目的 探讨骨坚散对激素性股骨头坏死模型大鼠骨、脂代谢的影响。 方法 将大鼠分为对照组、模型组和骨坚散低、中、高剂量组，每组10只。除对照组外，其余组均予脂多糖和糖皮质激素构建激素性股骨头坏死模型，骨坚散低、中、高剂量组分别予1.05、2.10、4.20 g/kg骨坚散每天灌胃。8周后检测血清低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯（TG）含量；RT-qPCR和Western blot分别检测股骨头组织中过氧化物酶体增殖物激活受体γ（PPARγ）、CCAAT增强子结合蛋白α（C/EBPα）、CCAAT增强子结合蛋白β（C/EBPβ）、Runt相关转录因子2（Runx2）、骨桥蛋白（OPN）、碱性磷酸酶（ALP）的mRNA和蛋白相对表达水平；Micro-CT观察大鼠股骨头骨质量的变化；苏木素-伊红（HE）染色观察股骨头组织病理形态变化；免疫组化（IHC）观察股骨头骨钙素（OCN）和Runx2蛋白表达。 结果 与模型组比较，骨坚散治疗后血清TC、TG及LDL-C含量减少（P < 0.05），而HDL-C含量增加（P < 0.05），PPARγ、C/EBPα、C/EBPβ mRNA和蛋白表达量降低（P < 0.05），Runx2、ALP、OPN的mRNA和蛋白表达量升高（P < 0.05），骨体积分数、骨小梁厚度、骨小梁数目、骨小梁连接密度及骨矿物质含量增加（P < 0.05），骨小梁分离度减少（P < 0.05），股骨头组织内空骨陷窝率降低（P < 0.05），OCN和Runx2蛋白表达水平升高（P < 0.05）。 结论 本研究显示，骨坚散低、中、高剂量组均具有调节骨脂代谢稳态的作用，且以骨坚散高剂量组作用最为显著；骨坚散可能通过PPARγ信号通路改善激素性股骨头坏死模型大鼠的脂代谢紊乱，促进成骨分化，恢复骨脂代谢平衡，进而促进骨坏死修复。

Objective To explore the effects of Gujiansan on bone and lipid metabolism in rat models of steroid-induced necrosis of the femoral head. Methods The rats were divided into the control group， the model group， and the low-dose， medium-dose， and high-dose groups of Gujiansan， with 10 rats in each group. Except for the control group， lipopolysaccharide and glucocorticoid were administered to the other groups to establish the steroid-induced necrosis of the femoral head model. The low-dose， medium-dose， and high-dose Gujiansan groups were respectively given 1.05， 2.10， and 4.20 g/kg of Gujiansan via gavage daily. Eight weeks later， the contents of low-density lipoprotein cholesterol （LDL-C）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， and triglycerides （TG） were measured. RT-qPCR and Western blot were employed to detect the relative mRNA and protein expression levels of peroxisome proliferator-activated receptor γ （PPARγ）， CCAAT enhancer binding protein α （C/EBPα）， CCAAT enhancer binding protein β （C/EBPβ）， Runt-related transcription factor 2 （Runx2）， osteopontin （OPN）， and alkaline phosphatase （ALP） in femoral head tissues. Micro-CT was utilized to observe the alterations in the bone mass of the rat femoral head； Hematoxylin-eosin （HE） staining was used to observe the pathological morphological changes of the femoral head tissue. Immunohistochemistry （IHC） was applied to observe the protein expressions of osteocalcin （OCN） and Runx2 in the femoral head. Results Compared with the model group， after treatment with Gujiansan， the contents of serum TC， TG， and LDL-C decreased （P < 0.05）， whereas the content of HDL-C increased （P < 0.05）. Additionally， the mRNA and protein expression levels of peroxisome PPARγ， C/EBPα， and C/EBPβ decreased （P < 0.05）， while those of Runx2， ALP， and OPN increased （P < 0.05）. Moreover， the bone volume fraction， trabecular thickness， trabecular number， trabecular connection density， and bone mineral content increased （P < 0.05）， the trabecular separation degree decreased （P < 0.05）， the rate of empty bone pits in the femoral head tissue decreased （P < 0.05）， and the expression levels of OCN and Runx2 proteins increased （P < 0.05）. Conclusion This study shows that the low-dose， medium and high-dose groups of Gujiansan all have the effect of regulating the homeostasis of bone lipid metabolism， and the high-dose group of Gujiansan has the most significant effect； Gujiansan may improve lipid metabolism disorders in rats with steroid-induced necrosis of the femoral head via the PPARγ signaling pathway， promote osteogenic differentiation， restore the balance of bone-lipid metabolism， and consequently promote the repair of osteonecrosis.