基于透射电镜下超微结构探讨不同温度悬起灸干预对压疮创面修复的影响  

Effects of suspension moxibustion of different temperature on pressure ulcer wound repair via ultrastructure under transmission electron microscopy

作　　者：于杰[1,2] 张守臣 李金贵[4] 黄俊杰[4] 周瑞刚 张文海 彭伟龙 赵钢 YU Jie;ZHANG Shouchen;LI Jingui;HUANG Junjie;ZHOU Ruigang;ZHANG Wenhai;PENG Weilong;ZHAO Gang(Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China;Suqian First People’s Hospital,Nanjing Medical University,Suqian 223800,Jiangsu,China;Harbin Medical University,Harbin 150081,Heilongjiang,China;College of Veterinary Medicine,Yangzhou University,Yangzhou 225009,Jiangsu,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]南京医科大学附属宿迁第一人民医院,江苏宿迁223800 [3]哈尔滨医科大学,黑龙江哈尔滨150081 [4]扬州大学兽医学院,江苏扬州225009

出　　处：《现代中西医结合杂志》2024年第12期1607-1614,共8页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家自然科学基金资助项目(82004375);中国博士后科学基金资助项目(2021MD703836);宿迁市“西楚英才”雄英计划双创人才资助项目(卫生创新)[(2022)-0051]。

摘　　要：目的 观察不同温度悬起灸干预对大鼠压疮创面组织超微结构的影响,明确悬起灸促进压疮创面修复的最佳干预温度,以期为临床艾灸治疗压疮及慢性难愈性创面提供理论依据。方法 取133只雌性健康SD成年大鼠,随机选择3只大鼠作为空白对照组,其余130只大鼠通过缺血再灌注损伤方式建立2~3期压疮模型。将模型制备成功的125只大鼠随机分为模型对照组、水凝胶组、低温艾灸干预组、中温艾灸干预组及高温艾灸干预组,每组25只。模型对照组和空白对照组仅进行碘伏常规处理;水凝胶组用碘伏处理压疮创面后将水凝胶伤口敷料覆盖于创面处;低、中、高温艾灸干预组给予碘伏处理后分别对压疮创面中心施以38~41℃、43~46℃、48~51℃的悬起灸干预(通过红外热像仪检测创面皮肤表面温度),艾灸干预1次/d,每次持续15 min。分别于干预1,3,5,7,10 d后取各造模组大鼠压疮创面组织,透射电镜下观察压疮组织超微结构;空白对照组大鼠一并取材以观察正常皮肤组织镜下超微结构。结果 与空白对照组相比,各造模组大鼠造模后干预前均出现表皮脱落或损伤及真皮层损伤。(1)表皮修复情况:模型对照组压疮创面中基底细胞结构及功能恢复相对较慢,干预10 d后才可见大部分基底细胞基本恢复正常,但细胞器相对较少,功能较低下。低、中温艾灸干预组干预5 d后可见大部分基底细胞基本恢复正常,中温艾灸干预组可见绝大部分基底细胞基本恢复正常,绝大部分基底细胞的线粒体状态较好,结构较清晰,10 d后基底细胞线粒体数目增多,胶原纤维致密,新生表皮完整,更优于低温艾灸干预组。水凝胶组干预5 d后可见部分基底细胞线粒体肿胀;7 d后可见大部分基底细胞细胞器增多,线粒体结构逐渐恢复正常。高温艾灸干预组干预7 d后可见少部分有线粒体自噬产生,相对略差于水凝胶组。(2)真皮修Objective It is to observe the effects of suspension moxibustion of different temperature on the ultrastructure of pressure ulcer wounds in rats,and to clarify the optimal intervention temperature of the moxibustion in promoting the repair of pressure ulcer wounds,with a view to providing theoretical evidences for the treatment of pressure ulcers and chronic refractory wounds with moxibustion in clinic.Methods A total of 133 healthy adult female SD rats were taken,in which 3 rats were randomly selected as the blank control group,while the remaining 130 rats were used to establish models of stage 2-3 pressure ulcer by ischemia-reperfusion injury.The 125 successfully model rats were randomly divided into model control group,hydrogel group,low-temperature moxibustion intervention group,medium-temperature moxibustion intervention group and high-temperature moxibustion intervention group,with 25 rats in each group.The model control group and blank control group were treated with iodophor only;the hydrogel group were treated with iodophor and then covered with hydrogel wound dressing on the wounds;the low,medium,and high temperature moxibustion intervention groups were treated with iodophor and then were respectively treated with suspe nded moxibustion to the center of the wounds at 38-41℃,43-46℃,and 48-51℃(the surface temperature of skin wounds was detected by infrared camera),once daily,15 min per time.After 1,3,5,7,and 10 days of intervention,the ultrastructure of the pressure ulcer tissues in rats of each modeling group and the normal skin tissues of rats in the blank control group were observed undertransmission electron microscopy.Resutls Compared with the blank control group,the rats in each modeling group were suffered from epidermal detachment or damage and dermal damage after modeling.①Epidermal repair:the recovery of structure and function of the basal cells in the pressure ulcer wounds of the model control group were slower,and most of the basal cells were basically restored to normal only with fewe

关 键 词：压疮 创面修复 悬起灸 温度 基底细胞 超微结构 表皮修复 

分 类 号：R632.1[医药卫生—外科学]