摘要
目的观察乳腺熏洗方熏洗对非哺乳期乳腺炎(NPM)术后创面愈合的影响,并探讨其作用机制。方法将98例NPM术后创面生肌收口期患者随机分为治疗组、对照组,每组49例,在常规换药的基础上,治疗组给予乳腺熏洗方熏洗治疗,对照组给予质量浓度为9 g/L的氯化钠溶液熏洗治疗,疗程为12 d。比较两组创腔体积缩小率、创口面积缩小率,以及创面肉芽组织状态评分、血常规[白细胞(WBC)、中性粒细胞(NEU)、中性粒细胞百分比(NEU%)、血小板(PLT)]、C反应蛋白(CRP)、红细胞沉降率(ESR)的变化情况;两组各选取5例病例,采用Western blot法检测创面组织白细胞介素-6(IL-6)、Janus激酶2(JAK2)、信号转导及转录激酶蛋白3(STAT3)蛋白表达的变化情况。结果(1)最终完成试验者94例,其中治疗组49例、对照组45例。(2)治疗组创腔体积缩小率、创口面积缩小率高于对照组(P<0.05)。(3)治疗前后组内比较,治疗组创面肉芽状态评分升高(P<0.05);组间治疗后比较,治疗组创面肉芽状态评分高于对照组(P<0.05)。(4)治疗前后组内比较,两组WBC、NEU、NEU%、PLT、CRP、ESR水平降低(P<0.05);组间治疗后比较,治疗组PLT、CRP水平低于对照组(P<0.05)。(5)治疗前后组内比较,对照组创面肉芽组织IL-6、JAK2、STAT3蛋白表达上调(P<0.05);组间治疗后比较,治疗组创面肉芽组织IL-6、STAT3蛋白表达水平低于对照组(P<0.05)。结论乳腺熏洗方熏洗能有效促进NPM术后创面愈合,其机制可能与抑制IL-6/JAK2/STAT3信号通路,进而抑制创面炎症反应有关。
Objective To observe the effect of Ruxian Xunxi Prescription(a prescription for breast fumigation)on wound healing following the nonpuerperal mastitis(NPM)surgery,and to explore the underlying mechanisms.Methods Ninety-eight patients experiencing granulation tissue formation during the wound healing phase after NPM surgery were randomly divided into two groups:a treatment group(n=49)and a control group(n=49).In addition to routine dressing changes,the treatment group received fumigation therapy using Ruxian Xunxi Prescription,while the control group received a 0.9%saline solution treatment.The treatment lasted 12 days.The study evaluated the reduction in wound cavity volume and wound area between the groups,along with assessments of granulation tissue condition and changes in routine blood test parameters:white blood cells(WBC),neutrophils(NEU),neutrophil percentage(NEU%),platelets(PLT),C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR).From each group,wound tissue samples from five cases were selected for Western blot analysis to examine changes in the expression of interleukin-6(IL-6),Janus kinase 2(JAK2),and signal transducer and activator of transcription 3(STAT3)proteins.Results①Of the initial participants,94 completed the study,with 49 in the treatment group and 45 in the control group.②The treatment group showed significantly higher reduction rates in wound cavity volume and wound area than the control group(P<0.05).③Intra-group comparisons before and after treatment showed increased scores for granulation tissue condition in the treatment group(P<0.05).Post-treatment inter-group comparisons showed higher score for granulation tissue condition in the treatment group than in the control group(P<0.05).④After treatment,levels of WBC,NEU,NEU%,PLT,CRP,and ESR decreased in both groups(P<0.05),with the treatment group showing lower levels of PLT and CRP than the control group(P<0.05).⑤Intragroup comparisons before and after treatment showed that the expression of IL-6,JAK2,and STAT3 proteins in wound granulation tissue increased in the control group(P<0.05).After treatment,the treatment group showed lower expression levels of IL-6 and STAT3 proteins than the control group(P<0.05).Conclusion Ruxian Xunxi Prescription effectively promotes wound healing after NPM surgery,potentially through mechanisms involving the inhibition of the IL-6/JAK2/STAT3 signaling pathway and the alleviation of inflammatory responses at the wound site.
作者
周悦
叶媚娜
程亦勤
王冰
吴晶晶
孟畑
仲芫沅
沈梦菲
程一凡
陈红风
ZHOU Yue;YE Meina;CHENG Yiqin;WANG Bing;WU Jingjing;MENG Tian;ZHONG Yuanyuan;SHEN Mengfei;CHENG Yifan;CHEN Hongfeng(Breast Surgery Department of Chinese Medicine,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《上海中医药杂志》
CSCD
2024年第8期35-40,共6页
Shanghai Journal of Traditional Chinese Medicine
基金
上海申康医院发展中心促进市级医院临床技能与临床创新能力三年行动计划重大临床研究项目(SHDC2020CR2051B)
上海中医药大学附属龙华医院第五批“龙医学者”临床科技创新培育项目(PY2022016)。
关键词
非哺乳期乳腺炎
中药熏洗疗法
乳腺熏洗方
创面愈合
炎症
临床试验
non-puerperal mastitis
traditional Chinese Medicine fumigation therapy
Ruxian Xunxi Prescription
wound healing
inflammation
clinical trial
作者简介
周悦,女,博士研究生,主治医师,主要从事中医药防治乳腺疾病临床与研究工作;通信作者:陈红风,主任医师,博士研究生导师,E-mail:chhfluk@126.com。
