Clinical Effect Observation And Network Pharmacology Analysis Of Huatanzhuyu Decoction Treating For Early-stage Osteonecrosis Of Femoral Head

Part one The clinical research on huatanzhuyu decoction for the treatment of early-stage osteonecrosis of femoral headObjective: To observe the clinical efficacy of Huatanzhuyu decoction in the treatment of early-stage osteonecrosis of femoral head.Methods: 1.A total of 65 patients with ARCOⅠ、Ⅱ、Ⅲa staging were randomly divided into control group and observation group.2.The control group was treated with Osteoking and the observation group was treated with Huatanzhuyu decoction.3.During the treatment,both groups avoided excessive activity and continued to do exercise.4.To improve the VAS scores、the Harris scores、 X-ray and liver and kidney function indexes in the treatment process.Results: 1.VAS scores Intra-group comparison: The VAS scores at the first,third and sixth month of treatment in the two groups were compared with those before treatment,and the differences were statistically significant.Comparison between groups :Compared with the control group,the differences were statistically significant at the first month、the third month and the sixth month(P <0.05).The observation group was better than the control group.2.Harris scores Intra-group comparison: The Harris scores at the first,third and sixth month of treatment in the two groups were compared with those before treatment,and the differences were statistically significant.Comparison between groups :There was no statistically significant difference between the observation group and the control group at the first month(P>0.05).Compared with the control group,the differences were statistically significant at the third month and the sixth month(P <0.05),and the observation group was better than the control group.3.Subsidence rate After 6 months of treatment,the control group finally collapsed 8 hips and the collapse rate was 14.55%.The observation group finally collapsed 7 hips,with a collapse rate of 12.96%.There was no statistically significant difference between the two groups(P>0.05).4.Liver and kidney function indexs There were no significant differences in ALT、AST、BUN in the observation group before treatment and after 6 months of treatment(P>0.05).Conclusion: There is no obvious advantage in delaying the process of necrosis of femoral head with the Huatanzhuyu decoction and the Osteoking.However,the Huatanzhuyu decoction can more significantly reduce the pain and improve the function of the hip joint in the treatment of early-stage osteonecrosis of femoral head and it is safe and reliable.Part two Network pharmacology-based study on action mechanism of Huatanzhuyu decoction treating for early-stage osteonecrosis of femoral headObjective: The network pharmacological analysis of Huatanzhuyu decoction was carried out to explore the possible mechanism of prevention and treatment of early-stage osteonecrosis of femoral head.Methods: 1.In the TCMSP database,we searched for the active components of Huatanzhuyu decoction and predicted the potential action targets of active components.2.To construct the network diagram of active components and targets.3.To retrieve the targets related to osteonecrosis of femoral head.4.To construct a network of protein interaction between Huatanzhuyu decoction and osteonecrosis of femoral head and select the key targets.5.The key targets were analyzed by means of the enrichment of signal pathways.The main enrichment pathways of the key target were found to predict the possible signal pathway of huatanzhuyu decoction treating for early-stage osteonecrosis of femoral head.Results: 1.A total of 254 active components of Huatanzhuyu decoction and 82 potential targets were found from the TCMSP database.2.There were 72 targets related to osteonecrosis of femoral head in 5 databases.3.A total of 96 key targets were screened by topological screening.4.96 key targets were found to be related to 69 signaling pathways through enrichment analysis.Conclusion: 1.The 69 signaling pathways can be divided into two groups:(1)Signaling pathways related to lipid metabolism;(2)Signaling pathways related to bone metabolism.2.We can forecast that the mechanism of Huatanzhuyu decoction treating for early-stage osteonecrosis of femoral head is directly or indirectly to regulate the signaling pathways related to lipid metabolism and bone metabolism.