脉络宁复合液通过闭孔神经阻滞治疗大鼠早期激素性股骨头坏死

杨玉红; 支满霞; 万政佐

doi:10.13422/j.cnki.syfjx.20190705

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脉络宁复合液通过闭孔神经阻滞治疗大鼠早期激素性股骨头坏死

药理 | 更新时间：2021-02-09

- 脉络宁复合液通过闭孔神经阻滞治疗大鼠早期激素性股骨头坏死
- Mailuoning Compound for Treatment of Early Steroid-induced Osteonecrosis of Femoral Head in Rats by Obturator Nerve Block
- 中国实验方剂学杂志 2019年25卷第7期页码：122-127
- 作者机构：
  
  1.中国中医科学院　望京医院，北京　 100102；
  2.杭州市中医院，杭州　 310007
- 作者简介：
  
  杨玉红，硕士，主治医师，从事中医和中西医结合疼痛治疗工作，E-mail：joyney203@163.com
  支满霞，主任医师，教授，硕士生导师，从事中西医结合疼痛临床工作，E-mail: zhimanx@msn.com;
  万政佐，硕士，主治医师，从事麻醉和中西医结合疼痛研究，E-mail:frank-honey@163.com
- 基金信息：
  
  首都医学发展科研基金项目(Ш-10)
- DOI：10.13422/j.cnki.syfjx.20190705
  中图分类号： R2-0;R22;R285.5;R289
- 收稿日期：2018-12-07，
  
  网络出版日期：2018-12-21，
  
  纸质出版日期：2019-04-05
- 稿件说明：
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杨玉红, 支满霞, 万政佐. 脉络宁复合液通过闭孔神经阻滞治疗大鼠早期激素性股骨头坏死[J]. 中国实验方剂学杂志, 2019,25(7):122-127.

Yu-hong YANG, Man-xia ZHI, Zheng-zuo WAN. Mailuoning Compound for Treatment of Early Steroid-induced Osteonecrosis of Femoral Head in Rats by Obturator Nerve Block[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(7): 122-127.
杨玉红, 支满霞, 万政佐. 脉络宁复合液通过闭孔神经阻滞治疗大鼠早期激素性股骨头坏死[J]. 中国实验方剂学杂志, 2019,25(7):122-127. DOI： 10.13422/j.cnki.syfjx.20190705.

Yu-hong YANG, Man-xia ZHI, Zheng-zuo WAN. Mailuoning Compound for Treatment of Early Steroid-induced Osteonecrosis of Femoral Head in Rats by Obturator Nerve Block[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(7): 122-127. DOI： 10.13422/j.cnki.syfjx.20190705.

摘要

目的：

探讨脉络宁复合液闭孔神经阻滞对大鼠早期激素性股骨头坏死(SONFH)的影响及作用机制。

方法：

将24只大鼠通过尾静脉注射内毒素10 μg·kg

－1

，24 h后腹腔注射醋酸泼尼松龙20 mg·kg

－1

·d

－1

，每24 h注射1次，连续注射3 d。造模完成后，随机分为模型组12只，脉络宁复合液组12只，另有6只作为正常组。脉络宁复合液组从第4天开始在闭孔神经注射脉络宁复合液2 mL·kg

－1

，每周注射3次，共8周。大鼠于造模后第9周的第1天采集动脉血，测定血脂的含量；取股骨头制备石蜡切片，观察股骨头组织病理的改变和定量分析空骨陷窝率、骨陷窝面积、骨小梁面积的变化；采用免疫组化法定量分析骨形成蛋白(BMPs)，转化生长因子-

(TGF-

)，血管内皮细胞生长因子(VEGF)，Ⅷ因子相关抗原(Ⅷ-R Ag)的变化。

结果：

模型组骨小梁稀疏，瘦长，结构紊乱，有断裂现象，可见部分骨细胞坏死，空骨陷窝增多；脉络宁复合液组骨小梁数量增加，结构基本清晰，多数为正常骨细胞，有少量坏死骨细胞，空骨陷窝明显减少。与模型组比较，脉络宁复合液组的空骨陷窝率、骨陷窝面积较模型组明显降低(

0.05)；脉络宁复合液组的VEGF

BMPs

TGF-

的阳性面积比和Ⅷ-R Ag的微血管密度表达明显高于模型组(

0.05)；脉络宁复合液组血脂含量明显降低(

0.05)。

结论：

脉络宁复合液通过调控VEGF

BMPs

TGF-

，Ⅷ-R Ag的表达和血脂含量的下调，从而改善股骨头的微循环状态，促进坏死股骨头内血管和新骨的生成，能有效控制早期SONFH的发展。为临床治疗早期SONFH提供了理论依据。

Abstract

Objective:

To investigate the effect and mechanism of Mailuoning Compound for treatment of early steroid-induced osteonecrosis of femoral head (SONFH) in rats by obturator nerve block.

Method:

24 rats were injected with endotoxin 10 μg·kg

-1

through tail vein. After 24 hours

prednisolone acetate 20 mg·kg

-1

was given by intraperitoneal injection

once every 24 hours for 3 consecutive days. After successful modeling

the rats were randomly divided into the model group (

=12)

the treatment group (

=12) and the normal control group (

=6). In the treatment group

2 mL·kg

-1

of Mailuoning compound was injected into the obturator nerve from the 4th day

3 times a week for 8 weeks. The arterial blood was collected from rats on the first day of the 9th week after model building to detect the content of blood lipid; the femoral head was taken to prepare the paraffin section

and the pathological changes of femoral head was observed and the changes of empty bone lacuna rate

bone trabecular area and bone lacuna area were quantitatively analyzed; The changes of bone morphogenetic proteins(BMPs)

transforming growth factor-

(TGF-

)

vascular endothelial cell growth factor(VEGF)

and Ⅷ factor related antigen(Ⅷ-R Ag) were quantitatively analyzed by immunohistochemical method.

Result:

In the model group

the bone trabeculae were sparse

thin

disorganized and broken; some of the bone cells were necrotic and the number of empty bone lacunae was increased. In the treatment group

the number of trabeculae was increased; the structure was clear

most of which was normal bone cells

with a few necrotic bone cells

and the number of empty bone lacunae was decreased obviously. The rate of empty bone lacuna and the area of bone lacuna in the treatment group were significantly lower than those in the model group (

0.05); the positive area ratio of VEGF

BMPs

TGF-

and the microvessel density of Ⅷ-R Ag in the treatment group were significantly higher than those in the model group (

0.05)

with significantly lower blood lipid contents (

0.05).

Conclusion:

Mailuoning compound can improve the microcirculation state of femoral head

promote the formation of new bone and blood vessel in femoral head by regulating the expression of VEGF

BMPs

TGF-

Ⅷ-R Ag and down-regulating blood lipid content

thus effectively controlling the development of early SONFH. This can provide a theoretical basis for the treatment of early SONFH.

关键词

Keywords

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