郭氏苦柏方促进大鼠肛瘘术后创面愈合效果及对MAPK信号通路的影响  

Efficacy of Guo's Kubai Decoction for wound healing in rat anal fistula and its effect on MAPK signaling pathway

作　　者：尹和宅 王启 袁梅 高宝莲 刘林 朱嘉梦 YIN Hezhai;WANG Qi;YUAN Mei;GAO Baolian;LIU Lin;ZHU Jiameng(Department of Coloproctology,Affiliated Jiaxing TCM Hospital of Zhejiang Chinese Medical University,Jiaxing 314001,China;不详)

机构地区：[1]浙江中医药大学附属嘉兴中医院肛肠科,314001 [2]浙江中医药大学附属嘉兴中医院检验科,314001 [3]浙江中医药大学附属嘉兴中医院病理科,314001 [4]浙江中医药大学研究生院、浙江中医药大学研究生联合培养基地

出　　处：《浙江医学》2025年第5期483-488,I0004,共7页Zhejiang Medical Journal

基　　金：浙江省基础公益研究计划项目(LGF22H270005);浙江省中医药管理局科研项目(2023ZL697);嘉兴市科技局科技计划项目(2024AY10028)。

摘　　要：目的探究郭氏苦柏方促进大鼠肛瘘术后创面愈合的效果,并分析其对丝裂原活化蛋白激酶(MAPK)信号通路的影响,为肛瘘术后创面管理提供新的中医治疗策略。方法取40只12周龄雄性SD大鼠采用随机数字表法分为正常组、模型组、高锰酸钾组和郭氏苦柏方组,每组10只。正常组背部构建创面,常规清创后无菌纱布外敷治疗;余3组在建立肛瘘术后创面模型后,分别采用涂抹粪液+常规清创、涂抹粪液+常规清创+高锰酸钾片稀释液外敷创面、涂抹粪液+常规清创+郭氏苦柏方药液外敷创面治疗,每日换药;均治疗14 d。观察各组大鼠创面肉芽组织病理学变化,计算创面愈合比例;采用蛋白质印迹法和实时荧光定量PCR法检测创面肉芽组织p38、MAPK活化激酶2(MK2)的蛋白和mRNA相对表达量。结果治疗第3、7、14天,正常组创面愈合比例均高于其他3组(均P<0.05);正常组创面肉芽组织p38、MK2蛋白相对表达量及mRNA相对表达量均低于其他3组(均P<0.05)。与模型组相比,高锰酸钾组、郭氏苦柏方组治疗第7、14天的创面愈合比例均升高,差异均有统计学意义(均P<0.05),治疗第7天,模型组创面肉芽组织可见较多炎性细胞浸润,高锰酸钾组、郭氏苦柏方组纤维细胞增殖、血管新生;治疗第14天,模型组创面肉芽组织可见少量毛细血管,高锰酸钾组、郭氏苦柏方组可见较多成纤维细胞,毛细血管丰富。与模型组相比,治疗第3天,高锰酸钾组、郭氏苦柏方组MK2蛋白相对表达量均下降(均P<0.05);治疗第7天,高锰酸钾组、郭氏苦柏方组p38、MK2蛋白相对表达量及mRNA相对表达量均下降;治疗第14天,高锰酸钾组、郭氏苦柏方组p38蛋白及mRNA相对表达量均下降,高锰酸钾组MK2蛋白相对表达量下降(均P<0.05)。治疗第3、7、14天,高锰酸钾组与郭氏苦柏方组的p38、MK2蛋白和mRNA相对表达量相比,差异均无统计学意义(均P>0.05)。结论郭氏苦柏Objective To explore the efficacy of Guo's Kubai Decoction in wound healing in rat anal fistula,and its effect on mitogen-activated protein kinase(MAPK)signaling pathway.Methods Forty 12-week-old male SD rats were randomly divided into normal group,model group,potassium permanganate(PP)group and Guo's Kubai Decoction(GK)group,with 10 rats in each group.A surgical wound was made on the back of rats in all groups,the anal fistula model was induced by smearing feces on the would in last three group.Then the would was treated with conventional debridement in normal group and model group,debridement+potassium permanganate in PP group,and debridement+Guo's Kubai Decoction was treated in GK group for 14 days,respectively.The wound healing rate,histopathological changes were observed;the protein and mRNA expression levels of p38 and MAPK-activated protein kinase 2(MK2)were detected by Western blot and quantitative real-time PCR.Results On the d3,d7 and d14 of treatment,the wound healing rate of the normal group were higher than that of other three groups(all P<0.05);the expression levels of p38,MK2 protein and mRNA in the normal group were all lower than those in other three gorups(all P<0.05).Compared with the model group,the wound healing rates of PP group and GK group were significantly higher at d7 and d14(all P<0.05).On d7,more inflammatory cell infiltration was seen in the model group,while the fibroblast proliferation and angiogenesis were observed in the PP group and GK group.On d14,a small number of capillaries were seen in the model group,while more fibroblasts and abundant capillaries were observed in the PP group and the GK group.Compared with the model group,on d3 the expression levels of MK2 protein in the PP group and the GK group were all lower(all P<0.05);on d7 the relative expression levels of p38,MK2 protein and mRNA in the PP group and the GK group decreased significantly(P<0.05);on d14 the expression levels of p38 protein and mRNA and the expression levels of MK2 protein in the PP group and GK group

关 键 词：丝裂原活化蛋白激酶信号通路 肛瘘 创面愈合 郭氏苦柏方 

分 类 号：R65[医药卫生—外科学]