Objective To investigate the possible mechanism of Bushen Huoxue Recipe（补肾活血方） in the treatment of steroid-induced femoral head necrosis. Methods A total of 120 SD rats were randomly divided into normal group

model group

Chinese medicine group and western medicine group

with 30 rats in each group. Except the normal group

the rats in the other groups were injected with methylprednisolone sodium succinate 20 mg/kg

twice a week for 6 weeks to establish an animal model of steroid-induced femoral head necrosis. After modeling

the Chinese medicine group was given Bushen Huoxue Recipe decoction 2 ml at concentration of 96. 67 mg/ml by gavage

and the western medicine group was given 2 ml of alendronate sodium aqueous solution at a concentration of 1. 29 mg/ml. The appearance of femoral head and histopathological changes after HE staining were observed. The expression of nuclear factor-kappaB receptor activating factor ligand（RANKL） and core binding factor α1（Cbfα1） protein and mRNA in femoral head tissues were detected. Results In the model group

the femoral head was rough and dull

and the osteoporosis was serious. Some of the femoral heads of the western medicine group had no rough surface and bright color

occasionally the color was slightly dull

and the bone was hard. The appearance and shape of the femoral head of the Chinese medicine group and the normal group was normal

and the bone was hard. HE staining showed that the model group had large area necrosis of the femoral head chondrocytes

the arrangement was not neat

with the chondrocyte nuclear condensation. The bone cells in the trabecular bone were significantly reduced

and the empty bone sag was significantly increased. The arrangement of femoral head chondrocytes in the Chinese medicine group was irregular and the structure was still intact. The empty bone lacuna was less common

which was the closest to the normal group. The change of the western medicine group was similar to that of the Chinese medicine group

but the empty bone lacuna was more than the Chinese medicine group. The expressions of RANKL

Cbfα1 protein and mRNA in the femoral head tissues of the Chinese medicine group and the western medicine group were lower than those in the model group（P < 0. 05）

but there was no significant difference between the Chinese medicine group and the western medicine group（P > 0. 05）. Conclusion Bushen Huoxue Recipe may down-regulate the expression of RANKL and Cbfα1 in femoral head tissue

thereby promoting the repair of femoral head necrosis and the formation of new bone in the femoral head.