重组牛碱性成纤维细胞生长因子联合曲安奈德治疗增生性瘢痕的临床研究  

Recombinant bovine basic fibroblast growth factor combined with triamcinolone acetonide for the treatment of hypertrophic scar

作　　者：陈鑫格 梁蓉 何秋月 唐平 高虎 Chen Xinge;Liang Rong;He Qiuyue;et al(Department of Dermatology,Wuhan Third Hospita,Wuhan 430000,China)

机构地区：[1]武汉市第三医院皮肤科,430000

出　　处：《中华保健医学杂志》2025年第1期146-150,共5页Chinese Journal of Health Care and Medicine

基　　金：湖北省武汉市中医药科研项目(WZ22C15)。

摘　　要：目的探究重组牛碱性成纤维细胞生长因子(rb-bfGF)联合曲安奈德治疗增生性瘢痕(HS)的临床疗效。方法前瞻性选取武汉市第三医院2022年2月~2023年1月期间收治的174例HS患者,随机数表法将患者分为曲安奈德组(n=58)、rb-bf-GF组(n=58)和联合组(n=58)。曲安奈德组使用曲安奈德注射治疗,rb-bf-GF组使用rb-bf-GF治疗,联合组联合使用曲安奈德和rb-bf-GF进行治疗。比较3组患者温哥华瘢痕量表(VSS)评分、四项目瘙痒量表(FIIQ)评分、数字评定量表(NRS)评分情况;比较3组患者治疗前后瘢痕厚度和面积变化;比较3组患者表皮生长因子(EGF)、血管内皮生长因子(VEGF)、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)等炎症因子变化情况;统计3组患者不良反应发生、随访复发情况以及疗效评定。结果治疗后,3组HS患者VSS评分、FIIQ评分、NRS评分均较前降低,且联合组VSS评分、FIIQ评分、NRS评分均低于曲安奈德组和rb-bf-GF组,差异具有统计学意义(F=12.341、4.364、8.834,P<0.05);治疗后,3组HS患者瘢痕厚度和面积均较前降低,且联合组瘢痕厚度和面积均低于曲安奈德组和rb-bf-GF组,差异具有统计学意义(F=10.313、140.187,P<0.05);治疗后,3组HS患者EGF、VEGF、IFN-γ、TNF-α水平均较前降低,且联合组EGF、VEGF、IFN-γ、TNF-α水平均低于曲安奈德组和rb-bf-GF组,差异具有统计学意义(F=4.034、3.826、7.900、5.641,P<0.05);联合组不良反应发生率、随访复发率低于曲安奈德组和rb-bf-GF组,差异具有统计学意义(χ^(2)=16.088、6.538,P<0.05);且联合组的疗效评价更优,差异具有统计学意义(χ^(2)=15.400,P<0.05)。结论rb-bfGF联合曲安奈德治疗增生性瘢痕疗效确切,优于曲安奈德单独治疗,且不良反应少。Objective To explore the clinical efficacy of recombinant bovine basic fibroblast growth factor(rb-bfGF)combined with triamcinolone acetonide in the treatment of hypertrophic scar(HS).Methods 174 HS patients admitted to Wuhan Third Hospital from February 2022 to January 2023 were prospectively selected as the study subjects.The patients were divided into three groups:the triamcinolone acetonide group(n=58),the rb-bfGF group(n=58),and the combination group(n=58).The triamcinolone acetonide group was treated with triamcinolone acetonide injection,the rb-bfGF group was treated with rb-bfGF,and the combination group was treated with a combination of triamcinolone acetonide and rb-bfGF.The vancouver scar scale(VSS)score,fouritem itch scale(FIIQ)score and digital rating scale(NRS)were compared between the three groups,and the scar morphological changes and scar area changes before and after treatment were recorded.Epidermal growth factor(EGF),vascular endothelial growth factor(VEGF),interferon-γ(IFN-γ),tumor necrosis fact-α(TNF-α),occurrence of adverse reactions,and follow-up recurrence were compared.Results After treatment,the VSS score,FIIQ score,and NRS score in the combination group were lower than those in the dexamethasone group and rb-bfGF group,with statistical significance(F=12.341,4.364,8.834,P<0.05).The scar thickness and area were lower than those in the dexamethasone group and rb-bfGF group,with statistical significance(F=10.313,140.187,P<0.05).The average levels of EGF,VEGF,IFN-γ,and TNF-αwere lower than those in the dexamethasone group and rb-bfGF group,with statistical significance(F=12.341,4.364,8.834,P<0.05).The incidence of adverse reactions and follow-up recurrence rate in the combination group were lower than those in the triamcinolone acetonide group and rb-bfGF group(4.034,3.826,7.900,5.641,P<0.05),and the difference was statistically significant(χ^(2)=16.088,6.538,P<0.05),The efficacy evaluation of the combined group was better,and the difference was statistically significant(χ^(2)=15.40

关 键 词：重组牛碱性成纤维细胞生长因子 曲安奈德 增生性瘢痕 

分 类 号：R751[医药卫生—皮肤病学与性病学]