回阳生肌膏治疗慢性难愈性皮肤溃疡疗效观察及作用机制探讨_临床医学论文.docVIP

回阳生肌膏治疗慢性难愈性皮肤溃疡疗效观察及作用机制探讨_临床医学论文 回阳生肌膏治疗慢性难愈性皮肤溃疡疗效观察及作用机制探讨_临床医学论文 作者：贾连城,盛巡,孙明杰,孙宇建,杨焕杰,张洪海,范建雷,赵伟 【摘要】 目的 考察回阳生肌膏治疗脾肾阳虚型慢性难愈性溃疡的临床疗效,并在细胞、分子层次上探讨其作用机制。方法 将102例慢性溃疡患者随机分为治疗组(外用回阳生肌膏纱条)、对照组(外用洗必泰油纱条),2组均服用温补脾肾的玉肾胶囊,6周后总结疗效。取治疗前后慢性皮肤溃疡患者创面边缘组织,用图像分析软件分析Ⅰ型/Ⅲ型胶原,观察成纤维细胞生长因子2(FGF-2)、血管内皮细胞生长因子(VEGF)、纤维连接蛋白(Fn)在伤口愈合过程中的表达情况。结果 治疗组愈显率为50.00%,对照组愈显率为33.33%,差异有统计学意义。回阳生肌膏可以改善慢性溃疡创面的局部炎症状态,促进新生血管生成；可促进胶原合成,尤其是Ⅰ型胶原形成；可使慢性皮肤溃疡边缘组织FGF-2表达和VEGF的表达有上升的趋势。结论 回阳生肌膏对慢性难愈性溃疡具有促进创面愈合的作用,促进新生血管生成和胶原合成是作用机制之一。 【关键词】 回阳生肌膏；慢性难愈性皮肤溃疡；成纤维细胞生长因子；血管内皮生长因子 Abstract：Objective To research the curative effect of the chronic refractory skin ulcer, which belong to yang deficiency of both spleen and kidney type with the treatment of Huiyang Shengji ointment, and discuss the mechanism at cell and molecular level. Methods According to the diagnostic criteria, 102 patients were divided into the treatment group (treated with topical Huiyang Shengji ointment) and the control group (treated with topical chlorhexidine). The effects were summarized six weeks later. The marginal tissue of the patients with the chronic skin ulcer was taken to analyze collagen Ⅰ/Ⅲ with the software and the expression of cytokine FGF-2, VEGF, Fn were observed during the wound heal. Results The effective rate was 50% in the treatment group, the control group was 33.33%, with statistical differences. Huiyang Shengji ointment can change the status of the chronic wound, promote growth of new blood vessels and improve the collagen synthesis, especially collagenⅠ. The expression of the FGF-2 and VEGF in the marginal tissue of the chronic skin ulcer showed a rising trend. Conclusions Huiyang Shengji ointment can accelerate the wound heal of chronic refractory skin ulcer. One of the mechanisms is related to promoting growth of new blood vessels and improving the collagen synthesis. Key words：Huiyang Shengji ointment；chronic refractory skin ulcer；FGF-2；VEGF 各类慢性皮肤溃疡,尤其是慢性难愈性溃疡是当前众多国内外学者关注的课题之一。回阳生肌膏是已故名医王玉章临证总结的有效方剂,长期用于慢性难愈性皮肤溃疡