2024, Vol. 28 ›› Issue (2): 288-294

Mechanism of Chinese medicine for promoting blood circulation and removing blood stasis combined with platelet-rich plasma to improve steroid-induced necrosis of the femoral head

Li Chengming, Xue Dongling, Yang Xinyu, Xiao Chi, Cui Daping   

Abstract: BACKGROUND: At present, it is found that both Chinese medicine for activating blood circulation and removing blood stasis and platelet-rich plasma technology can repair damaged blood vessels, promote vascular regeneration, rebuild blood supply in the femoral head, restore normal blood supply, and further promote osteogenesis. Both of them have certain advantages in early intervention of steroid-induced necrosis of femoral head. It can also further understand the mechanism of blood activating and stasis removing herbs and platelet-rich plasma technology in improving steroid-induced necrosis of the femoral head, and provide new ideas for future treatment.  
OBJECTIVE: To review the research progress of the mechanism of the combination of blood activating and blood stasis removing herbs and platelet-rich plasma technology on steroid-induced necrosis of the femoral head according to the related literature at home and abroad.
METHODS: PubMed, Web of Science, Metstr, CNKI and WanFang databases were searched for relevant articles. “Traditional Chinese medicine, signal pathways, steroid induced necrosis of femoral head, vascular endothelial growth factor, platelet rich plasma” were used as the Chinese and English search terms separately. The time limit for searching the literature was from January 2000 to July 2022, and 75 related articles were finally included.  
RESULTS AND CONCLUSION: Both Chinese medicine for activating blood circulation and removing blood stasis and platelet-rich plasma technology have certain advantages in intervening the early stage of steroid-induced necrosis of femoral head. For traditional Chinese medicine, both single and compound drugs can effectively alleviate the further development of steroid-induced necrosis of the femoral head. The specific mechanism is as follows: (1) The traditional Chinese medicine for activating blood circulation and removing blood stasis has a significant anticoagulation effect, which can antagonize the abnormal (hypercoagulable) state of blood caused by hormone drugs, and further restore the normal blood supply in the femoral head. (2) Traditional Chinese medicine for activating blood circulation and removing blood stasis can repair damaged vascular endothelium, regenerate blood vessels and remodel blood supply in the femoral head by activating vascular endothelial growth factor. (3) The traditional Chinese medicine of promoting blood circulation and removing blood stasis has the obvious effect of removing blood stasis, which can reduce the accumulation of fat cells in the bone marrow cavity and relieve the pressure in the femoral head. (4) Traditional Chinese medicine for promoting blood circulation and removing blood stasis can regulate relevant signal pathways, maintain bone metabolism, promote the differentiation and balance of osteoblasts and osteoclasts, and effectively reduce steroid-induced necrosis of the femoral head. In addition, platelet-rich plasma contains a large amount of high concentration of cell growth factor, which plays a positive role in osteogenesis and vascular regeneration, and can also improve the abnormal state of the blood. Traditional Chinese medicine for activating blood circulation and removing blood stasis combined with platelet-rich plasma technology can play their biological roles, and the intervention effect is more significant.

Key words: steroid-induced necrosis of the femoral head, abnormal blood condition, angiogenesis, osteogenesis, Chinese herbal medicine for activating blood circulation and removing blood stasis, platelet-rich plasma