Analysis Of High Risk Factors Of GA-ONFH And Network Pharmacology Study On Intervention Mechanism Of Traditional Chinese Medicine

Background:Osteonecrosis of the femoral head,also known as aseptic necrosis or ischemic necrosis of the femoral head,is a common clinical disease caused by the ischemia of bone cells.Because of its continuous progress,it often leads to the structural change or even collapse of the femoral head,and the final outcome is often the loss of function of the affected side of the hip joint.High dose glucocorticoid is one of the main causes of non-traumatic necrosis of the femoral head.In the clinical diagnosis and treatment process,many subjects need to use glucocorticoids as the first-line treatment drugs,but the early screening of high-risk factors of femoral head necrosis for such patients is lack of relevant research.Early screening of high risk factors and early intervention of susceptible population are becoming the primary measures to prevent and treat the disease.Previous studies have shown that classical chinese medicine prescription for warming and tonifying the kidney yang,can significantly improve the symptoms of kidney yang deficiency caused by the application of glucocorticoids,at the same time,it has a certain prevention and treatment effect on steroid related necrosis of the femoral head.Further study on the mechanism and treatment of chinese medicine can better explain its"warming and tonifying the kidney yang".It has a certain prevention and treatment effect on steroid related necrosis of the femoral head,and further explore the mechanism and treatment way of traditional Chinese medicine in the treatment of this disease,so as to put forward new ideas for the prevention and treatment of GA-ONFH.Objective:1.Through serological test and general conditions of patients,early screening of potential kidney yang deficiency hormone related osteonecrosis of femoral head(GA-ONFH)patients with high-dose hormone use history was carried out,and high-risk factors affecting the occurrence and development of the disease were collected and screened,so as to carry out early education and intervention for patients with high-risk factors who do not meet the diagnostic criteria of GA-ONFH in various departments,so as to reduce the risk The risk of occurrence and progression of the disease.2.According to the related theory of pathological mechanism of GA-ONFH,through the network pharmacology research approach,further explore the mechanism that the combination of single Chinese herb in Yougui decoction can prevent GA-ONFH.Methods:1.According to the inclusion and exclusion criteria,60 cases of steroid related osteonecrosis of femoral head confirmed by the Department of orthopedics and traumatology of Jiangsu Hospital of traditional Chinese medicine from June 2016 to June 2017 and 60 cases of glucocorticoid dosage conforming to the inclusion criteria applied by the Department of Rheumatology of Jiangsu Hospital of traditional Chinese medicine at the same time were collected and divided into case group and control group.Their sex,age,white blood cell count,red blood cell count,hemoglobin count,platelets,C-reactive protein(CRP),AST,alt,ALP,TC,TG,HDL,LDL,?-glutamyl Peptidase(GGT),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer.Spss22.0 statistical software was used to analyze the above information by binary logistic regression analysis,and the relationship between the above factors and GA-ONFH in high-risk population was analyzed.APOE genotype and MTHFR(tetrahydrofolate reductase)genotype were recorded in some patients and compared with the genotype ratio of healthy population in the previous literature to analyze the relationship between the above factors and ga-onfh in high-risk population.2.According to tcmsp database,Batman database,Swiss target prediction database and gene Cards Database,string database search results,respectively collate the chemical composition,chemical composition target,dyslipidemia and coagulation related genes,protein synergy and other information of the three traditional Chinese medicines(Angelica,aconite and cinnamon)in Yougui decoction,use venny2.1 online software,Cytoscape 3.7.1 software,r3.6.0 software and other online pharmacological research methods to study their composition target pathway The complex mechanism was studied to provide further evidence for the prevention and treatment of GA-ONFH by traditional Chinese medicineConclusion:In this study,the retrospective cohort study was used to screen out the risk factors of GA-ONFH in high-dose glucocorticoid group by sorting out the general situation and serological test results,and using logistic regression analysis.The results showed that TC,FIB and DD were the risk factors of high correlation.In ApoE and MTHFR gene screening,APOE E4/4 and MTHFR TT are high risk indexes of cholesterol metabolism and coagulation dysfunction,and also can be risk factors of routine screening.It suggested that the long-term or short-term high-dose glucocorticoid men should regularly check their blood lipid level and coagulation function within 2 years,If conditions permit,ApoE and MTHFR gene screening should also be carried out,and intervene in time in case of abnormality to avoid GA-ONFH.Through the method of network pharmacology and based on the results of previous studies,the active components,targets and signal pathways of angelica,aconite and cinnamon,which are the single traditional Chinese medicine related to lipid metabolism and coagulation function,are deeply explored in traditional Chinese medicine.It is confirmed that they are related to the change of plasmin activity,the reduction of small blood aggregation,the improvement of vascular smooth muscle cell deformability and the inhibition of cholesterol absorption The role is closely related.This paper further explained the mechanism of traditional Chinese medicine on the prevention and treatment of steroid related necrosis of femoral head in kidney yang deficiency type,provided new evidence for the prevention and treatment of hormone related necrosis of femoral head in traditional Chinese medicine,and provided ideas and clues for the evaluation of the synergistic effect of traditional Chinese medicine in prescriptions.However,the sample size of this study is small and the subject span is not wide.It still needs multi-disciplinary,multi-center comparative study and multi-faceted practice to better provide reliable advice for clinical practice.