Based On EphrinA2-EphA2 Signaling Pathway To Explore The Clinical Efficacy And Aechanism Of Panax Notoginseng Huoxuebushen Prescription For Steroidal Femur Head Necrosis

Objective: Based on ephrinA2-EphA2 signaling pathway,to explore the clinical efficacy and related mechanism of Panax Notoginseng Bushen formula in the treatment of hormone-induced femoral head necrosis,in order to provide reference and theoretical basis for clinical treatment of hormone-induced femoral head necrosis with Panax notoginseng Bushen Huoxun formula.Methods: In the case of 50 patients with hormonal femoral necrosis from January 2021 to October 2022,the number of patients with the drug was divided into the control group and the test group,each of which was 25.In the control group,the average age of the control group was 45.72±11.65,the male was 18,the women were 7,the left was 11,and the right was 14.The average age of the patients was 49.12±13.64,men were 20,five in women,10 on the left and 15 on the right.The control group was treated with the healing agent of hengguulang,and the test group was treated with three or seven blood supplements,and the treatment was six months.By contrast,the analysis of the response of the vas score in the six weeks of the treatment of the vas score,the vas score,the sf-36 score,and the difference of the imaging evaluation and the rt-pcr test of the epha2-expression ephrina2 expression,and evaluated the clinical efficacy and safety of the necrosis of the hormone femoral necrosis.Results: VAS pain score,Harris hip function score,SF-36 physiological function,SF-36 physiological function,SF-36 emotional function and X-ray efficacy evaluation of 2 groups at each follow-up time point were higher than before medication,and experimental group was higher than control group(P< 0.05).The SF-36 somatic pain score in both groups was higher than that before medication,and the follow-up results of 3 months after treatment and 6months after treatment were higher in observation group than in control group(P < 0.05).The SF-36 vitality and SF-36 social function scores of both groups were higher than those before medication,and the follow-up results of the observation group were higher than those of the control group 1 month after treatment(P < 0.05).The X-ray efficacy scores of both groups were higher than those before the treatment,and the follow-up results of the observation group were higher than those of the control group after 1 month,3 months and 6 months of treatment(P < 0.05).There was no statistical significance in imaging evaluation between the two groups at each follow-up time point(P >0.05),but the number of progressive cases in both groups decreased with time.The PCR results of serum samples collected from 3 patients before and after intervention showed that the mRNA expression levels of EphA2 and EphrinA2 genes in experimental group were lower than those in control group after intervention.Conclusion: Panax notoginseng Huoxue Tonifying kidney can improve the clinical symptoms of patients with hormone-induced femoral head necrosis,promote bone repair and delay the progression of femoral head necrosis.The protein content of ephrinA2 and EphA2 in serum of patients taking Panax Notoginseng Huoxuebushen formula increased compared with that of patients taking Henggu bone injury healing agent,suggesting that panax Notoginseng Huoxuoxuoxushen formula may affect bone metabolism through EphrinA2-epha2 signaling pathway to repair femoral head necrosis.In the treatment of steroid-induced femur head necrosis in traditional Chinese medicine,the method of “Huoxuebushen”has a satisfactory clinical effect,which provides a new idea for the prevention and treatment of hormone-induced femur head necrosis in the future.