云南白药加血竭对环状混合痔术后难愈创面的促愈及作用机制

宋红梅; 邓嘉秋; 陈龙开; 罗绪

doi:10.13422/j.cnki.syfjx.20181538

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云南白药加血竭对环状混合痔术后难愈创面的促愈及作用机制

临床 | 更新时间：2024-01-04

- 云南白药加血竭对环状混合痔术后难愈创面的促愈及作用机制
- Healing Effect and Mechanism of Yunnan Baiyao and Dracon Blood for Postoperative Wound of Ring Mixed Hemorrhoid
- 中国实验方剂学杂志 2018年24卷第15期页码：222-227
- 作者机构：
- 作者简介：
- 基金信息：
  
  贵州省中医药管理局基金项目（D-302）
- DOI：10.13422/j.cnki.syfjx.20181538
  中图分类号： R266
- 纸质出版日期：2018
- 稿件说明：
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宋红梅, 邓嘉秋, 陈龙开, 等. 云南白药加血竭对环状混合痔术后难愈创面的促愈及作用机制[J]. 中国实验方剂学杂志, 2018,24(15):222-227.

SONG Hong-mei, DENG Jia-qiu, CHENG Long-kai, et al. Healing Effect and Mechanism of Yunnan Baiyao and Dracon Blood for Postoperative Wound of Ring Mixed Hemorrhoid[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(15): 222-227.
宋红梅, 邓嘉秋, 陈龙开, 等. 云南白药加血竭对环状混合痔术后难愈创面的促愈及作用机制[J]. 中国实验方剂学杂志, 2018,24(15):222-227. DOI： 10.13422/j.cnki.syfjx.20181538.

SONG Hong-mei, DENG Jia-qiu, CHENG Long-kai, et al. Healing Effect and Mechanism of Yunnan Baiyao and Dracon Blood for Postoperative Wound of Ring Mixed Hemorrhoid[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(15): 222-227. DOI： 10.13422/j.cnki.syfjx.20181538.

摘要

目的：观察云南白药加血竭治疗环状混合痔术后难愈创面的临床疗效及对基质金属蛋白酶-3（MMP-3），金属蛋白酶组织抑制物-1 （TIMP-1），血管内皮生长因子（VEGF）和转化生长因子-β1（TGF-β1）水平的影响。方法：将116例患者随机按数字表法分为对照组和观察组各58例。经清创、消毒处理措施后，对照组给予生肌玉红膏涂抹患处，观察组给予云南白药加血竭涂抹患处，1~2次/d，两组患者均连续治疗14 d。比较两组创面恢复情况，进行创面组织形态观察，检测治疗前后血清MMP-3，TIMP-1，VEGF和TGF-β1水平。结果：观察组临床总有效率为94.83%，高于对照组的81.03%（χ2=5.198，P<0.05）；治疗第7天时，观察组创面面积、创面肉芽组织、水肿程度和创面渗液评分均低于对照组（P<0.01）；治疗第14天时，观察组创面面积和创面肉芽组织评分均低于对照组（P<0.01）；观察组创面愈合时间平均为（10.75±3.64）d，短于对照组的（14.85±5.73）d；治疗第7天，观察组创面中成纤维细胞数、新生毛细血管数和创面巨噬细胞比率均显著升高且高于对照组（P<0.01）；在治疗后14 d，两组患者成纤维细胞数、新生毛细血管数和创面巨噬细胞比率均较治疗后7 d下降（P<0.01），与对照组比较观察组成纤维细胞数、新生毛细血管数和创面巨噬细胞比率均低于对照组（P<0.01）；治疗后观察组患者血清MMP-3，VEGF和TGF-β1均高于对照组，TIMP-1水平低于对照组（P<0.01）。结论：云南白药加血竭用于环状混合痔外剥内扎术后难愈创面，能促进创面修复愈合，缩短了愈合时间，可通过改善创面的组织形态变化及调节血清VEGF，TGF-β1和MMP-3/TIMP-1水平来促进创面毛细管血管形成，促使肉芽组织生长与表皮修复。

Abstract

Objective: To observe the clinical efficacy of Yunnan Baiyao and Dracon Blood on the wound which is hard to heal after the operation of mixed hemorrhoid and investigate its effects on the levels of matrix metalloproteinases-3 (MMP-3)

tissue inhibitor of metalloproteinase-1 (TIMP-1)

vascular endothelial growth factor (VEGF) and transforming growth factor-β1 (TGF-β1). Method: One hundred and sixteen patients were randomly divided into control group (58 cases) and observation group (58 cases) by random number table. After debridement and disinfection

patients in control groups got Shengji Yuhong paste

and in observation group

Yunnan Baiyao and Dracon Blood was applied on the wound

1-2 times/days. Both groups got the treatment for continuous 14 days. The recovery situation of wound was compared between two groups; histomorphology of the wound was observed

and levels of MMP-3

TIMP-1

VEGF and TGF-β1 were detected before and after treatment. Result: The total effective rate of disease in was 94.83% in observation group

higher than 81.03% in control group (χ2=5.198

P<0.05). At the 7th day after treatment

scores of wound area

granulation tissue of wound

edema degree and wound exudate in observation group were lower than those in control group (P<0.01). At the 14th day after treatment

scores of wound area and granulation tissue of wound were lower than those in control group (P<0.01). Wound healing time in observation group was (10.75±3.64)days

shorter than (14.85±5.73) days in control group (P<0.01). At the 7th day after treatment

number of fibroblasts

number of new capillaries and wound macrophage ratio in observation group were higher than those in control group (P<0.01). At the 14th day after treatment

number of fibroblasts

number of new capillaries and wound macrophage ratio were lower than those at the 7th day after treatment in both groups

and these three indexes in observation group were lower than those in control group (P<0.01). Levels of MMP-3

VEGF and TGF-β1 in observation group were higher and level of TIMP-1 was lower than those in control group (P<0.01). Conclusion: Yunnan Baiyao and Dracon Blood can promote the recovery of wound

shorten the healing time

change histomorphology of wound and regulate levels of VEGF

TGF-β1 and MMP-3/TIMP-1 to promote the formation of capillary vessels in wound surface

the growth of granulation tissue and repair of epidermis.

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