解毒生肌膏调控NLRP3炎症小体减轻蕴毒腐溃证糖尿病足溃疡炎症反应的临床研究  

Clinical study on Jiedu Shengji ointment(解毒生肌膏)regulating NLRP3 inflammatory bodies to alleviate infammatory reaction of diabetes foot ulcer with toxin accumulation and canker syndrome

作　　者：曾安兴 黄新灵[2] 周忠志[2] Zeng Anxing;Huang Xinling;Zhou Zhongzhi(Hunan University of Chinese Medicine,Changsha,Hunan 410208,China;The First Affiliated Hospital,Hunan University of Chinese Medicine,Changsha,Hunan 410007,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《感染、炎症、修复》2025年第1期1-7,共7页Infection Inflammation Repair

基　　金：国家自然科学基金资助项目(82305256)。

摘　　要：目的:观察解毒生肌膏治疗蕴毒腐溃证糖尿病足溃疡的临床疗效并探讨其通过调控核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎症小体减轻炎症反应的作用。方法:选取糖尿病足溃疡蕴毒腐溃证患者48例,并将其随机分为治疗组和对照组2组,每组24例,最终每组剔除3例。两组患者均予以基础治疗和基础创面处理,在此基础上,治疗组创面涂以解毒生肌膏,对照组创面涂以磺胺嘧啶银乳膏,每日换药1次,疗程为14 d。比较两组患者治疗第14天的Bates-Jensen伤口评估工具(BWAT)创面量化积分,渗液量,临床疗效,细菌阳性率,NLRP3炎症小体、白细胞介素(IL)-1β、IL-18表达等变化情况,苏木素-伊红(HE)染色观察创面组织病理学变化,记录两组不良反应发生情况。结果:治疗组总有效率为90.5%,对照组总有效率为61.9%(P<0.05),治疗组BWAT创面量化积分,渗液量,细菌阳性率,晚期糖基化终末产物(AGEs)、NLRP3炎症小体、IL-1β、IL-18表达均显著低于对照组(P<0.05);治疗期间,两组均未出现严重不良反应。结论:解毒生肌膏可通过减少糖尿病足溃疡AGEs蓄积,降低NLRP3炎症小体表达水平及IL-1β、IL-18等炎症介质水平,改善过度炎症反应,促进溃疡愈合。Objective:To explore the clinical efficacy of Jiedu Shengji ointment(解毒生肌膏)in regulating nucleotidebinding oligomerization domain-like receptor protein 3(NLRP3)inflammatory body to reduce inflammatory reaction of foot ulcer in diabetes patients with toxin accumulation and ulceration syndrome.Methods:Forty-eight patients with diabetes foot ulcer syndrome of accumulated toxin and rotting were selected and randomly divided into the treatment group and the control group,with 24 patients in each group.Finally,3 cases were eliminated from each group.Both groups were given basic treatment.On this basis,the treatment group was given Jiedu Shengji ointment,and the control group was given sulfadiazine silver cream.The dressing was changed once a day and the course of treatment was 14 days.The changes in various expression such as Bates-Jensen wound assessment tool(BWAT)wound quantification score,exudate volume,clinical efficacy,positive rate of bacteria,NLRP3 inflammasome,interleukin-1β(IL-1β),and IL-18 were compared between the two groups on the 14th day of treatment.Hematoxylin-eosin(HE)staining was used to observe the histopathological changes of the wound surface.And the occurrence of adverse reactions in the two groups was recorded.Results:The total effevtive rate was 90.5%in the treatment group and 61.9%in the control grouf(P<0.05).The wound quantification score,exudate situation,positive rate of bacteria,advanced glycation end products(AGEs),NLRP3 infammasome,IL-1β,and IL-18 in the treatment group were significantly lower than those in the control group(P>0.05).During the treatment,no serious adverse reactions occurred in both group.Conclusions:Jiedu Shengji ointment can reduce the accumulation of AGEs in diabetes foot ulcers,reduce the expression levels of NLRP3 inflammatory bodies,IL-1β,IL-18 and other inflammatory mediators,improve the excessive inflammatory response,and promote ulcer healing.

关 键 词：解毒生肌膏 糖尿病足溃疡 蕴毒腐溃证 炎症 NLRP3 

分 类 号：R587.2[医药卫生—内分泌]