摘要
目的:探讨黄芪当归汤联合序贯换药法对肛周脓肿术后创面愈合的促进作用。方法:取24只SD大鼠建立肛周脓肿术后模型,分为模型组、黄芪当归汤组、中医序贯换药组和黄芪当归汤联合中医序贯换药组,另取6只健康SD大鼠不作任何处理,作为正常组。除正常组外各组给药处理均1次/d,共干预21 d。观察创面愈合情况,测量治疗第7、14、21天的创面愈合率;苏木精-伊红染色(HE)观察创面组织病变;酶联免疫吸附测定(ELISA)检测创面组织中肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-10水平;免疫组织化学检测创面组织中血管内皮生长因子(VEGF)和血管内皮细胞特异性标记物(CD31)表达水平;流式细胞术检测创面组织中的CD86+巨噬细胞和CD206+巨噬细胞数量;蛋白质印迹法(Western blotting)检测创面组织中Janus激酶2(JAK2)、p-JAK2、信号传导及转录激活因子3(STAT3)、p-STAT3蛋白表达水平。结果:模型组大鼠创面组织在21 d内均未完全愈合,其余用药组大部分创面组织完全愈合。与正常组比较,模型组创面组织结构破坏严重,组织中TNF-α浓度、IL-6浓度、VEGF、CD31蛋白表达升高(P<0.05),CD86^(+)巨噬细胞数量增加(P<0.05),IL-10浓度及JAK2、p-JAK2、STAT3、p-STAT3蛋白表达降低(P<0.01),CD206^(+)巨噬细胞数量减少(P<0.05)。与模型组比较,黄芪当归汤组、中医序贯换药组和黄芪当归汤联合中医序贯换药组均有明显改善(P<0.05),其中黄芪当归汤联合中医序贯换药组效果最佳(P<0.01)。结论:内服黄芪当归汤联合外用中医序贯换药可以促进大鼠肛周脓肿术后创面血管新生与创面愈合。
Objective:To determine whether Huangqi Danggui decoction combined with sequential dressing change can promote wound healing after perianal abscess surgery.Methods:Totally 24 SD rats were used to establish a postoperative model of perianal abscess and the rats were divided into model group,Huangqi Danggui decoction group,Traditional Chinese Medicine(TCM)sequential dressing change group(sequential group),and Huangqi Danggui decoction combined with TCM sequential dressing change group(combination group).Another 6 healthy SD rats were taken without any treatment as the normal group.Except for the normal group,the treatments were given once a day for a total of 21 days.The wound healing rates were measured at 7th day,14th day,and 21st day.HE staining was used to observe the wound tissue lesions.Enzyme-linked immunosorbent assay(ELISA)was used to detect the concentrations of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and andinterleukin-10(IL-10)in wound tissue.The expression levels of vascular endothelial growth factor(VEGF)and vascular endothelial cell specific marker(CD31)in wound tissue were detected by immunohistochemistry.The number of CD86^(+) macrophages and CD206^(+) macrophages in wound tissue was detected by flow cytometry.Western blotting was used to detect the protein expressions of Janus kinase 2(JAK2),phosphorylase Janus kinase 2(p-JAK2),signal transducer and activator of transcription 3(STAT3),and phosphorylase signal transducer and activator of transcription 3(p-STAT3)in wound tissue.Results:The wound tissue of the model group was not completely healed within 21 days,and most of the wound tissue of the other medication groups were completely healed.Compared with the normal group,the wound tissue structure of the model group was severely damaged,and the TNF-α,IL-6,VEGF and CD31 protein expressions were increased(P<0.05).The number of CD86+macrophages were increased(P<0.05),and the IL-10,JAK2,p-JAK2,STAT3 and p-STAT3 protein expressions were decreased in model group(P<0.01).The number of CD206+macrophages was reduced in model group(P<0.05).Compared with the model group,the Huangqi Danggui decoction group,sequential group and combination group showed significant improvement(P<0.05),and the combination group showed the best effect(P<0.01).Conclusions:The method of oral administration of Huangqi Danggui decoction and external application of TCM sequential dressing change,can promote wound angiogenesis and wound healing.
作者
张永丽
钱海华
孙林梅
张欣颖
宫丹丹
胡建生
ZHANG Yongli;QIAN Haihua;SUN Linmei;ZHANG Xinying;GONG Dandan;HU Jiansheng(Xi'an Hospital of Traditional Chinese Medicine,Xi'an Shaanxi 710016,China;Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing Jiangsu 210023,China)
出处
《中医药导报》
2025年第9期32-37,54,共7页
Guiding Journal of Traditional Chinese Medicine and Pharmacy
基金
陕西省重点研发计划项目(2023-YBSF-625)
西安市科技计划项目(22YXYJ0058)
西安市科技局重点项目(24YXYJ0024)。
关键词
肛周脓肿
创面愈合
黄芪当归汤
中医序贯疗法
血管新生
大鼠
perianal abscess
wound healing
Huangqi Danggui decoction
traditional Chinese medicine sequential therapy
angiogenesis
rats
作者简介
通信作者:胡建生,男,主治医师,研究方向为中西医结合治疗肛肠疾病。
