紫草素外敷治疗下肢静脉性溃疡的作用机制  

Mechanism of shikonin with external application in the treatment of venous ulcer in lower limb

作　　者：杨晓[1] 何一波 卢慧敏 李文惠[1] 杜玉青 黄仁燕 闫少庆[1] 王宏飞 柳国斌[1] YANG Xiao;HE Yibo;LU Huimin;LI Wenhui;DU Yuqing;HUANG Renyan;YAN Shaoqing;WANG Hongfei;LIU Guobin(Department of Surgery,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院血管外科,上海201203

出　　处：《中华中医药杂志》2023年第11期5540-5543,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：上海市卫生健康委员会科研项目(No.202240228);国家自然科学基金青年科学基金项目(No.81804095);上海市2021年度“科技创新行动计划”医学创新研究专项项目(No.21Y21920200)。

摘　　要：目的:探讨紫草素外敷对新西兰大白兔下肢静脉性溃疡(VLUs)创面愈合的促进作用及其可能机制。方法:42只新西兰大白兔随机分为一般溃疡组,模型组,水凝胶敷料组,凡士林组,紫草素低、中、高浓度组,每组6只。观察第7、21天大白兔皮肤溃疡创面愈合情况。用HE染色、免疫组化等方法观察溃疡创面肉芽组织病理学变化及创面组织中关键蛋白的阳性表达率。结果:各组大白兔溃疡创面第21天愈合率均显著高于第7天(P<0.01)。与模型组、一般溃疡组、凡士林组同期比较,其余各组第7、21天创面愈合率显著升高(P<0.01)。HE染色:紫草素低、中、高浓度组细胞结构排列整齐,成纤维细胞增多明显,模型组细胞结构排列紊乱,成纤维细胞增多不明显;免疫组化:7组大白兔创面组织中,紫草素中浓度组TGF-β1、p-Smad3蛋白的阳性率分别为53.5%、58.7%,显著高于水凝胶敷料组和一般溃疡组(P<0.05),紫草素中浓度组Smad7蛋白的阳性率为13.1%,显著低于水凝胶敷料组和一般溃疡组(P<0.05)。结论:紫草素外用创面后TGF-β1、p-Smad3蛋白高表达,Smad7蛋白低表达,促进成纤维细胞增殖,可能是紫草素外用促进创面愈合的主要原因。Objective:To investigate the effect of shikonin on wound healing about venous ulcer in lower limbs(VLUs)in rabbits and its possible mechanism.Methods:Forty-two Healthy New Zealand white rabbits were randomly divided into 7 groups:general ulcer group,VLUs model group,hydrogel dressing group,vaseline group and shikonin low,medium and high doses groups,with 6 rabbits in each group.Observe the wound healing of skin ulcer in rabbits on the 7th and 2ist days.HE staining,immunohistochemistry and other methods were used to observe the pathological changes of granulation tissue and the positive expression rate of key proteins in ulcer wound tissue.Results:The healing rate of ulcer wound in all groups were significantly higher at day 21 than at day 7(P<0.01).Compared with the model group.general ulcer group and vaseline group,the wound healing rate of the other groups were significantly increased at day 7 and 21(P<0.01).HE staining:the cell structure of the low,middle and high shikonin group was orderly arranged,and the number of fibroblasts was significantly increased,while the cell structure of the lower limb venous ulcer group was disorderly arranged,and the number of fibroblasts was not significantly increased;Immunohistochemistry:the positive rates of TGF-β1 and p-Smad3 protein of group in middle concentration of shikonin in the seven rabbits wound tissue groups were 53.5%and 58.7%,higher than those in the hydrogel dressing group and the general ulcer group,and the difference are statistically significant(P<0.05);the positive rate of Smad7 protein in middle concentration of shikosin group was 13.1%,which was lower than hydrogel dressing group and general ulcer group,and the difference was statistically significant(P<0.05).Conclusion:After external application of shikonin on the wound surface,the high expression of TGF-β1,p-Smad3 protein and the low expression of Smad7 protein can promote the proliferation of fibroblasts.This may be the main reason for the external use of shikonin to promote wound healing.

关 键 词：下肢静脉性溃疡 臁疮 紫草素 溃疡愈合 TGF-β1/Smads信号通路 

分 类 号：R285.5[医药卫生—中药学]