Abstract:

BACKGROUND: Improvement of the microcirculation and reversal of bone turnover are the key to treat avascular necrosis of femoral head. Qing’e Wan has been used for osteoporosis treatment (“bone atrophy”) described in the Inner Canon of Yellow Emperor, and now Jiawei Qing’e Wan is also used for treating early-stage non-invasive osteonecrosis of femoral head (ONFH) achieving satisfactory outcomes.
OBJECTIVE: To investigate the effect of Jiawei Qing’e Wan on bone turnover markers, hemorheology and inflammation-associated factors in patients with early stage ONFH and to clarify the underlying mechanism.
METHODS: A total of 60 patients with early stage of ONFH (69 hips) were enrolled and randomized into treatment and control groups (n=30 per group), followed by given the basic treatment combined with Jiawei Qing’e Wan and caltrate for 24 weeks, respectively. Bone marrow edema, Harris score, visual analogue scale score, lipid levels, blood rheological parameters, tumor necrosis factor-α and bone turnover marker levels were detected before and after treatment and compared between groups.
RESULTS AND CONCLUSION: Before treatment, the treatment and control groups had 26 and 24 hips with bone marrow edema, with the incidence rate of 74.29% and 70.59%, respectively (P > 0.05). After 24-week treatment, the treatment efficiency (subside+improvement) of bone marrow edema in the treatment and control group was 80.77% and 29.17%, respectively (P < 0.05). There were no significant differences in the visual analogue scale, Harris score, lipid levels, blood rheological parameters, and levels of tumor necrosis factor-α, β-Crosslaps, N-osteocalcin and N-terminal peptide of type I procollagen (T-PINP) between groups before treatment (P > 0.05). In the treatment group, the lipid levels and some of the blood rheological parameters after treatment were improved significantly (P < 0.05), and the visual analogue scale, and levels of tumor necrosis factor-α, β-Crosslaps, N-osteocalcin and T-PINP were significantly lower than those in the control group and before treatment (P < 0.05), while Harris scores were significantly higher than those before treatment and the control group (P < 0.05). All above indicators showed no significant differences before and after treatment in the control group (P > 0.05). These results suggest that Jiawei Qing’e Wan can effectively improve lipid metabolism, blood viscosity, and the levels of tumor necrosis factor-α and bone turnover markers in patients with early-stage ONFH, thereby improving the blood microcirculation and bone turnover, and relieving the clinical symptoms of bone marrow edema, which heightens the life quality of patients.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Drugs, Chinese Herbal, Femur Head Necrosis, Tumor Necrosis Factor-alpha, Tissue Engineering