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目的:观察补阳还五汤对激素性股骨头坏死(SANFH)大鼠血液流变学、凝血及纤溶的影响,探讨其防治SANFH的机理。方法:取30只SD大鼠随机分为3组:正常对照组、模型组、治疗组。以每周2次注射醋酸泼尼松龙24.5mg/kg进行造模,正常对照组注射等容积生理盐水。造模同时给药,治疗组予补阳还五汤水提液灌胃,模型组及正常对照组喂生理盐水。第6周取血标本检测血液流变学、凝血及纤溶指标。结果:①血液流变学测定结果:模型组全血黏度、血浆黏度、红细胞压积、红细胞聚集指数明显高于正常对照组(P<0.05),治疗组全血黏度、血浆黏度、红细胞聚集指数明显低于模型组(P<0.05),治疗组红细胞压积与模型组比较无显著变化(P>0.05)。②凝血指标测定结果:模型组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)较正常组短(P<0.05),而纤维蛋白原(FIB)升高(P<0.05)。治疗组PT、APTT、TT较模型组延长(P<0.05),而FIB降低(P<0.05)。③纤溶指标测定结果:模型组的组织型纤溶酶原激活物(tPA)较正常组减少,而tPA抑制剂1(PAI-1)无明显差异(P>0.05)。治疗组tPA较模型增加,PAI-1无明显差异(P>0.05)。④治疗组血液流变学、凝血及纤溶各指标与正常对照组间比较无显著变化(P>0.05)。结论:补阳还五汤能够改善因激素导致的异常血液流变状态、凝血及纤溶功能,改善高凝状态,有利于阻止或延缓SANFH的发生和发展。
Objective: To observe the effect of Buyang Huanwu Decoction on hemorrheology, coagulation and fibrinolysis in rats with steroid-induced osteonecrosis of the femoral head (SANFH), and to explore its mechanism of preventing and treating SANFH. Methods: Thirty SD rats were randomly divided into three groups: normal control group, model group and treatment group. Injection of prednisolone acetate 24.5mg / kg twice a week for modeling, the normal control group injected equal volume of saline. At the same time, the rats in the treatment group were treated with Bu Yang Huanwu Decoction aqueous solution, and the model group and the normal control group were given normal saline. Blood samples were taken at 6 weeks for hemorheology, coagulation and fibrinolysis. Results: ① The results of hemorheology: The whole blood viscosity, plasma viscosity, hematocrit and erythrocyte aggregation index in the model group were significantly higher than those in the normal control group (P <0.05). The whole blood viscosity, plasma viscosity, erythrocyte aggregation index (P <0.05). The hematocrit of the treatment group had no significant change compared with the model group (P> 0.05). (2) The results of coagulation index test: The prothrombin time (PT), APTT and TT in the model group were shorter than those in the normal group (P <0.05), while the fibrinogen (FIB) High (P <0.05). The treatment group PT, APTT, TT than the model group extended (P <0.05), while FIB decreased (P <0.05). (3) The results of fibrinolytic assay: The levels of tissue plasminogen activator (tPA) in the model group decreased compared with the normal group, while the tPA inhibitor 1 (PAI-1) showed no significant difference (P> 0.05). The treatment group tPA increased compared with the model, PAI-1 no significant difference (P> 0.05). ④ There was no significant difference in the indexes of hemorheology, coagulation and fibrinolysis between the treatment group and the normal control group (P> 0.05). Conclusion: Buyang Huanwu Decoction can improve abnormal blood rheology induced by hormones, coagulation and fibrinolysis and improve hypercoagulability, which is good for preventing or delaying the occurrence and development of SANFH.