Intervention And Application Of Gufuhuotang To Experimental Steroid-induced Avascular Necrosis Of Femoral Head

Effect of Gufuhuotang on Blood Rheology and Fat Metabolism of Steroid-induced Necrosis of Femoral Head.Objective: to discuss SANFH pathogenesis and effect of Gufuhuotang on blood rheology and fat metabolism of SANFH.Methods: the animals, randomly divided into four groups, 8 each: control group, model group, xianlinggubao group ( 0.6g. kg^-1 ) and high dosage group ( 30g. kg^-1 ), were given intragluteal injection with prednisone acetate of 7.5mg/kg twice a week, and control group were injected with normal saline of the same volume twice a week, while xianlinggubao and Gufuhuotang groups as well as model group were administered with xianlinggubao and Gufuhuotang every day. In case of infection, all the animals were injected with penicillin (5*10 unit/ each) twice a week for 6 weeks. They were weighed once a week and the fur condition and activities were observed. After the last administration, blood abstracted from heart was used to examine BV ( high 200_s^-1, low 40_s^-1 ), PV, HCT and blood from central artery of rear ear was separated to examine CHOL and TRIG; LM and TEM were used to observe the tissue section and acute toxicity experiment was conducted with Gufuhuotang. Examination of blood rheology and blood lipid of all rabbits had statistical procession with t mothod. By SAS statistical soft ware, their weight, rate of empty lacuna were given a test of normality, homogeneity test of variance, analysis of variance, Q test, and the data were expressed with mean standard deviation ( x±S).Results: normal morphologic observation: during the experiment, the weight of control group increased gradually; model group decreased, subcutaneous fat reduced; xianlinggubao and Gufuhuotang groups decreased a little, and the state was better than model group. 6 weeks later, compared to model group, there was significant difference between the weight comparison (p<0.05), but there was no obvious difference between control and xianlinggubao and Gufuhuotang (p>0.05). Blood rheology results: of model group, BV of low shear, PV and HCT were higher than those of control group, difference significant (p<0.01); of xianlinggubao and Gufuhuotang groups, BV of low shear, PV and HCT were lower than those of model group, difference significant (p<0.05 or p<0.01). Blood lipid results: of model group, CHOL and TRIG were higher than those of control group, difference significant (p<0.01); of xianlinggubao and Gufuhuotang groups, CHOL and TRIG were lower than those of model group, difference significant (p<0.05 or p<0.01). HE section and TEM results: of control group, beneath cartilage, cartilage cells ranged in order, small vessels abundant, bone trabecula in order, intramedullary tissue close-knit; intramedullary fat cells distributed evenly, few empty lacuna were seen in osseous lamella; of model group, a number of empty lacuna were in femoral head, fat cells in medullary cavity increased obviously, focal hemorrhage appeared in marrow, bone nucleus membrane splintered under TEM and nucleus concentrated, chromatin dissolved, fat drops were seen in cytoplasm, exceptionally corpulent fat cells pressed on veinlet, accordingly, the lumen grew narrow, in cytoplasm of capillary endothelial cells there were fat drops of low electron density; of xianlinggubao and Gufuhuotang groups, empty lacuna were relatively few, intramedullary fat cells were less and smaller, bone trabecula were sparse without any break. The rate of empty lacuna of control group was 12.87±2.36, model group 21.75±2.92, xianlinggubao group 16.62±2.39, gufuhuotang group 15.87±1.88; analysis of variance: F=18.67, P=0.0001, there was significant difference between; Q test results: compared to control group and xianlinggubao and Gufuhuotang groups, empty lacuna rate of model group was significantly different (p<0.05); there was no significant difference between high and low dosage groups (p>0.05); compared to control group, both xianlinggubao and Gufuhuotang groups had significant difference (p<0.05). Rat acute toxicity test results: preliminary test could not obtain LD50, so with maximum dose the animals remained better condition in 7 days, weight increasing, without abnormal activities ,death and toxic reaction. The maximum dose was 816g crude drug / kg / day, 255 times as much as adults clinical dosage ( an adult 70kg, dosage is 228g crude drug a day).Conclusion: high dosage hormone results in inordinate fat metabolism, hyperlipidemia, inordinate fat metabolism bone tissue, cell fat of femoral head degenerating and necrotizing, blood hyperviscious and stasis in vein, pressure in femoral head increasing, bone tissue ischemic and necrotizing. xianlinggubao and Gufuhuotang can and improve the animal SANFH rheology and fat metabolism with little toxicity.