Effect of Qing’e Pill plus Salvia on Non-Traumatic Osteonecrosis of the Femoral Head of Idiopathic Type in Earlier Stage: A Case Report of a Twelve-Month of Period

Bo Shuai, Yanping Yang, Lin Shen, Manxiang Wu

Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

DOI: 10.4236/cm.2014.52013                

Abstract

Background: Compromised circulatory and bone/lipid metabolic dysfunction are two major contributors to non-traumatic osteonecrosis of the femoral head (ONFH). Qing’e pill plus Salvia has significant anti-inflammatory and anti-atherosclerotic action, and it could also regulate bone formation and remodeling by suppressing osteoclasts. Case Report: We describe a case of a 62-year- old man with ONFH of idiopathic type in earlier stage that could not be adequately controlled with oral non-steroidal analgesics and restoring bone loss agents for past 3 years. After six months treatment with Qing’e pill plus Salvia, the plasma low-density lipoprotein (LDL), high-density lipoprotein (HDL), apolipoprotein A1 (apo A1), apolipoprotein B (apo B), total cholesterol (TC), triglycerides (TG), and blood viscosity were measured on an empty stomach. The Harris scores were maintained during a six months follow-up after discontinuation of Qing’e pill plus Salvia. Discussion: Our case has shown that plasma levels of inflammatory and atherosclerotic relaxed factors and the Harris scores may be controlled with herbal medication in ONFH of idiopathic type in earlier stage that could not be adequately controlled with oral non-steroidal analgesics and restoring bone loss agents.

Keywords

Qing’e Pill, Osteonecrosis, Femoral Head, Ischemic, Biomarker, Traditional Chinese Medicine

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Shuai, B., Shen, L., Yang, Y.P., Xie, J., Shou, Z.X. and Wei, B. (2010) Low Plasma Adiponectin as a Potential Biomarker for Osteonecrosis of the Femoral Head. The Journal of Rheumatology, 37, 2151-2155. http://dx.doi.org/10.3899/jrheum.100342
[2]	Hirata, T., Fujioka, M., Takahashi, K.A., Arai, Y., Asano, T., Ishida, M., Kuribayashi, M., Akioka, K., Okamoto, M., Yoshimura, N., Satomi, Y., Nishino, H., Fukushima, W., Hirota, Y., Nakajima, S., Kato, S. and Kubo, T. (2007) ApoB C7623T Polymorphism Predicts Risk for Steroid-Induced Osteonecrosis of the Femoral Head after Renal Transplantation. Journal of Orthopaedic Science, 12, 199-206. http://dx.doi.org/10.1007/s00776-007-1110-9
[3]	Motomura, G., Yamamoto, T., Miyanishi, K., Jingushi, S. and Iwamoto, Y. (2004) Combined Effects of an Anticoagulant and a Lipid-Lowering Agent on the Prevention of Steroid-Induced Osteonecrosis in Rabbits. Arthritis & Rheumatology, 50, 3387-3391. http://dx.doi.org/10.1002/art.20517
[4]	Pengde, K., Fuxing, P., Bin, S., Jing, Y. and Jingqiu, C. (2008) Lovastatin Inhibits Adipogenesis and Prevents Osteonecrosis in Steroid-Treated Rabbits. Joint Bone Spine, 75, 696-701. http://dx.doi.org/10.1016/j.jbspin.2007.12.008
[5]	Miyanishi, K., Yamamoto, T., Irisa, T., Yamashita, A., Jingushi, S., Noguchi, Y. and Iwamoto, Y. (2002) Bone Marrow Fat Cell Enlargement and a Rise in Intraosseous Pressure in Steroid-Treated Rabbits with Osteonecrosis. Bone, 30, 185-190. http://dx.doi.org/10.1016/S8756-3282(01)00663-9
[6]	Kong, X.Y., Wang, R.T., Tian, N., Li, L., Lin, N. and Chen, W.H. (2012) Effect of Huogu II Formula with Medicinal Guide Radix Achyranthis Bidentatae on Bone Marrow Stem Cells Directional Homing to Necrosis Area after Osteonecrosis of the Femoral Head in Rabbit. Chinese Journal of Integrative Medicine, 18, 761-768. http://dx.doi.org/10.1007/s11655-011-0940-7
[7]	Zhang, W., Kanehara, M., Ishida, T., Guo, Y., Wang, X., Li, G., Zhang, B., Kondo, H. and Tachi, S. (2004) Preventive and Therapeutic Effects of Acupuncture on Bone Mass in Osteopenic Ovariectomized Rats. The American Journal of Chinese Medicine, 32, 427-443. http://dx.doi.org/10.1142/S0192415X04002089
[8]	Radke, S., Battmann, A., Jatzke, S., Eulert, J., Jakob, F. and Schutze, N. (2006) Expression of the Angiomatrix and Angiogenic Proteins CYR61, CTGF, and VEGF in Osteonecrosis of the Femoral Head. Journal of Orthopaedic Research, 24, 945-952. http://dx.doi.org/10.1002/jor.20097
[9]	Ajmal, M., Matas, A.J., Kuskowski, M. and Cheng, E.Y. (2009) Does Statin Usage Reduce the Risk of Corticosteroid-Related Osteonecrosis in Renal Transplant Population? Orthopedic Clinics of North America, 2, 235-239. http://dx.doi.org/10.1016/j.ocl.2009.01.004
[10]	Glueck, C.J., Freiberg, R.A., Sieve, L. and Wang, P. (2005) Enoxaparin Prevents Progression of Stages I and II Osteonecrosis of the Hip. Clinical Orthopaedics and Related Research, 164-170. http://dx.doi.org/10.1097/01.blo.0000157539.67567.03
[11]	Jager, M., Zilkens, C., Bittersohl, B., Matheney, T., Kozina, G., Blondin, D. and Krauspe, R. (2010) Efficiency of Iloprost Treatment for Osseous Malperfusion. International Orthopaedics, 35, 761-765. http://dx.doi.org/10.1007/s00264-010-0998-4
[12]	Lai, K.A., Shen, W.J., Yang, C.Y., Shao, C.J., Hsu, J.T. and Lin, R.M. (2005) The use of Alendronate to Prevent Early Collapse of the Femoral Head in Patients with Nontraumatic Osteonecrosis: A Randomized Clinical Study. The Journal of Bone & Joint Surgery, 87, 2155-2159. http://dx.doi.org/10.2106/JBJS.D.02959
[13]	Camporesi, E.M., Vezzani, G., Bosco, G., Mangar, D. and Bernasek, T.L. (2010) Hyperbaric Oxygen Therapy in Femoral head necrosis. The Journal of Arthroplasty, 25, 118-123. http://dx.doi.org/10.1016/j.arth.2010.05.005
[14]	Wu, W.Y. and Wang, Y.P. (2012) Pharmacological Actions and Therapeutic Applications of Salvia Miltiorrhiza Depside Salt and Its Active Components. Acta Pharmacologica Sinica, 33, 1119-1130. http://dx.doi.org/10.1038/aps.2012.126
[15]	Yang, Y.P., Shen, L., Zhou, P.Q. and Xie J. (2002) Effects of Blood Rheology on Patients with Necrosis of Femoral Head Caused by Alcohol with Bushen Huoxuefang. Chinese Journal of Traditional Medical Traumatology & Orthopedics, 10, 28-30.
[16]	Zhou, P.Q., Shen, L., Yang, Y.P. and Xie, J. (2004) Effects of Blood Rheology and Bone Mineral Density on Patients with Necrosis of Femoral Head Caused by Alcohol with Bushen Huoxuefang. Chinese Journal of Traditional Medical Traumatology & Orthopedics, 12, 27-29.
[17]	Yang, Y.P., Shen, L., Liu, S.R., Xie, J. and Zhou, P.Q. (2004) Effects of Bone Density on Experimental Rabbits with Avascular Necrosis of Femoral Head by Bushenhuoxuefang. Chinese Journal of Traditional Medical Traumatology & Orthopedics, 12, 5-7.
[18]	Zhou, P.Q., Shen, L., Yang, Y.P. and Xie, J. (2006) Effects of Bone Density and Biomechanics on Experimental Rabbits with Avascular Necrosis of Femoral Head by Bushenhuoxuefang. Chinese Journal of Rehabilitation Medicine, 21, 1139-1143.
[19]	Shen, L., Du, J.Y., Yang, J.Y., Yang, Y.P. and Gao, L. (1994) Effect of Qing’e Pill on Ovariectomy Osteoporosis Rats. Traditional Chinese Medicinal Research, 7, 19-21.
[20]	Xiong, Z.L., Guo, X.J., Xu, Y. and Li, F.M. (2002) Effect of Extracts from Qing’e Pill on the Proliferation and Differentiation of Osteoblast-Like Cells UMR106. Pharmacology and Clinics of Chinese Materia Medica, 18, 3-5.
[21]	Ling, J.Y., Shen, L., Liu, Q., Xue, S. and Zhu, R. (2013) Effect of Xiaoyu Zhixue Tablet on Expression of Platelet Membrane Glycoprotein I b α and Quality of Life in Patients with Menorrhagia. Acta Medicinae Universitatis Scientiae et Technologiae Huazhong, 42, 601-604.
[22]	Shuai, B., Shen, L., Yang, Y.P., Xie, J., Zhou, P.Q., Xu, X.J., Li, C.G. and Wu, M.X. (2012) Effect of Bushenhuoxue Decoction on the Osteogenic Differentiation of Bone Marrow Stromal Cells in the Steroid Induced Osteonecrosis of the Femoral Head. Research of Integrated Traditional Chinese and Western Medicine, 4, 297-301.