| Objective:1.Through the comprehensive analysis of the medical records of NONFH inpatients in Gansu Provincial Hospital of Traditional Chinese Medicine,this study aims to clarify the high incidence of constitution types in NONFH patients and improve the database data of NONFH patients.2.To study the expression of ADPN and Apo E in bone tissue of NONFH patients and explore the pathogenesis of NONFH.To provide evidence for NONFH medication and disease prognosis prediction.Methods:1.A total of 677 hospitalized patients with NONFH admitted to Gansu Provincial Hospital of Traditional Chinese Medicine from October 2017 to December 2020 were collected.The age,gender,body mass index,etiology,incidence side,and TCM constitution type of the patients were retrospectively analyzed.Descriptive analysis was performed and clinical conclusions were drawn.2.The femoral head specimens of patients with NONFH were collected,and the database of bone tissue specimens was established.Thirty patients with NONFH and 30 patients with TONFH were randomly selected as the case group and the control group.Combined with the literature research and previous experimental results,the indexes were selected.The expression levels of ADPN and Apo E proteins in the necrotic and normal areas of femoral head specimens in the two groups were determined by Western-Blot method,and the SPSS 24.0 software was used for statistical analysis.Results:1.Results of TCM constitution distribution:(1)A total of 677 patients with NONFH were investigated,including 610 Han,36 Hui,16 Dongxiang,13 Tibetan and 2 Tu.Male accounted for 53.32%,female accounted for 46.68%,male to female ratio was 1.14:1.(2)The minimum age of patients was 20 years old,and the maximum age was 86 years old.The average age of overall onset was 55.49±12.94.(3)A total of 384 56.72%of the patients had BMI≥24.0 kg/m~2,of which 188 were women,accounting for 59.49%of the total number of women and 196 were overweight men,accounting for 54.29%.(4)According to the proportion of etiology in the survey:idiopathic>hormone>alcohol,accounting for 68.69%,24.22%,7.09%respectively.(5)677 patients with NONFH were mainly unilateral,steroid bilateral incidence accounted for 45.73%,alcoholic ONFH bilateral incidence accounted for 43.75%,idiopathic bilateral incidence accounted for 33.98%.(6)A total of 621 cases of single constitution,accounting for 91.73%of the total number.Among them,158 cases were mild(25.44%)and463 cases were biased(74.56%).The top three single constitution types with high incidence were blood stasis,qi deficiency and phlegm dampness,accounting for 16.26%,15.46%and13.69%of the total number of patients with single constitution types,respectively.2.Experimental results:ADPN protein expression in NONFH femoral head necrosis area was lower than other regions,but the difference was not statistically significant(P>0.05).The protein expression level of Apo E in the necrotic region of NONFH femoral head was lower than that in other regions,but only the expression level in the necrotic region of NONFH femoral head was statistically significant compared with that in the necrotic region of TONFH femoral head(P<0.05).Conclusion:1.It is further confirmed that blood stasis,qi deficiency and phlegm dampness are the high incidence constitution types of NONFH.NONFH can occur in all age groups,and the high incidence population in the region is mainly concentrated in the middle-aged and elderly people over 40 years old.The ratio of male to female was 1.14:1.Most of them were unilateral,and obesity accounted for 56.72%.The incidence of immune system diseases and chronic inflammation in this region is high,so the proportion of patients with steroid-induced femoral head necrosis is high.2.ADPN level in blood cannot fully represent the level of NONFH patients.High fat state may not be the key link in the occurrence of NONFH.Conclusion:(1)It is further confirmed that blood stasis,qi deficiency and phlegm dampness are the high incidence constitution types of NONFH;(2)NONFH can occur in all ages,and the high-risk groups in this region are mainly concentrated in the middle-aged and elderly people over 40 years old;(3)The ratio of male to female is 1.14:1.Most of them were unilateral,and obesity accounted for56.72%.The incidence of immune system diseases and chronic inflammation in this region is high,so the proportion of patients with steroid-induced femoral head necrosis is high.(4)Blood stasis,qi deficiency and phlegm-dampness are the high incidence TCM constitutions of NONFH.The age of patients with blood stasis is lower,and the average age of patients with qi deficiency is higher.(5)ADPN level in blood cannot fully represent the level of NONFH patients;High fat state may not be the key link in the occurrence of NONFH. |
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