摘要
目的:观察补肾祛瘀法对激素性股骨头缺血性坏死兔血脂及凝血指标的影响。方法:将健康大白兔50只随机分为正常组10只和造模组40只。造模组采用注射内毒素及激素的方法,诱导建立兔激素性股骨头坏死模型,将造模成功的模型兔分为模型组、中药组各18只,中药组给予补肾祛瘀方混悬液灌胃,正常组、模型组灌胃等体积生理盐水,灌胃8周后处死大白兔取材,观察各组兔股骨头CT扫描显示情况及常规HE染色下兔股骨头病理学特征及空骨陷窝比率与血脂、凝血指标变化情况。结果:组织病理学显示正常组兔股骨头髓腔中破骨细胞数量较少,骨髓细胞及脂肪细胞正常,模型组髓腔脂肪细胞增大、增多。空骨陷窝比率模型组平均为(30.55±3.20)%,正常组平均为(12.46±2.40)%,中药组平均为(22.45±2.88)%,中药组高于正常组但低于模型组。模型组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、纤溶酶原激活剂抑制物(PAI)、D-二聚体(D-Dimer)均高于正常组(P<0.01),高密度脂蛋白(HDL)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、抗凝血酶Ⅲ(AT-Ⅲ)低于正常组(P<0.01)。与模型组比较,中药组TC、TG、LDL、PAI、D-Dimer降低(P<0.01),HDL、PT、APTT、AT-Ⅲ升高(P<0.01)。结论:短期内大剂量使用激素可以引起模型兔股骨头坏死,脂代谢及凝血指标异常,骨内微循环障碍;补肾祛瘀法可改善股骨头坏死兔脂代谢及凝血指标,促进股骨头内微循环,扭转股骨头缺血状态。
Objective:To observe the effects of kidney-tonifying stasis-eliminating method on blood lipid and coagulation indexes of steroid-induced femoral head necrosis rabbits.Methods:Fifty rabbits were separated into ten in the normal group and 40 in the modeling group,the modeling group used injection of endotoxin and steroid to induce and establish rabbit models with steroid-induced femoral head necrosis,rabbit models were allocated to the model group and herb group,18 rabbits each group,herb group were drenched with the suspension of kidney-tonifying stasis-eliminating prescription,the normal group and the model group with equivalent dose of physiological saline,the rabbits were sacrificed after drenching for eight weeks,to observe pathological feature of rabbit femoral head,empty bone lacunae ratio after conventional HE staining,blood lipid and coagulation indexes CT scanning results of rabbit femoral head.Results:Histopathological study demonstrated that there were less osteoclast of cavum pulpi in the normal group,marrow cells and fat cells were normal,the fat cells of cavum pulpi in the model group enlarged and increased,the percentage of empty bone lacunae was(30.55±3.20)%,the percentage of the normal group(12.46±2.40)%and herb group(22.45±2.88)%,herb group was higher than the normal group,but lower than the model group,the model group was higher than the normal group in the levels of TC,TG,LDL,PAI and D-Dimer(P<0.01),lower than the normal group in the levels of HDL,PT,APTT and AT-Ⅲ(P<0.01).Compared with the model group,the levels of TC,TG,LDL,PAI and D-Dimer reduced in herb group(P<0.01),the levels of HDL,PT,APTT and AT-Ⅲrose(P<0.01).Conclusion:Large dose of steroid in short term could induce rabbit femoral head necrosis,lipid metabolism and abnormal coagulation index,intraosseous microcirculation disturbance;kidney-tonifying stasis-eliminating prescription could improve lipid metabolism and coagulation indexes,promote microcirculation in femoral head and prevent ischemic state of femoral head.
作者
段卫峰
刘骏逸
杜志军
刘又文
DUAN Weifeng;LIU Junyi;DU Zhijun;LIU Youwen(Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Luoyang 450000,China)
出处
《西部中医药》
2019年第11期26-31,共6页
Western Journal of Traditional Chinese Medicine
基金
2017年度河南省中医药科学研究专项课题(编号2017ZY2032)
关键词
股骨头坏死
激素性
空骨陷窝比率
血脂
凝血指标
补肾祛瘀方
兔
femoral head necrosis
steroid-induced
empty bone lacunae ratio
blood lipid
coagulation index
kidney-tonifying stasis-eliminating prescription
rabbits
