降低(P<0.01);与模型组比较,生骨再造丸组和综合治疗组血清TG,TC,LDL-C水平明显降低,HDL-C水平明显升高,差异均有统计学意义(P<0.05或P<0.01),且综合治疗组对TC,LDL-C的改善作用更显著(P<0.05)。结论生骨再造丸联合髓芯减压术可降低激素性股骨头缺血性坏死模型兔血脂,并增加股骨头骨小梁密度。
Objective To investigate the therapeutic effect of co-administration of Shenggu Zaizao Wan and core decomposition on blood lipid level and trabecular architecture in model rabbits with steroid induced avascular necrosis of the femoral head（ SANFH）,as well as to explore the underlying mechanism. Methods A total of 6028-week-old male chinchilla rabbits were randomly divided into control group of 8 rabbits and experimental group of52 rabbits. The control group（ group A） was left untreated. For experimental group,lipopolysaccharide and methylprednisolone were co-administered incessantly for 4 weeks to model steroid induced avascular necrosis of the femoral head. After modeling,experimental group was immediately subdivided into 4 subgroups with 13 rabbits in each.They were as follows： the model control group（ group B）,took no further treatment; the Shenggu Zaizao Wan group（ group C）,was continuously treated with Shenggu Zaizao Wan concentrate with a dose of 4.6 mL/（ kg·d）; the surgery group（ group D）,was intervened with myeloid drilling core decomposition; and the comprehensive treatment group（ group E）,was treated by Shenggu Zaizao Wan concentrate with a dose of 4.6 mL/（ kg·d） after core decomposition. After 8 weeks,blood samples were collected for blood lipid measurement（ TC,TG,HDL-C,LDL-C）,then all rabbits were sacrificed and caput femorises were removed for HE staining. Trabecular architecture and density,osteocyte morphology,the number of fat cell in the medullary cavity were observed and compared among all groups. Results HE staining of caput femoris showed that there were necrotic niduses in group B,while there were denser trabeculae,gradual decrease of fat cells,increase of hematopoietic cells,restoration of osteonecrosis in the other modeling groups,especially distinct in group E. Compared with group A,blood lipid profiles changed in the other model groups,TG,TC,LDL-C increased（ P 〈 0. 01）,HDL-C decreased（ P 〈 0. 01）,especially in group B.Compared with group B,blood lipid profiles were ameliorated in group C,D and E,while TG,TC,LDL-C decreased,HDL-C increased. The difference was statistically significant（ P 〈 0. 05 or P 〈 0. 01）,especially in group E（ P 0.05）. Conclusion The combined therapy is effective in reducing blood fat cells and improving bone mineral density in model rabbits with SANFH.