MEBT/MEBO联合八珍汤加减对Ⅲ~Ⅳ期压疮创面组织中CK19表达水平的影响  

Influence of MEBT/MEBO Combined with Modified Bazhen Decoction on the Expression of CK19 in Wound Tissues of Pressure Ulcer ofⅢ-ⅣStage

作　　者：冯晓琪 侯玉洁 王玉玲 刘宁[2] 向丽萍[2] FENG Xiaoqi;HOU Yujie;WANG Yuling;LIU Ning;XIANG Liping(Hunan University of Chinese Medicine,Changsha,Hunan 410208,China;Department of Wound Repair,The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410005,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第二附属医院创面修复科,湖南长沙410005

出　　处：《中国烧伤创疡杂志》2022年第3期165-169,178,共6页The Chinese Journal of Burns Wounds & Surface Ulcers

基　　金：中国红十字基金会徐荣祥再生生命公益基金科研项目(2021-04)。

摘　　要：目的分析创疡再生医疗技术(MEBT/MEBO)联合八珍汤加减对Ⅲ~Ⅳ期压疮创面组织中细胞角蛋白19(CK19)表达水平的影响。方法选取2021年3月至2022年1月湖南中医药大学第二附属医院收治的45例Ⅲ~Ⅳ期压疮患者作为研究对象,采用随机数表法将其随机分为治疗组23例和对照组22例。治疗组患者采用MEBT/MEBO联合八珍汤加减治疗,对照组患者单纯采用MEBT/MEBO治疗,Western blotting法检测创面组织中CK19的表达水平,并对比两组患者创面压疮愈合计分量表(PUSH)评分及临床疗效。结果治疗2、3、4周时,治疗组患者创面组织中CK19表达水平均明显高于对照组(Z=-2.407、-2.191、-2.566,P=0.016、0.028、0.010)。治疗4周后,治疗组患者创面PUSH评分为(9.21±2.15)分,明显低于对照组患者的创面PUSH评分(11.77±1.85)分(t=-4.262,P<0.001);治疗组患者中有效22例、无效1例,总有效率为95.65%,明显优于对照组患者的有效12例、无效10例,总有效率54.55%(Z=-3.172,P=0.002)。结论MEBT/MEBO联合八珍汤加减可促进Ⅲ~Ⅳ期压疮创面愈合,其机制可能与两者联合应用促进表皮干细胞分化及CK19表达的作用更强有关。Objective To analyze the influence of the regenerative medical technology for wounds and ulcers(MEBT/MEBO)combined with Modified Bazhen Decoction on the expression of cytokeratin 19(CK19)in the wound tissues of pressure ulcer of stageⅢ-Ⅳ.Methods 45 patients with stageⅢ-Ⅳpressure ulcer,admitted into The Second Affiliated Hospital of Hunan University of Chinese Medicine between March 2021 and January 2022,were enrolled as research subjects,and divided into treatment group(n=23)and control group(n=22)using the random number table.Patients were treated with MEBT/MEBO combined with Modified Bazhen Decoction in treatment group,while patients in control group were treated with MEBT/MEBO alone.The expression levels of CK19 were detected using the Western blotting,and scores of pressure ulcer scale for healing(PUSH)and clinical efficacy of patients were compared between the two groups.Results At week 2,3 and 4 of treatment,the expression levels of CK19 in wound tissues were obviously higher in treatment group than control group(Z=-2.407,-2.191 and-2.566,P=0.016,0.028 and 0.010).After 4 weeks of treatment,the PUSH score in wound tissues was(9.21±2.15)points in treatment group,markedly lower than(11.77±1.85)points in control group(t=-4.262,P<0.001);the clinical efficacy was evaluated as effective in 22 cases and ineffective in 1 case in treatment group,and the total effective rate was 95.65%,much better than control group in which the treatment was effective in 12 cases,ineffective in 10 cases and the total effective rate was 54.55%(Z=-3.172,P=0.002).Conclusion The combined application of MEBT/MEBO and Modified Bazhen Decoction can significantly speed up the wound healing of stageⅢ-Ⅳpressure ulcer,of which the mechanism may be associated with enhanced differentiation of epidermal stem cells and expression of CK19 under the combined therapy.

关 键 词：压疮 创疡再生医疗技术 补托法 八珍汤 细胞角蛋白19 

分 类 号：R632.1[医药卫生—外科学]