九一丹及其有效组分抑制巨噬细胞M1表型极化对MRSA感染慢性难愈性疮面的作用机制  

The mechanism of Jiuyi powder and its effective components in inhibiting the M1 phenotype polarization of macrophages on chronic and refractory wounds infected by MRSA

作　　者：殷玉莲[1] 孟畑 马丽娜 范奕伟 程一凡 仲芫沅 陈红风[1] YIN Yu-lian;MENG Tian;MA Li-na;FAN Yi-wei;CHENG Yi-fan;ZHONG Yuan-yuan;CHEN Hong-feng(Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200023

出　　处：《海南医学院学报》2022年第5期326-331,共6页Journal of Hainan Medical University

基　　金：上海市科学技术委员会,“科技创新行动计划”扬帆计划(20YF1449800);上海中医药大学附属龙华医院,龙医学者育苗计划(LYTD-74)。

摘　　要：目的:观察九一丹及其有效组分对慢性难愈性疮面模型大鼠疮面细菌培养以及巨噬细胞表型因子的影响,分析其祛腐生肌的作用机制。方法:32只SD大鼠分成对照组、九一丹组、升丹组、煅石膏组,每组8只。采用MRSA感染皮损疮面造模法建立大鼠慢性难愈性疮面模型,成模后对照组予每日常规呋喃西林消毒更换无菌纱布处理,九一丹组、升丹组、煅石膏组在对照组基础上使用定量九一丹、升丹、煅石膏进行换药,每日1次,连续7 d。换药前及末次给药后采集大鼠疮面分泌物作细菌培养、分离血清检测肿瘤坏死因子-α(TNF-α)、诱导型一氧化氮合酶(iNOS)与白细胞介素(IL)-6对应的含量,同时在末次换药后,切除大鼠疮面组织用于组织病理检测和免疫荧光双染标记巨噬细胞M1表型。结果:末次换药后,九一丹组疮面愈合情况优于其余各组,各组疮面愈合率有显著性差异(P<0.05),组织形态学显示九一丹组炎症得到明显控制并具有愈合趋势;末次换药后,各组血清中TNF-α、IL-6、iNOS含量均呈下降趋势,九一丹组换药前后血清IL-6、TNF-α、iNOS含量下降明显(P均<0.05);煅石膏组与升丹组仅换药前后血清IL-6含量组内比较具有统计学意义(P均<0.05);另外,结果显示九一丹组换药后血清中IL-6、iNOS含量与对照组存在统计学差异(P均<0.05)。换药后组织免疫荧光双染结果提示,九一丹组、升丹组M1巨噬细胞阳性率明显低于对照组(P<0.05)。九一丹组及升丹组的MRSA转阴率优于对照组及煅石膏组(P<0.05)。结论:九一丹能够改善慢性难愈性疮面炎症情况,并有一定抑菌、祛腐、生肌的作用,而其潜在的作用机制可能与抑制疮面局部巨噬细胞M1表型极化有关。Objective:To observe the effects of Jiuyi powder and its active components on the bacterial culture and macrophage phenotypic factors of the chronic refractory wound rat model,and to explore its mechanism of removing decay and promoting muscle regeneration.Methods:A total of 32 SD rats were divided into the control group,the Jiuyi powder group,the Shengdan group,and the calcined gypsum group,with 8 rats in each group.MRSA-infected skin lesions and wounds were induced to establish models of chronic and difficult-to-heal wounds in rats.After the models were established,the control group was treated with daily routine nitrofural disinfection and replace of sterile gauze.Based on the treatment of the control group,quantitative Jiuyi powder,Shengdan powder,and calcined gypsum powder were used for dressing change,once a day for 7 consecutive days for the other three groups,respectively.Before and after the last administration,wound secretions were collected for bacterial culture,serum were seperated for the determination of TNF-α,IL-6 and iNOS contents.At the same time,after the last administration,the rat wound tissue was excised for histopathology and immunofluorescence double staining to label macrophages and their M1 phenotype.Results:After the last dressing change,the wound healing of Jiuyi powder group was better than that of the other groups,and the wound healing rate of each group was significantly different(P<0.05).The histology examination showed that the inflammation of Jiuyi powder group was controlled with a healing trend.After the last dressing change,the contents of TNF-α,IL-6 and iNOS in serum of all groups decreased,and the contents of IL-6,TNF-αand iNOS in serum of Jiuyi powder group decreased significantly than that before the medication(P<0.05).There was statistical significance in serum IL-6 content between calcined gypsum group and Shengdan group before and after medication(P<0.05).In addition,the results showed that the contents of IL-6 and iNOS in serum of Jiuyi powder group were statisticall

关 键 词：慢性难愈性疮面 九一丹 巨噬细胞 表型极化 大鼠 

分 类 号：R285.5[医药卫生—中药学]