古方青娥丸加味介导脂联素和1,25-（OH）2D3-VDR mRNA促血管化骨新生治疗INFH的机制

股骨头缺血性坏死（INFH）保髋治疗关键在骨修复和血管新生。我们既往研究表明脂联素水平可作为早期诊断INFH 潜在的生物学标志物之一。本课题组在“肾藏精，精生髓，髓生骨”等理论指导下，运用古方青娥丸加丹参防治INFH疗效显著，但机理尚未完全阐明。我们近期小样本临床研究显示该方能够提高患者脂联素及1,25-(OH)2 D3的含量。理论上脂联素参与INFH发病密切相关的脂质代谢、血管新生及骨代谢的过程，1,25-(OH)2 D3可通过血管内皮细胞与成骨样细胞间的相互信息传递系统促进血管化和骨化。因此，我们选择脂联素及1，25-(OH)2 D3作为治疗INFH的中间交汇点及调控靶点，探讨脂联素信号通路和1,25-(OH)2 D3-VDR mRNA表达水平与INFH局部骨修复和血管新生的关系，同时研究古方对上述指标的影响，以期进一步阐明INFH发病机理和古方作用机制，具有重大的理论价值和临床意义。

The bone repairment and angiogenesis were the key for treating ischemic necrosis of the femoral head (INFH). Our recent studies have shown the level of adiponectin was one of the potential biomarker for diagnosing the early stagy of INFH. Our research group was long-term commitment to the study of INFH. We have conclued that it was effective to prevent and treat early stage of INFH using ancient Qinge pill plus Salvia under the the guidance of traditional Chinese theory of “essence in kidney, marrow comes from essence and bone comes from marrow” , but the mechanisim was not yet fully elucidated. Our recent studies have shown that the pill can increase serum levels of adiponectin and 1,25-(OH)2 D3. It was reported that adiponectin was closely related with lipid metabolism, angiogenesis, and bone metabolism, and 1,25-(OH)2 D3 could promote vascular endothelial cells and osteoblast-like cells differentiation into blood vessels and ossification by cells mutual information transmission system. So we expect to detect the relationship in the signaling pathway of adiponectin, expression of 1,25-（OH）2D3 and its receptor, and local bone repair and angiogenesis in the INFH by the moleclular biology, immunohistochemistry, micro-CT, and confocal methods. And to detect the above indicators interfered by Qinge pill. Then to clarify the pathogenesis of INFH and mechanism of Qinge pill. It has great theoratical value and clinical significance in this study.