Objective:To observe the promoting effects of blood-activating and stasis-removing Chinese drugs combined with vascular endothelial growth factor (VEGF) gene transfer on angiogenesis in ischemic necrosis of the femoral head.Methods:Forty Japanese giant-ear rabbits were randomly divided into a control group, a model group, a Chinese drug group, a gene group, and a combined group.After 8 weeks of treatment, the rate of VEGF positive cell expression in the synovium of the femoral head was measured using the immunohistochemical method, and the number of blood vessels in the femoral head was measured by digital subtraction angiography.Results:The rate of VEGF positive cell expression in the model group was significantly lower than that in the Chinese drug group (P＜0.05) and very significantly lower than those in other groups (P＜0.01);but in the combined group it was significantly higher than in the Chinese drug group (P＜0.05).The differences in the number of blood vessels in area A between the model group and other groups were not statistically significant.However, in area B, the number of blood vessels significantly increased in the control group, the gene group and the combined group as compared with the model group (P＜0.05), and in the combined group the number of blood vessels was significantly more than in the gene group (P＜0.05);but in the Chinese drug group it was not significantly different than the model group P＞0.05).Conelusion:Either the blood-activating and stasis-removing Chinese drugs or VEGF gene transfer can promote the angiogenesis and building of collateral circulation for femoral head ischemic necrosis, and the combined therapy with Chinese drugs or VEGF gene transfer may show a better therapeutic effect.The present study provides an experimental basis for clinical application of the combined therapy with the blood-activating and stasis-removing Chinese drugs and VEGF gene transfer.