Abstract: Objective To explore the molecular mechanism of Yanghe Decoction(Yanghe Tang, YHT)in thetreatment of femoral head necrosis(ONFH)by applying network pharmacology and molecular docking. Methods Through TCMSP database, Uniprot database, GeneCards database and DAVID database, the core compounds, core targets and signal pathways of effective compounds in Yanghe decoction in treaingt ONFH were probed, and YHT core compounds with ONFH's important target HIF-1a Molecular docking with VEGFA were compared. Results The TCMSP database was used to examine the compound components and corresponding targets of traditional Chinese medicine. According to the screening criteria of OB≥30% and DL≥0.18, duplicate values were removed, and finally 119 main active compounds in Yanghe Decoction were retrieved. After the target was corrected by Uniprot gene, 226 target genes were obtained. A total of 284 disease target genes were obtained from the GeneCards database, and the disease targets and compound targets were cross-mapped to obtain 40 potential targets of Yanghe Decoction in the treatment of ONFH, and 40 potential targets in the STRING database.Through the Cytoscape 3.7.1 software, the PPI network was topologically analyzed, and five core targets(IL-6, TNF, TP53, VEGFA, and CASP3)were obtained in addition to important targets directly related to ONFH(including VEGFA, CASP3, HIF-1α, IL-6, TNF, etc). Through the DAVID database, the Go function annotation and KEGG function enrichment analysis of potential targets were performed, and finally the PI3K-Akt signaling pathway related to bone metabolism was obtained, and the TNF signaling pathway related to immune and inflammatory response was related to blood. The pathways related to supply were HIF-1 signaling pathway, VEGF signaling pathway, positive regulation of angiogenesis, etc. Molecular docking showed that the binding energy of quercetin and HIF-1α was the lowest, and that of Stigmasterol and VEGFA was the lowest. These two molecular docking methods were more likely to occur. Conclusion It is predicted that YHT can regulate and control the immune inflammatory response, bone metabolism and blood circulation in the process of bone necrosis through HIF-1 signaling pathway, TNF signaling pathway, PI3K-Akt signaling pathway, etc., and achieve the effects of intervention and treatment of ONFH.

Key words: Yanghe decoction, osteonecrosis of the femoral head, PI3K-Akt signaling pathway, HIF-1 signaling pathway, VEGFA, HIF-1α