CAJ | 학술논문

目的观察紫花烧伤膏对大鼠皮瓣存活的影响,并探讨其作用机制.方法 Wistar 大鼠72只,随机分为紫花组(外用紫花烧伤膏)、阳性对照组(外用海普林乳膏)、阴性对照组(未手术组)和模型组(外用凡士林),每组18只.在大鼠背部设计蒂在头侧的8 cm×2 cm的随意型皮瓣,2次/日涂药,观察大鼠皮瓣成活情况；比较术后1、2、3和7d血清超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)的变化并行组织形态学检查.结果皮瓣成活面积百分比:紫花组(73.58±10.74)％,模型组(33.40±16.05)％,紫花组比模型组提高了54.61％ (Q =10.63,P＜0.01),与海普林组(71.65±11.92)％比较,差异无统计学意义(P＞0.05)；紫花组血清SOD和NO含量高于模型组,MDA、TNF-α和IL-6含量低于模型组(P＜0.01),与海普林组比较,差异无统计学意义(P＞0.05).术后7d紫花组与海普林组皮瓣组织水肿、坏死及炎性细胞浸润较模型组轻,肉芽组织、成纤维细胞增生明显,紫花组有大量新生的毛细血管形成,皮瓣血管所占面积明显高于模型和海普林组(P＜0.01).结论紫花烧伤膏可明显改善大鼠皮瓣血液循环,提高皮瓣的成活率,其机制可能与抗自由基损害、改善局部微循环、提高NO的含量、降低TNF-α和IL-6水平、减少炎性因子释放,改善氧化应激状态,减轻炎性反应有关.
목적 관찰자화소상고대대서피판존활적영향,병탐토기작용궤제.방법 Wistar 대서72지,수궤분위자화조(외용자화소상고)、양성대조조(외용해보림유고)、음성대조조(미수술조)화모형조(외용범사림),매조18지.재대서배부설계체재두측적8 cm×2 cm적수의형피판,2차/일도약,관찰대서피판성활정황；비교술후1、2、3화7d혈청초양화물기화매(SOD)、병이철(MDA)、일양화담(NO)、종류배사인자-α(TNF-α)화백세포개소-6(IL-6)적변화병행조직형태학검사.결과 피판성활면적백분비:자화조(73.58±10.74)％,모형조(33.40±16.05)％,자화조비모형조제고료54.61％ (Q =10.63,P＜0.01),여해보림조(71.65±11.92)％비교,차이무통계학의의(P＞0.05)；자화조혈청SOD화NO함량고우모형조,MDA、TNF-α화IL-6함량저우모형조(P＜0.01),여해보림조비교,차이무통계학의의(P＞0.05).술후7d자화조여해보림조피판조직수종、배사급염성세포침윤교모형조경,육아조직、성섬유세포증생명현,자화조유대량신생적모세혈관형성,피판혈관소점면적명현고우모형화해보림조(P＜0.01).결론 자화소상고가명현개선대서피판혈액순배,제고피판적성활솔,기궤제가능여항자유기손해、개선국부미순배、제고NO적함량、강저TNF-α화IL-6수평、감소염성인자석방,개선양화응격상태,감경염성반응유관.
Objective To observe the effect of zi-hua burn cream on the survival of skin flaps in rats,and its mechanisms.Methods 72 Wistar rats,were randomly divided into four groups as zi-hua group(n =18,external application of alfalfa burn cream),control group(n =18,external application of heparin sodium cream),model group(n =18,external application of vaseline),negative control(n =18,no operation).8 cm × 2 cm random skin flaps with pedicle on the side of head were designed on the back of Wistar rats.The drug was applied on the flap surface,2 times a day.The survival of skin flaps was observed.The change of serum superoxide dismutase (SOD) 、malondialdehyde(MDA) 、nitric oxide(NO),tumer necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were compared at 1,2,3,7 d after operation,and histologic examination was performed.Results The survival rate of zi-hua group(73.58 ± 10.74)％ was significantly higher than that of model group (33.40 ± 16.05) ％,showing a statistical difference (Q =10.63,P ＜0.01).There was no significant difference between the zi-hua group and control group(71.65 ± 11.92) ％.The level of serum SOD,NO in zi-hua group and control group was higher than that in model group,while the level of serum MDA、TNF-α and IL-6 was lower than that in model group(P ＜ 0.01).On 7 day after operation,skin flaps tissue edema、necrosis and inflammatory cell infiltration in zi-hua group and control group was less obvious than that in model group.There was significant proliferation of granuloma and fibroblast and formation of neonatal capillary in zi-hua group and control group.The vascular density in zi-hua group was obviously higher than that in the model group and control group(P ＜ 0.01).Conclusions Zi-hua burn cream could significantly improve the blood supply of skin flaps,increase the survival rate of skin flaps in rats.Its mechanism may be associated with the anti-free-radical-damage action,improve local microcirculation,improve the NO content,reduce the TNF-α and IL-6 level,reduce inflammation factor release,improve oxidative stress state,and reduce inflammation reaction.