【目的】观察骨蚀再造丸对激素性股骨头坏死的治疗作用及机制。 【方法】将雄性SD大鼠随机分为正常组、模型组、仙灵骨葆胶囊组和骨蚀再造丸组。除正常组，其他各组大鼠复制激素性股骨头坏死模型。成功造模后，连续给药6周。取大鼠胸腺和脾脏计算免疫器官指数，酶联免疫吸附法 （ELISA） 测定大鼠关节液白细胞介素1β （IL-1β） 、肿瘤坏死因子α （TNF-α）的含量，苏木素-伊红 （HE） 染色法测定空骨陷窝率、骨小梁面积比，Micro-CT分析股骨头参数[骨体积分数 （BV/TV） 、骨小梁数量 （Tb.N） 、骨小梁厚度 （Tb.Th） 、骨小梁分离度 （Tb.Sp） ]，小动物骨骼强度测定仪测定股骨头骨骼强度。 【结果】与正常组比较，模型组脾脏、胸腺指数显著下降，关节液IL-1β、TNF-α含量显著增加，空骨陷窝率升高，骨小梁面积比降低，BV/TV、Tb.N、Tb.Th降低， Tb.Sp升高，股骨头骨骼强度显著降低，差异均有统计学意义 （P＜0.05或P＜0.01） ；与模型组比较，仙灵骨葆胶囊组和骨蚀再造丸组脾脏、胸腺指数显著升高，关节液IL-1β、TNF-α含量降低，空骨陷窝率显著降低，骨小梁面积比显著升高，BV/TV、Tb.N、Tb.Th升高，Tb.Sp降低，股骨头骨骼强度显著升高，差异均有统计学意义 （P＜0.05或P＜0.01） 。 【结论】骨蚀再造丸通过调节细胞免疫，减少炎症因子分泌，进而降低股骨头病理损伤，增强骨骼强度，可有效防止激素性股骨头坏死进一步发展。

Objective To observe the therapeutic efficacy and mechanism of Gushi Zaizao Pills for steroid-induced osteonecrosis of the femoral head （SONFH） . Methods Male SD rats were randomly divided into normal group，model group，Xianling Gubao Capsules group and Gushi Zaizao Pills group. Except for the normal group，the rats in all other groups were replicated the SONFH model. After successful modeling， the continuous drug administration was carried out for six weeks. The thymus and spleen of the rats were taken to calculate the immune organ indices，the contents of interleukin 1β （IL-1β） and tumor necrosis factor α （TNF-α） in rat synovial fluid were detected by enzyme-linked immunosorbent assay （ELISA） ，the percentage of empty lacunae and area ratio of trabecular bone was detected by hematoxylin-eosin （HE） staining，and the femoral head parameters [reduction of bone volume fraction （BV/TV） ，trabecular number （Tb.N） ，trabecular thickness （Tb.Th） and trabecular separation （Tb. Sp） ] were analyzed by Micro-CT，and bone strength of femoral head was detected by small animal bone strength tester. Results Compared with the normal group，the spleen and thymus indicators were significantly decreased in the model group，the levels of IL-1β and TNF-α in rat synovial fluid were significantly increased，the percentage of empty lacunae was increased，the area ratio of trabecular bone was decreased，the BV/TV，Tb.N and Tb. Th were decreased， the Tb. Sp was increased， the bone strength of femoral head was significantly decreased，the differences being all statistically significant （P＜0.05 or P＜0.01） . Compared with the model group，the spleen and thymus indicators were significantly increased in Xianling Gubao Capsules group and Gushi Zaizao Pills group，the levels of IL-1β and TNF-α in rat synovial fluid were decreased，the percentage of empty lacunae was significantly decreased，the area ratio of trabecular bone was significantly increased，the BV/TV，Tb.N and Tb.Th were increased，the Tb.Sp was decreased，and the bone strength of femoral head was significantly increased，the differences being all statistically significant （P＜0.05 or P＜0.01） . Conclusion Gushi Zaizao Pills can effectively prevent the further development of SONFH by regulating cellular immunity and reducing the secretion of inflammatory factors，thereby reducing the pathological damage of the femoral head and enhancing the bone strength.

R285.5

国家自然科学基金地区科学基金项目 （编号：81860401）；河南省自然科学基金项目 （编号：232300421193）；河南省医学科技攻关计划项目 （编号：SBGJ202103103）；河南省中医药科学研究专项课题 （编号：2022ZY2064、2022ZY1182、20-21ZY3023）；河南省重点研发与推广专项 （科技攻关） 项目 （编号：232102311202）