[1]王荣田,林诗富,万蓉,等.不同治法方药对激素性股骨头坏死鸡血脂、血黏度、凝血及纤溶功能的影响[J].中医正骨,2013,25(03):21-30.
　WANG Rong-tian*,LIN Shi-fu,WAN Rong,et al.Effects of different therapeutic methods and prescriptions on blood fat,blood viscosity,blood coagulation and fibrinolysis of chickens with steroid-induced necrosis of femoral head[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(03):21-30.
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不同治法方药对激素性股骨头坏死鸡血脂、血黏度、凝血 及纤溶功能的影响()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期数:
2013年03期
页码:
21-30
栏目:
股骨头坏死
出版日期:
2013-03-20

文章信息/Info

Title:
Effects of different therapeutic methods and prescriptions on blood fat,blood viscosity,blood coagulation and fibrinolysis of chickens with steroid-induced necrosis of femoral head
作者:
王荣田1; 林诗富1; 万蓉2; 殷小杰2; 王智耀1; 刘道兵1; 林娜2; 陈卫衡1
1.中国中医科学院望京医院,北京 100102;
2.中国中医科学院中药研究所,北京 100700
Author(s):
WANG Rong-tian*; LIN Shi-fu; WAN Rong; YIN Xiao-jie; WANG Zhi-yao; LIU Dao-bing; LIN Na; CHEN Wei-heng.
*Wangjing Hospital of China Academy Of Chinese Medical Sciences,Beijing 100102,China
关键词:
股骨头坏死 血脂 血液黏度 血液凝固 动物实验
Keywords:
Femur head necrosis;  Blood fat;  Blood viscosity;  Blood coagulation;  Animal experimentation
摘要:
目的:观察健脾化痰、活血通络与补肾壮骨、活血通络两种不同治法对激素性股骨头坏死鸡血脂、血黏度、凝血及纤溶功能的影响,探讨二者防治股骨头坏死的作用机制和效果。方法:将80只来航鸡随机分为正常组、模型组、洛伐他汀组、健脾组和补肾组,除正常组外其余各组动物均胸肌注射甲基氢化泼尼松琥珀酸钠,洛伐他汀组、健脾组和补肾组同时给予相应的药物,并于给药后8周和16周分批静脉采血,测定全血黏度、血浆黏度、红细胞压积、纤维蛋白原、高密度脂蛋白、低密度脂蛋白、总胆固醇、甘油三脂、血浆纤溶酶原、抗凝血酶Ⅲ、组织型纤溶酶原激活物、活化部分凝血酶时间、凝血酶时间及凝血酶原时间。采血后处死动物,取出双侧股骨头,切片后进行组织学观察。结果:①光镜下组织学观察结果。正常组软骨细胞排列整齐,骨小梁排列规则、致密、饱满,周边可见成骨细胞和少量破骨细胞,未见脂肪细胞增生及肥大; 模型组软骨细胞呈簇状肥大,排列不规则,骨小梁变细,部分软骨下骨小梁断裂、分离,骨髓腔内脂肪细胞肥大、增生,可见空骨陷窝; 洛伐他汀组骨小梁稀疏,可见空骨陷窝及髓腔内变大的脂肪细胞; 健脾组软骨细胞排列整齐,骨小梁排列尚规则、致密,周边可见大量成骨细胞及少量破骨细胞; 补肾组骨陷窝较少,髓腔内脂肪细胞零散分布,髓腔内造血细胞较丰富。②空骨陷窝率。8周时各组动物空骨陷窝率比较,差异有统计学意义(F=6.081,P=0.010)。模型组空骨陷窝率高于正常组、洛伐他汀组和健脾组(q=2.273,P=0.029; q=2.550,P=0.015; q=2.830,P=0.007),模型组与补肾组比较,差异无统计学意义。16周时各组动物空骨陷窝率比较,差异有统计学意义(F=27.910,P=0.000)。模型组高于正常组、健脾组和补肾组(q=6.330,P=0.000; q=3.730,P=0.000; q=4.440,P=0.000),模型组与洛伐他汀组比较,差异无统计学意义。③骨髓内脂肪面积。8周时各组动物骨髓内脂肪面积比较,差异有统计学意义(F=11.230,P=0.000)。模型组高于正常组、洛伐他汀组、健脾组和补肾组(q=2.470,P=0.019; q=2.470,P=0.018; q=7.890,P=0.000; q=7.710,P=0.000)。16周时各组动物骨髓内脂肪面积比较,差异有统计学意义(F=57.140,P=0.000)。模型组高于正常组、洛伐他汀组、健脾组和补肾组(q=12.240,P=0.000; q=3.148,P=0.003; q=3.910,P=0.000; q=3.690,P=0.000)。④血脂。8周时各组实验动物总胆固醇、甘油三脂、高密度脂蛋白及低密度脂蛋白比较,差异均有统计学意义(F=17.630,P=0.000; F=27.450,P=0.000; F=6.820,P=0.000; F=6.670,P=0.000)。正常组总胆固醇和甘油三脂均低于模型组(q=5.740,P=0.000; q=8.180,P=0.000),高密度脂蛋白高于模型组(q=3.030,P=0.005); 洛伐他汀组总胆固醇和甘油三脂均低于模型组(q=7.050,P=0.000; q=8.480,P=0.000),高密度脂蛋白高于模型组(q=2.800,P=0.008); 健脾组总胆固醇、甘油三脂、低密度脂蛋白均低于模型组(q=7.127,P=0.000; q=8.900,P=0.000; q=4.110,P=0.000),高密度脂蛋白高于模型组(q=2.860,P=0.007); 补肾组总胆固醇、甘油三脂、低密度脂蛋白均低于模型组(q=5.970,P=0.000; q=7.220,P=0.000; q=4.170,P=0.000),高密度脂蛋白高于模型组(q=5.190,P=0.000); 健脾组总胆固醇、甘油三脂、高密度脂蛋白均低于补肾组(q=2.090,P=0.042; q=2.216,P=0.037; q=2.335,P=0.025); 其余各项指标组间比较,差异无统计学意义。16周时各组实验动物总胆固醇、甘油三脂、高密度脂蛋白及低密度脂蛋白比较,差异均有统计学意义(F=17.160,P=0.000; F=10.650,P=0.000; F=9.260,P=0.000; F=3.312,P=0.021)。正常组总胆固醇、甘油三脂、低密度脂蛋白均低于模型组(q=6.900,P=0.000; q=4.640,P=0.000; q=5.690,P=0.000); 洛伐他汀组总胆固醇、甘油三脂、高密度脂蛋白均低于模型组(q=5.420,P=0.000; q=5.590,P=0.000; q=3.980,P=0.000); 健脾组总胆固醇、甘油三脂、高密度脂蛋白、低密度脂蛋白均低于模型组(q=-5.751,P=0.000; q=2.215,P=0.040; q =5.594,P=0.000); 补肾组总胆固醇、甘油三脂、低密度脂蛋白低于模型组(q=7.230,P=0.000; q=4.690,P=0.000; q=4.550,P=0.000); 补肾组甘油三脂低于健脾组和洛伐他汀组(q=2.230,P=0.029; q=2.080,P=0.039); 其余各项指标组间比较,差异均无统计学意义。⑤血黏度。8周时各实验组全血黏度(10/s)、全血黏度(50/s)、全血黏度(200/s)、血浆黏度、红细胞压积、纤维蛋白原比较,差异均有统计学意义(F=4.860,P=0.030; F=2.650,P=0.040; F=2.630,P=0.050; F=2.680,P=0.048; F=3.130,P=0.027; F=7.920,P=0.000)。模型组全血黏度(10/s)、全血黏度(50/s)、红细胞压积、血浆黏度、纤维蛋白原均高于正常组(q=3.230,P=0.003; q=2.060,P=0.046; q=2.990,P=0.005; q=3.050,P=0.004; q=5.420,P=0.000); 健脾组全血黏度(10/s)、全血黏度(50/s)、全血黏度(200/s)、红细胞压积、血浆黏度、纤维蛋白原均低于模型组(q=3.370,P=0.002; q=2.060,P=0.047; q=2.640,P=0.012; q=2.480,P=0.018; q=2.170,P=0.041; q=3.080,P=0.004); 补肾组血浆黏度低于模型组(q=2.030,P=0.048),纤维蛋白原高于健脾组(q=2.830,P=0.007); 其余各指标组间比较,差异均无统计学意义。16周时各实验组全血黏度(10/s)、全血黏度(50/s)、全血黏度(200/s)、血浆黏度、红细胞压积、纤维蛋白原比较,差异均有统计学意义(F=6.089,P=0.001; F=3.220,P=0.024; F=2.281,P=0.020; F=9.268,P=0.000; F=8.569,P=0.000; F=9.532,P=0.000)。模型组全血黏度(10/s)、全血黏度(50/s)、全血黏度(200/s)、红细胞压积、血浆黏度、纤维蛋白原均高于正常组(q=3.912,P=0.000; q=2.857,P=0.007; q=2.645,P=0.012; q=4.330,P=0.000; q=4.920,P=0.000; q=5.829,P=0.000); 健脾组全血黏度(10/s)、全血黏度(50/s)、全血黏度(200/s)、红细胞压积、血浆黏度均低于模型组(q=4.070,P=0.000; q=3.920,P=0.000; q=2.990,P=0.005; q=4.980,P=0.000; q=2.170,P=0.041); 补肾组全血黏度(10/s)、全血黏度(50/s)、全血黏度(200/s)、血浆黏度低于模型组(q=2.740,P=0.010; q=2.840,P=0.008; q=3.770,P=0.000; q=2.220,P=0.032); 其余各指标组间比较,差异均无统计学意义。⑥凝血功能。8周时各组实验动物血浆活化部分凝血酶时间、凝血酶原时间及凝血酶时间比较,差异均有统计学意义(F=6.400,P=0.001; F=8.700,P=0.000; F=7.300,P=0.000)。模型组活化部分凝血酶时间、凝血酶原时间、凝血酶时间均短于正常组(q=4.320,P=0.000; q=4.250,P=0.000; q=3.490,P=0.001); 健脾组凝血酶原时间、凝血酶时间均长于模型组(q=4.990,P=0.000; q=4.337,P=0.000); 补肾组凝血酶原时间、凝血酶时间均长于模型组(q=4.080,P=0.000; q=4.970,P=0.000); 其余各项指标组间比较,差异均无统计学意义。16周时各组实验动物血浆活化部分凝血酶时间和凝血酶时间比较,差异均有统计学意义(F=19.120,P=0.000; F=3.470,P=0.017); 各组凝血酶原时间比较,差异无统计学意义。模型组活化部分凝血酶时间、凝血酶时间均短于正常组(q=5.302,P=0.000; q=2.410,P=0.210); 健脾组活化部分凝血酶时间长于模型组(q=3.290,P=0.002); 补肾组活化部分凝血酶时间和凝血酶时间均长于模型组(q=6.890,P=0.000; q=3.470,P=0.001); 其余各项指标组间比较,差异无统计学意义。⑦纤溶功能。8周时各组实验动物血浆抗凝血酶Ⅲ、组织型纤溶酶原激活物比较,差异均有统计学意义(F=8.300,P=0.000; F=16.590,P=0.000); 各组血浆纤溶酶原比较,差异无统计学意义。模型组组织型纤溶酶原激活物低于正常组(q=6.800,P=0.000); 健脾组组织型纤溶酶原激活物高于模型组和补肾组(q=4.160,P=0.000; q=3.770,P=0.001); 其余各项指标组间比较,差异均无统计学意义。16周时各组实验动物血浆抗凝血酶Ⅲ、组织型纤溶酶原激活物比较,差异均有统计学意义(F=10.980,P=0.000; F=43.950,P=0.000); 各组血浆纤溶酶原比较,差异无统计学意义。模型组抗凝血酶Ⅲ、组织型纤溶酶原激活物均低于正常组(q=5.810,P=0.000; q=9.030,P=0.000); 健脾组组织型纤溶酶原激活物高于模型组(q=4.080,P=0.000); 其余各项指标组间比较,差异均无统计学意义。结论:健脾和补肾两种治法方药均具有一定程度的改善激素性股骨头坏死鸡血脂、血黏度及凝血功能的作用,但二者发挥作用的强度和时间不同,健脾法更具优势。
Abstract:
Objective:To compare the effects between STRENGTHENING SPLEEN RESOLV PHLEGM combined with ACTIVAT BLOOD DREDGING COLLATERALS and REINFORCING KIDNEY SUPPERS BONE combined with ACTIVAT BLOOD DREDGING COLLATERALS on blood fat,blood viscosity,blood coagulation and fibrinolysis of chickens with steroid-induced necrosis of femoral head(SNFH),and to explore the mechanism of action and the role of the two methods in the prevention of SNFH.Methods:Eighty leghorn chickens were randomly divided into normal group,model group,lovastatin group,STRENGTHENING SPLEEN(SS)group and REINFORCING KIDNEY(RK)group.Chickens were administrated with pectoral intramuscular injection of methylprednisolone sodium succinate except those in the normal group,and chickens in lovastatin group,SS group and RK group were simultaneously administrated with respective medicine.After 8 and 16 weeks of medication,venous blood was respectively collected from the chickens in batches for detecting the following parameters as whole blood viscosity(ηb),plasma viscosity(ηp),hematocrit(HCT),fibrinogen(FIB),high density lipoprotein(HDL),low density lipoprotein(LDL),cholesterol total(CHOL),triglyceride(TG),plasma plasminogen(PLG),antithrombinⅢ(AT-Ⅲ),tissue-type plasminogen activator(t-PA),activated partial thromboplastin time(APTT),thrombin time(TT)and prothrombin time(PT).After blood collection,the chickens were executed for fetching out their bilateral femoral heads,which were sectioned for histological observation.Results:1)The results of histological observation under a light microscope:In normal group cartilage cells lined up in order; bone trabeculae were in regular,close and well-stacked arrangement,surrounded by some osteoblasts and a small number of osteoclasts; and no hypertrophic fat cells were found.The following situations were found in model group as tufted hypertrophic cartilage cells arranged irregularly,thin bone trabeculae,fracture and separation of partial bone trabeculae under the cartilage,hypertrophic fat cells in marrow cavity and empty bone lacuna.Sparse bone trabeculae,empty bone lacuna and larger fat cells in marrow cavity were found in lovastatin group.In SS group the cartilage cells lined up in order and the bone trabeculae lined up regularly and closely,surrounded by a large number of osteoblasts and a small number of osteoclasts.A small number of bone lacuna,sparse fat cells and plenty of hematopoietic cells in marrow cavity were found in RK group.2)Empty bone lacuna rate:There were statistical differences in empty bone lacuna rate among the groups at 8 weeks(F=6.081,P=0.010).The empty bone lacuna rate of the model group was higher than that of normal group,lovastatin group and SS group respectively(q=2.273,P=0.029; q=2.550,P=0.015; q=2.830,P=0.007),and there was no statistical difference between model group and RK group.There were statistical differences in empty bone lacuna rate among the groups at 16 weeks(F=27.910,P=0.000).The empty bone lacuna rate was higher in the model group compared to normal group,SS group and RK group respectively(q=6.330,P=0.000; q=3.730,P=0.000; q=4.440,P=0.000),and there was no statistical difference between model group and lovastatin group.3)Area of fat in bone marrow cavity:There were statistical differences in the area of fat in bone marrow cavity among the groups at 8 weeks(F=11.230,P=0.000).The area of fat in bone marrow cavity was greater in the model group compared to normal group,lovastatin group,SS group and RK group respectively(q=2.470,P=0.019; q=2.470,P=0.018; q=7.890,P=0.000; q=7.710,P=0.000).There were statistical differences in the area of fat in bone marrow cavity among the groups at 16 weeks(F=57.140,P=0.000).The model group surpassed normal group,lovastatin group,SS group and RK group respectively(q=12.240,P=0.000; q=3.148,P=0.003; q=3.910,P=0.000; q=3.690,P=0.000).4)Blood fat levels:There were statistical differences in the levels of CHOL,TG,HDL and LDL among the groups at 8 weeks(F=17.630,P=0.000; F=27.450,P=0.000; F=6.820,P=0.000; F=6.670,P=0.000).CHOL and TG levels were all lower in the normal group compared to the model group(q=5.740,P=0.000; q=8.180,P=0.000),while HDL levels were higher in the normal group compared to the model group(q=3.030,P=0.005).CHOL and TG levels were lower in the lovastatin group compared to the model group(q=7.050,P=0.000; q=8.480,P=0.000),while HDL levels were higher in the lovastatin group compared to the model group(q=2.800,P=0.008).CHOL,TG and LDL levels were lower in the SS group compared to the model group(q=7.127,P=0.000; q=8.900,P=0.000; q=4.110,P=0.000),while HDL levels were higher in the SS group compared to the model group(q=2.860,P=0.007).CHOL,TG and LDL levels were lower in the RK group compared to the model group(q=5.970,P=0.000; q=7.220,P=0.000; q=4.170,P=0.000),while HDL levels were higher in the RK group compared to the model group(q=5.190,P=0.000).CHOL,TG and HDL levels were lower in the SS group compared to the RK group(q=2.090,P=0.042; q=2.216,P=0.037; q=2.335,P=0.025).There were no statistical differences in the levels of rest indexes among the groups.There were statistical differences in CHOL,TG,HDL and LDL levels among the groups at 16 weeks(F=17.160,P=0.000; F=10.650,P=0.000; F=9.260,P=0.000; F=3.312,P=0.021).CHOL,TG and LDL levels were lower in the normal group compared to the model group(q=6.900,P=0.000; q=4.640,P=0.000; q=5.690,P=0.000).CHOL,TG and HDL levels were lower in the lovastatin group compared to the model group(q=5.420,P=0.000; q=5.590,P=0.000; q=3.980,P=0.000).CHOL,TG,HDL and LDL levels were lower in the SS group compared to the model group(q=-5.751,P=0.000; q=2.215,P=0.040; q=5.594,P=0.000).CHOL,TG and LDL levels were lower in the RK group compared to the model group(q=7.230,P=0.000; q=4.690,P=0.000; q=4.550,P=0.000).TG levels were lower in the RK group compared to the SS group and the lovastatin group respectively(q=2.230,P=0.029; q=2.080,P=0.039).There were no statistical differences in the levels of rest indexes among the groups.5)Blood viscosity levels:There were statistical differences in the levels of ηb(10/s,50/s and 200/s),ηp,HCT and FIB among the groups at 8 weeks(F=4.860,P=0.030; F=2.650,P=0.040; F=2.630,P=0.050; F=2.680,P=0.048; F=3.130,P=0.027; F=7.920,P=0.000).The levels of ηb(10/s and 50/s),HCT,ηp and FIB were higher in the model group compared to the normal group(q=3.230,P=0.003; q=2.060,P=0.046; q=2.990,P=0.005; q=3.050,P=0.004; q=5.420,P=0.000).The levels of ηb(10/s,50/s and 200/s),HCT,ηp and FIB were lower in the SS group compared to the model group(q=3.370,P=0.002; q=2.060,P=0.047; q=2.640,P=0.012; q=2.480,P=0.018; q=2.170,P=0.041; q=3.080,P=0.004).The levels of ηp was lower in the RK group compared to the model group(q=2.030,P=0.048),while the levels of FIB was higher in the RK group compared to the SS group(q=2.830,P=0.007).There were no statistical differences in the levels of the rest indexes among the groups.There were statistical differences in the levels of ηb(10/s,50/s and 200/s),ηp,HCT and FIB among the groups at 16 weeks(F=6.089,P=0.001; F=3.220,P=0.024; F=2.281,P=0.020; F=9.268,P=0.000; F=8.569,P=0.000; F=9.532,P=0.000).The levels of ηb(10/s,50/s and 200/s),HCT,ηp and FIB were higher in the model group compared to the normal group(q=3.912,P=0.000; q=2.857,P=0.007; q=2.645,P=0.012; q=4.330,P=0.000; q=4.920,P=0.000; q=5.829,P=0.000).The level of ηb(10/s,50/s and 200/s),HCT and ηp were lower in the SS group compared to the model group(q=4.070,P=0.000; q=3.920,P=0.000; q=2.990,P=0.005; q=4.980,P=0.000; q=2.170,P=0.041).The levels of ηb(10/s,50/s and 200/s)and ηp were lower in the RK group compared to the model group(q=2.740,P=0.010; q=2.840,P=0.008; q=3.770,P=0.000; q=2.220,P=0.032).There were no statistical differences in the levels of the rest indexes among the groups.6)Blood coagulation function:There were statistical differences in APTT,PT and TT of the plasma among the groups at 8 weeks(F=6.400,P=0.001; F=8.700,P=0.000; F=7.300,P=0.000).APTT,PT and TT of model group were all shorter than those of normal group(q=4.320,P=0.000; q=4.250,P=0.000; q=3.490,P=0.001); PT and TT of SS group were all longer than those of model group(q=4.990,P=0.000; q=4.337,P=0.000); PT and TT of RK group were all longer than those of model group(q=4.080,P=0.000; q=4.970,P=0.000); while there were no statistical differences in the rest indexes among the groups.There were statistical differences in APTT and TT of plasma among the groups at 16 weeks(F=19.120,P=0.000; F=3.470,P=0.017); while there was no statistical difference in PT among the groups.APTT and TT of model group were all shorter than those of normal group(q=5.302,P=0.000; q=2.410,P=0.210); APTT of SS group was longer than that of model group(q=3.290,P=0.002); APTT and TT of RK group were all longer than those of model group(q=6.890,P=0.000; q=3.470,P=0.001); while there were no statistical differences in the rest indexes among the groups.7)Fibrinolysis:There were statistical differences in the plasma concentrations of AT-Ⅲ and t-PA among the groups at 8 weeks(F=8.300,P=0.000; F=16.590,P=0.000); while there were no statistical differences in plasma PLG concentrations among the groups.The concentrations of t-PA in plasma of model group were lower than those of normal group(q=6.800,P=0.000); the plasma concentrations of t-PA of SS group were higher than those of model group and RK group respectively(q=4.160,P=0.000; q=3.770,P=0.001); while there were no statistical differences in the plasma concentrations of rest indexes among the groups.There were statistical differences in the plasma concentrations of AT-Ⅲ and t-PA among the groups at 16 weeks(F=10.980,P=0.000; F=43.950,P=0.000); while there were no statistical differences in plasma PLG concentrations among the groups.The concentrations of AT-Ⅲ and t-PA in plasma of model group were lower than those of normal group(q=5.810,P=0.000; q=9.030,P=0.000); the concentrations of t-PA in plasma of SS group were higher than those of model group(q=4.080,P=0.000); while there were no statistical differences in the plasma concentrations of rest indexes among the groups.Conclusion:Although both the therapy of STRENGTHING SPLEEN and the therapy of REINFORCING KIDNEY can improve blood fat,blood viscosity and blood coagulation of SNFH chickens to some extent,they have different intensity of action and different effective date,and the former has more advantages.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81173417,30901982,30472131)
通讯作者:陈卫衡 E-mail:drchenweiheng@163.com
更新日期/Last Update: 2013-03-20