生肌长皮膏联合加压包扎治疗下肢慢性溃疡的机制研究  

Chronic leg ulcer treatment using Shengji Zhangpi Paste with pressure bandaging:mechanism study

作　　者：林越[1,2] 刘辉辉[1] 刘磊[1] 郑晓[1] 蒉纲[3] 郭善禹[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院普外科,上海200011 [2]上海交通大学医学院附属瑞金医院麻醉科,上海200025 [3]上海交通大学医学院附属第九人民医院中医科,上海200011

出　　处：《外科理论与实践》2014年第6期539-543,共5页Journal of Surgery Concepts & Practice

基　　金：上海市科学技术委员会中医现代化项目(09DZ1970400)

摘　　要：目的:研究并探讨生肌长皮膏联合加压治疗促进下肢慢性溃疡愈合的临床疗效和作用机制。方法:2010年3月至2013年9月我院外科门诊96例下肢慢性溃疡病人,分为长皮膏组、长皮膏加压组和对照组,每组32例。治疗后3、7、14和21 d观察3组病人创面肉芽生长和溃疡愈合情况,记录愈合时间,取创面肉芽组织标本测定组织中羟脯氨酸含量和缺氧诱导因子1(HIF-1)基因的表达。结果:生肌长皮膏联合加压治疗可促进下肢慢性溃疡创面愈合,缩短创面愈合时间,增加羟脯氨酸含量并促进HIF-1基因表达,与对照组和长皮膏组相比,差异有统计学意义(P<0.05)。结论:生肌长皮膏联合加压治疗能通过促进胶原合成和HIF-1的分泌从而显著加快创面愈合,缩短创面愈合时间,为其临床应用提供了依据。Objective To study on clinical effect and mechanism of treatment of Shengji Zhangpi Paste combined with pressure bandaging for chronic leg ulcer. Methods A total of 96 patients with chronic leg ulcer in Outpatient Surgery were enrolled in this study from March 2010 to September 2013. There were Shengji Zhangpi Paste group, group of Shengji Zhangpi Paste combined with pressure and control group with 32 cases each. On the treatment 3 day, 7 day, 14 day and 21 day, acestoma was assessed and healing time measured. Granulations tissue were taken for assessment of hydroxyproline and the expression of hypoxia-inducible factor-1 （HIF-1）. Results Shengji Zhangpi Paste combined with pressure bandaging promoted the healing of chronic leg ulcer and shortened the healing time. It also increased hydroxyproline and expression of HIF-1. There was significant difference of hydroxyproline and expression of HIF-1 statistically between group of Shengji Zhangpi Paste combined with pressure and Shengji Zhangpi Paste group and between Shengji Zhangpi Paste group and control group（P〈0.05）. Conclusions Treatment of Shengji Zhangpi Paste combined with pressure could promote the synthesis of collagen and HIF-1 formation. All these effects markedly accelerate healing of leg ulcer and pro- vide the evidence for its clinical application.

关 键 词：下肢慢性溃疡 愈合时间 羟脯氨酸 缺氧诱导因子1 

分 类 号：R632.1[医药卫生—外科学]