清热利湿方对肛肠手术术后创面愈合作用的研究  

Effects of Chinese Herbal Compound on Wound Healing after Anorectal Surgery: A Study in SD Rats

作　　者：杨豪杰[1] 刘华[1] YANG Haojie;LIU Hua(Yueyang Hospital of Integrative Chinese and Western Meidieine Affiliated to Shanghai University of Traditional Chines Medicine, Shanghai 200437, Chin)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院

出　　处：《中华中医药学刊》2018年第2期377-380,I0018-I0020,共7页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81273765);上海市高级中西医结合人才培养项目(ZYSNXD012-RC-ZXY012)

摘　　要：目的：研究清热利湿外洗方（虎杖、蒲公英、苦参、黄柏）促进肛肠手术术后创伤愈合的可能影响。方法：以SD大鼠肛旁创面模型为研究对象,在术后第3、7、11天代表愈合的3个时间点,分别观察清热利湿外洗方、生理盐水及高锰酸钾组各组创面色泽、渗出、愈合率,通过光镜观察创面上皮爬行、肉芽组织增生、胶原纤维、成纤维细胞、炎症细胞浸润、组织水肿等愈合及炎症情况。电镜下观察各组大鼠新生肉芽组织中血管内皮细胞紧密连接及胶原纤维合成、分布情况。结果：造模后第3、7、11天,清热利湿方组与高锰酸钾组对伤口分泌物影响无差异（P〉0.05）,两者分泌物均少于生理盐水组（P〈0.05）。造模后第3天3组创面愈合率无差异（P〉0.05）;第7、11天创面愈合率清热利湿方优于其他两组（P〈0.05）,高锰酸钾组与生理盐水组无差异（P〉0.05）。光镜结果可见清热利湿方组肉芽组织无明显水肿,新生毛细血管丰富且成纤维细胞排列整齐;胶原蛋白合成多于高锰酸钾且分布规则。电镜结果可见清热利湿方组血管内皮细胞紧密连接将相邻细胞紧密嵌合;胶原纤维分布致密、规则,纤维束排列紧密。结轮：清热利湿方与高锰酸钾均能有效减少伤口分泌物,抑制急性炎症反应,但清热利湿方能更有效的促进上皮爬行、加快肉芽组织内各成分再生。Objective：To explore the effects of Chinese herbal compound（ Polygonum cuspidatum, Taraxacum, radix sophorae flavescentis, Phellodendron chinense Sehneid） on wound healing after anoreetal surgery in SD rats. Methods：Total- ly 90 clean - grade male SD rats weighing （ 300 ＋ 50 ） g were sequentially numbered and then randomly divided into treat- ment group （n = 30） , control group （n = 30） and blank group （n = 30）. All the rats received anorectal surgery to estab- lish animal modes. Rats in controlled group were given potassium permanganate for external use after surgery. In con- trast, rats in treatment group were given Chinese herbal compound for external use. Rats in blank group were given 0.9% normal salin. Twenty - one rats in each group were chosen randomly for observing the change of wound secretion, granula- tion tissue and epithelium tissue on the 3rd,7th, 1 lth postoperative day. Meanwhile, wound healing rates were estimated by analyzing wound area on the 3rd ,7th, 11 th postoperative day. Three rats in each group were killed randomly for making pathological sections on the 3rd,7th, l lth postoperative day respectively, in order to observe the HE staining results, Masson＇ s stain results and electron microscope results. Results ： There was no difference in decreasing wound secretion between the treatment group and controlled group（P 〉 0. 05） on the 3rd,Tth, 11 th postoperative day. Both groups worked better than the blank group（P 〈0. 05）. There was no difference in wound healing rate between three groups on the 3rd postoperative day （P 〉 0. 05 ）. The treatment group worked better than the other two groups on the 7th, 11 th postoperative day （ P 〈 O. 05 ）. There was no difference between the controlled group and blank group （ P 〉 0.05 ）. Histopathology results revealed that granulation tissue had no obvious edema, the newly formed capillaries were rich and the fibroblasts were orderly in the treatment group. Meanwhile, the treatment group promoted

关 键 词：中药 肛肠手术 术后 创面愈合 

分 类 号：R657.1[医药卫生—外科学]