生肌象皮膏对难愈性创面点状植皮后伤口分泌物炎症因子的影响  

Effects of Shengji Xiangpi Plaster(生肌象皮膏) on Secretion Inflammatory Factors of Refractory Wound after Punctate Skin Grafting

作　　者：卢旭亚[1] 李品川[1] 孙俊超[1] 朱朝军[1] 张朝晖[1] LU Xuya;LI Pinchuan;SUN Junchao;ZHU Chaojun;ZHANG Zhaohui(The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300150)

机构地区：[1]天津中医药大学第二附属医院,天津市河北区增产道69号300150

出　　处：《中医杂志》2018年第16期1386-1390,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81573972)

摘　　要：目的评价生肌象皮膏联合点状植皮治疗难愈性创面的临床疗效并探讨其可能机制。方法选择难愈性创面患者48例,随机分为生肌象皮膏组和凡士林组各24例。患者创面床准备充分后即可行点状植皮,然后生肌象皮膏组以单层生肌象皮膏纱条覆盖,凡士林组敷以凡士林纱布覆盖,再以无菌干纱布稍加压包扎。以后隔日更换生肌象皮膏纱条或凡士林纱布直至完全愈合。观察皮片成活率及愈合时间,同时在植皮后0、2、4、6、8天分别收集伤口分泌物,检测肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、转化生长因子β1(TGF-β1)和血管内皮生长因子(VEGF)含量。结果生肌象皮膏组皮片成活率为(93.78±4.87)%,凡士林组皮片成活率为(82.37±3.19)%,两组皮片存活率比较差异有统计学意义(P<0.05)。与本组0天时比较,两组在4、6天时TNF-α、IL-1β、TGF-β1和VEGF含量均明显升高(P<0.05)。与凡士林组同时间比较,生肌象皮膏组在6、8天时TNF-α、IL-1β含量降低,在4、6、8天时TGF-β1、VEGF含量高于凡士林组(P<0.05)。结论生肌象皮膏联合点状植皮治疗难愈性创面可提高皮片成活率,其机制可能是通过减少植皮术后炎症反应,促进新生毛细血管及新生上皮形成。Objective To assess the clinical efficacy of Shengji Xiangpi Plaster（生肌象皮膏） combing punctuate skin grafting in treating refractory wounds and to explore the potential mechanism. Methods A total of 48 cases with refractory wounds were selected and randomly divided into Shengji Xiangpi Plaster group and Vaseline group,with 24 cases in each group. After the patient＇ s wound bed was fully prepared,the punctate skin graft was carried out. In the Shengji Xiangpi Plaster group,the wound was covered with a single layer of Shengji Xiangpi Plaster,and the Vaseline group was covered with Vaseline gauze,and then wrapped with sterile dry gauze. After that,the Shengji Xiangpi Plaster gauze or Vaseline gauze was replaced every other day until it was completely healed. The survival rate and healing time of the skin grafts were observed. At the same time,wound secretions were collected on the 0,2 nd,4 th,6 th and 8 th day after skin grafting. The tumor necrosis factor α（TNF-α） and interleukin-1β（IL-1β）,transforming growth factor β1（TGF-β1） and vascular endothelial growth factor（VEGF） contents were detected. Results The skin graft survival rate of the Shengji Xiangpi Plaster group was 93. 78 ± 4. 87%,and the Vaseline group was82. 37 ± 3. 19%. There was statistical difference in the skin graft survival rate of two groups（P〈0. 05）. Compared with baseline,the levels of TNF-α,IL-1β,TGF-β1 and VEGF were significantly increased in the two groups on the4 th and 6 th day（P〈0. 05）. Compared with the Vaseline group,the levels of TNF-α and IL-1β of Shengji Xiangpi Plaster group were decreased on the 6 th and 8 th day,and the levels of TGF-β1 and VEGF were higher than those of Vaseline on the 4 th,6 th and 8 th day（P〈0. 05）. Conclusion Shengji Xiangpi Plaster combing punctuate skin grafting can increase the survival rate of the skin. The mechanism may be to reduce the inflammatory reaction after skin grafting and promote the formation of new capillary and neoplastic epithelium.

关 键 词：点状植皮 难愈性创面 生肌象皮膏 炎症因子 皮片成活 

分 类 号：R264[医药卫生—中医外科学]