【目的】 观察骨坏死康复丸对激素性股骨头坏死（SONFH）大鼠的治疗作用及机制。【方法】 将60只大鼠随机分为空白组， 模型组，仙灵骨葆胶囊组及骨坏死康复丸低、中、高剂量组，每组10只。除空白组，其他各组大鼠采用脂多糖联合糖皮质 激素诱导法建立SONFH模型。干预结束后，分别进行股骨头的血管造影观察骨髓内微血管变化、苏木素-伊红（HE）染色并 计算空骨陷窝率、Micro-CT 扫描分析、压缩实验，采用实时定量聚合酶链反应（RT-qPCR）法检测全血磷脂酰肌醇 3-激酶 （PI3K）、蛋白激酶B（Akt）1、血管内皮生长因子（VEGF）、血小板内皮细胞黏附分子1（CD31）基因表达。【结果】 与空白组比较，模型组股骨头髓腔内血供差，空骨陷窝率增加（P＜0.05），骨密度、骨体积分数显著降低（P＜0.05），股骨头最大载荷及 弹性模量降低（P＜0.05），全血Akt1、PI3K、VEGF、CD31 mRNA表达水平降低（P＜0.05）；与模型组比较，骨坏死康复丸高 剂量组和仙灵骨葆胶囊组股骨头髓腔内血供较好，空骨陷窝率减少（P＜0.05），骨密度、骨体积分数、骨小梁数量、骨小梁 厚度显著升高（P＜0.05）及骨小梁分离度显著减小（P＜0.05），股骨头最大载荷及弹性模量升高（P＜0.05），全血Akt1、PI3K、 VEGF、CD31 mRNA表达水平升高（P＜0.05）；骨坏死康复丸高剂量组上述各指标与仙灵骨葆胶囊组比较，差异均无统计学 意义（P＞0.05）。【结论】 骨坏死康复丸可改善大鼠激素性股骨头坏死，其机制与促进 VEGF/PI3K/Akt通路基因表达，进而促 进血管新生有关。

Objective To observe the therapeutic effect and mechanism of Guhuaisi Kangfu Pills on rats with steroid-induced osteonecrosis of the femoral head（SONFH）. Methods Sixty rats were randomly divided into blank group，model group，Xianling Gubao Capsules group and Guhuaisi Kangfu Pills low-，medium- and high- dose groups，10 rats in each group. Except for the blank group，the SONFH model was established by lipopolysaccharide combined with Glucocorticoid induction method in all other groups of rats. At the end of the intervention，for the femoral head，blood vessel radiography was performed to observe the microvascular changes in the bone marrow， and hematoxylin-eosin（HE）staining and calculation of the empty bone trap rate，Micro-CT scanning analysis， and compression experiments were carried out， and the real-time quantitative polymerase chain reaction（RTqPCR）was used to detect the gene expressions of phosphatidylinositol 3-kinase（PI3K），protein kinase B（Akt） 1，vascular endothelial growth factor（VEGF）and platelet endothelial cell adhesion molecule 1（CD31）in whole blood. Results Compared with the blank group，the blood supply in the femoral head medullary cavity of the model group was poor，the empty bone lacuna rate was increased（P＜0.05），the bone mineral density and bone volume fraction were significantly decreased（P＜0.05），the maximum load and elastic modulus of the femoral head were decreased（P＜0.05），and the mRNA expression levels of Akt1，PI3K，VEGF and CD31 in whole blood were decreased（P＜0.05）. Compared with the model group，the blood supply in the femoral head medullary cavity was relatively good，the empty bone lacuna rate was decreased（P＜0.05），the bone mineral density，bone volume fraction， trabecular number and trabecular thickness were significantly increased（P＜0.05）， the trabecular separation was significantly decreased（P＜0.05），the maximum load and elastic modulus of the femoral head were increased（P＜0.05），and the mRNA expression levels of Akt1，PI3K，VEGF and CD31 in the whole blood were increased（P＜0.05）in the high-dose group of Guhuaisi Kangfu Pills and Xianling Gubao Capsules group. There was no significant difference in the above indexes between the high-dose group of Guhuaisi Kangfu Pills and the Xianling Gubao Capsules group（P＞0.05）. Conclusion Guhuaisi Kangfu Pills improves SONFH in rats，and its mechanism is related to the promotion of VEGF/PI3K/Akt pathway gene expression， thereby promoting angiogenesis.

R285.5

河南省医学科技攻关计划项目（编号：LHGJ20220898）；河南省中医药科学研究专项课题（编号：20-21ZY3023）