外敷复方五凤草液对结核性溃疡患者创面愈合影响及作用机制研究  

Study on The Effect and Mechanism of External Application of Compound Wufengcao Solution on Tissue Healing of Tuberculous Ulcer Patients

作　　者：薛倩一[1] 黄子慧[1] 钱佳燕 洪练青[1] XUE Qian-yi;HUANG Zi-hui;QIAN Jia-yan;HONG Lian-qing(Nanjing Integrated Traditional Chinese and Western Medicine Hospital,Nanjing 210014,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院,南京210014

出　　处：《中国中医基础医学杂志》2021年第10期1622-1626,1637,共6页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：南京市卫计委重点科技项目(ZKX16067)-复方五凤草液作用于结核性溃疡的浓度药效关系及其分子机制;南京市卫健委重点科技项目(ZKX18048)-基于JAK/STAT通路探讨复方五凤草液干预结核性溃疡的分子机制;江苏省中医药局科技项目(YB2017042)-中医综合治疗瘰疬病的大样本队列研究;南京市“十三五”卫健委青年人才项目(QRX17030)。

摘　　要：目的:观察外敷复方五凤草液对结核性溃疡患者创面愈合的临床疗效并初步探究其作用机制。方法:选择60例结核性溃疡患者随机分为对照组和观察组各30例,在基础抗结核治疗基础上,对照组给予康复新液外用治疗,观察组给予以复方五凤草液外用治疗,观察4周。在给药前以及给药治疗第1、2、4周记录患者的局部体征积分,检测患者血浆中TGF-β、TNF-α,肉芽组织中IL-1,IL-6,NF-κB,VEGF,PDGF的含量,采用qPCR技术检测肉芽组织中TGF-β、TNF-αmRNA的表达,并观察创面大体观及组织病理切片。结果:观察组总体有效率明显高于对照组,给药4周后与对照组比较,观察组患者血浆TNF-α,肉芽组织中IL-1,IL-6,NF-κB含量明显降低,血浆TGF-β及肉芽组织VEGF,PDGF含量显著提高,肉芽组织TGF-βmRNA水平上升、TNF-αmRNA水平下降,溃疡创面肉芽组织学形态改善。结论:复方五凤草液能有效促进结核性溃疡患者创面的愈合,其作用机制可能与降低TNF-α通路相关蛋白的表达水平、提高TGF-β相关生物因子的表达水平相关。Objective:To observe the clinical effect of compound Wufengcao solution for external use on wound healing in patients with tuberculous ulcer and explore its mechanism preliminarily.Methods:Sixty patients with tuberculous ulcer were selected and randomly divided into the control group and the observation group with 30 cases each,and received a 4-week basic anti-tuberculosis treatment.At the same time,the control group was treated with Kangfuxin solution for external use,and the observation group was treated with compound Wufengcao solution.All patients were recorded the local physical signs index before administration and the first 1,2,and 4 weeks of the treatment period.The content of TGF-βand TNF-αin the serum and levels of IL-1,IL-6,NF-κB,VEGF,and PDGF in ulcer tissue of the patients were detected by Elisa,and the transcription levels of TGF-βand TNF-αmRNA in granulation tissue was detected by qPCR.Meanwhile,the wound tissue was observed by pathological section.Results:The overall effective rate of the observation group was significantly higher than that of the control group.After 4 weeks of administration,compared with the control group,the levels of TNF-αin plasma and IL-1,IL-6 and NF-κB in tissues of observation group were significantly reduced,the contents of TGF-βin plasma and VEGF and PDGF in tissues were significantly increased,The level of TGF-βmRNA in the wound tissue increased,the level of TNF-αmRNA decreased,and the histological morphology of the ulcer wound was improved.Conclusion:Compound Wufengcao solution can effectively promote wound healing in patients with tuberculous ulcer,and its mechanism of action may be associated with reduced expression levels of TNF-αpathway associated protein and increased the expression levels of TGF-βrelated biological factors.

关 键 词：复方五凤草液 结核性溃疡 肿瘤坏死因子-α 转化生长因子-Β 作用机制 

分 类 号：R263[医药卫生—中医外科学]