体外冲击波疗法在烧伤后瘢痕治疗中的应用及对TGF-β_(1)和bFGF的影响  

Application of Extracorporeal Shock Wave Therapy in the Treatment of Scar After Burn and Its Effect on TGF-β1 and bFGF

作　　者：黄璐 张芬 杨艳辉 HUANG Lu;ZHANG Fen;YANG Yanhui(Department of Medical Cosmetology Plastic and Burn Surgery,Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,Hubei,China)

机构地区：[1]恩施土家族苗族自治州中心医院医学美容整形烧伤外科,湖北恩施445000

出　　处：《中国美容医学》2023年第7期13-16,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨体外冲击波疗法(Extracorporeal shock wave therapy,ESWT)对烧伤瘢痕的修复作用及对转化生长因子β_(1)(Transforming growth factor-β_(1),TGF-β1)、重组人碱性成纤维细胞生长因子(Basic fibroblast growth factor,bFGF)的影响。方法:将2019年1月-2022年1月笔者医院烧伤整形科收治的88例烧伤后产生皮肤瘢痕患者纳入研究,按照随机数字表法分为对照组和观察组,各44例。对照组患者采用激光联合糠酸莫米松乳膏涂抹治疗,观察组患者采用ESWT联合糠酸莫米松软膏涂抹治疗,两组均连续治疗12周。比较两组疗效、TGF-β_(1)及bFGF水平等瘢痕相关因子水平,采用温哥华瘢痕量表(Vancouver scar scale,VSS)评估两组瘢痕情况,采用医院自制的满意度调查问卷评估两组主观满意度,同时记录治疗期间发生的各项不良反应。结果:观察组治疗有效率为88.64%,高于对照组的70.45%(P<0.05);治疗后两组VSS评分及TGF-β1、bFGF等瘢痕相关因子水平均降低,且观察组低于对照组(P<0.05);观察组治疗满意度为95.45%,高于对照组的79.55%(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:烧伤瘢痕患者应用ESWT治疗修复效果显著,可降低TGF-β_(1)、bFGF水平,促进瘢痕组织减退,安全性好,患者满意度高。Objective To investigate the effect of extracorporeal shock wave(ESWT)on the healing of burn scar and the expression of transforming growth factor-β_(1)(TGF-β_(1))and basic fi broblast growth factor(bFGF).Methods From January 2019 to January 2022,88 patients with skin scar after burn were enrolled in the study.They were randomly divided into control group and observation group,with 44 cases in each group.The patients in the control group were treated with laser combined with mometasone furoate cream,and the patients in the observation group were treated with ESWT combined with mometasone furoate cream for 12 weeks.The curative effect,the levels of TGF-β_(1) and bFGF were compared between the two groups.The vancouver scar scale(VSS)was used to evaluate the scar condition of the two groups,and the hospital-made satisfaction questionnaire was used to evaluate the subjective satisfaction of the two groups.The adverse reactions during the treatment were recorded.Results The effective rate of the observation group was 88.64%,higher than 70.45%of the control group(P<0.05).After treatment,the VSS score and the levels of scar related factors such as TGF-β_(1) and bFGF in the two groups decreased,and the observation group was lower than that in the control group(P<0.05).The satisfaction rate of the observation group was 95.45%,which was higher than that of the control group(79.55%)(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion ESWT can significantly reduce the levels of TGF-β_(1) and bFGF and promote scar tissue regression in burn scar patients,promote scar tissue loss,good safety,high patient satisfaction.

关 键 词：烧伤瘢痕 体外冲击波 激光 糠酸莫米松乳膏 修复作用 转化生长因子β1 血管内表皮生长因子 

分 类 号：R619.6[医药卫生—外科学]