Abstract：
Nontraumatic avascular necrosis of the femoral head(NANFH) is a common and refractory femoral head disease that causes bone death due to interruption of blood supply. Early clinical symptoms are atypical, such as hip pain and limited joint function. In the late stage, severe pain, shortening of the affected limb, claudication, and other serious symptoms are common, which se-riously affects the quality of life of patients. Therefore, it is of great significance to actively improve the clinical symptoms of NANFH to enhance the quality of life of patients. The pathogenesis of NANFH is complex, such as traumatic vascular circulatory disorders, the use of hormones or other drugs, alcoholism, and diabetes mellitus. These factors directly or indirectly lead to femoral head vascular damage, thrombosis, and coagulation system disorders, which reduce the blood supply to the acetabulum and femoral head, thus causing ischaemic death of the femoral head or even femoral head collapse. NANFH is mainly categorized as "bone impotence" and "bone paralysis" in traditional Chinese medicine(TCM). The treatment of NANFH with TCM has the characteristics and advantages of a long history, stable and reliable therapeutic effect, fewer adverse reactions, good patient tolerance, and high acceptance. Previous studies have shown that the promotion of angiogenesis is a key initiative in the prevention and treatment of NANFH, and TCM can promote fe-moral head angiogenesis by interfering with the expression of angiogenesis-related factors, which in turn can help to restore the blood supply of the femoral head and thus improve clinical symptoms of NANFH and prevent and treat NANFH. This article described the roles of blood supply interruption and angiogenesis in NANFH and the accumulated knowledge and experience of TCM in NANFH and summarized the role of angiogenesis-related factors in NANFH and the research progress on TCM intervention, so as to provide an idea for the subsequent research and a new basis for the clinical application of TCM in the treatment of NANFH.
摘要：
非创伤性股骨头缺血性坏死（NANFH）是一种常见的难治性股骨头疾病，由于血液供应中断而导致骨死亡。早期临床症状不典型，如髋部疼痛和关节功能受限。在后期阶段,剧烈疼痛,患肢缩短，跛行,和其他严重的症状是常见的，严重影响患者的生活质量。因此,积极改善NANFH临床症状对提高患者生活质量具有重要意义。NANFH的发病机制复杂,如创伤性血管循环障碍，使用激素或其他药物，酗酒,和糖尿病。这些因素直接或间接导致股骨头血管损伤,血栓形成,和凝血系统疾病，这减少了髋臼和股骨头的血液供应，从而导致股骨头缺血性死亡甚至股骨头塌陷。NANFH在中医（TCM）中主要分为骨阳痿和骨麻痹。中医治疗NANFH具有历史悠久的特点和优势,稳定可靠的治疗效果，不良反应少,患者耐受性好,和高接受度。先前的研究表明，促进血管生成是预防和治疗NANFH的关键举措，中药可以通过干预血管生成相关因子的表达促进血管生成，这反过来可以帮助恢复股骨头的血液供应，从而改善NANFH的临床症状并预防和治疗NANFH。本文阐述了血供中断和血管生成在NANFH中的作用以及中医药在NANFH中积累的知识和经验，并总结了血管生成相关因子在NANFH中的作用以及中医药干预的研究进展。为后续研究提供思路,为中医药治疗NANFH的临床应用提供新的依据。
