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复方中药油膏治疗猪深Ⅱ°烫伤创面的实验研究

Experimental Study of Compound Chinese Medicine Ointment for the Swine’s Scald Wound with Deep Ⅱ Degree

【作者】 朱磊

【导师】 崔正军;

【作者基本信息】 郑州大学 , 外科学, 2013, 硕士

【摘要】 背景:目前社会中发生的烧烫伤、化学药品灼伤以及电击伤等意外伤害疾病呈上升趋势。治疗上述疾病的药物种类繁多,主要有西药(如磺胺嘧啶银)、中药(东方一号)、外用敷料(如断层猪皮)以及民间密方。但在药物治疗过程中存在一些不足:譬如西医治疗方面主要依靠各类抗生素,因长期使用容易使细菌产生耐药及二重感染,而且多数抗生素易对身体产生不良的反应,即降低了患者的免疫力,且难杀死超级细菌,加上国家对抗生素的使用管理越来越严格,所以治疗该类疾病应尽量减少抗生素的应用;中医方面所使用的中成药,其疗效不明显且疗程较长,不但增加了患者的痛苦,而且增加了患者家庭的经济负担;目前临床上使用的外用治疗敷料如银敷料、医用断层猪皮、异体皮等,疗效尚可,但费用较昂贵,普通患者难以承担医疗费用,故在临床上难以推广使用;流传于民间治疗烧烫伤的密方,疗效不确且,且缺乏必要的科学论证,易造成病情延误,甚至导致致残及死亡等严重不良后果的发生。针对上述不足,近年来,对于治疗烧烫伤,临床上越来越注重中药膏剂的开发和应用,中药膏剂组方不但具有科学合理,制备方便,而且疗效显著,价格低廉,毒副作用较小的优点。目的:复方中药油膏是由多味中药合制成的复合制剂,为了研究复方中药油膏在烧烫伤创面愈合过程中的作用,本实验首先探索杜洛克小猪深Ⅱ°烫伤模型的建立。然后根据此模型设计进行系列试验,观察深Ⅱ度烫伤创面,创面在药物的作用下,测组织块中MDA含量、SOD活性及血清中IL-6、内毒素及TGF-p的含量,观察创面愈合速度和愈合质量,初步探讨复方中药油膏对烫伤创面愈合的机制,同时观察复方中药油膏与磺胺嘧啶银、京万红在深Ⅱ度创面愈合中的疗效比较。总结药物对烫伤创面愈合的变化规律,上述各活性成分与烫伤创面愈合的相互关系,为复方中药油膏治疗深Ⅱ度烫伤创面提供必要的实验依据。方法:将12只杜洛克小猪背部对称部位制作成深Ⅱ度皮肤烫伤模型,烫伤创面直径为4cm,随机分为A、B、C、D四组,每组3只小猪。各组创面每天碘伏消毒,0.9%NS液清洗后,A组(实验组):创面涂抹复方中药油膏油膏;B组(磺胺嘧啶银软膏):创面涂抹磺胺嘧啶银软膏;C组(京万红):创面涂抹京万红;D组(空白对照组):不涂任何药物。伤后连续观察烫伤创面愈合情况变化,分别于第1天、第7天、第14天、第21天用医用环钻于每只猪每个创面上距创面边缘内0.5cm取2块等量的创面组织,通过耳缘静脉抽取2ml血液注入无菌EP管内,选取一块组织粉碎后离心,测组织中的MDA含量及SOD的活力,血液离心后测血清中IL-6、内毒素及TGF-p。另一块置于10%甲醛溶液固定,脱水包埋成蜡块,石蜡包埋组织切片后,通过HE染色,观察各组烫伤创面愈合过程中病理组织学上的变化情况。结果:(1)烫伤后第1天,A、B、C、D组烫伤猪创面皮肤组织中MDA含量无明显差异,差异无统计学意义(P>0.05)。用药后,与D组比较,A、B、C组组织块中的MDA含量均逐渐降低。烫伤后第2天,A组中的MDA含量高于B组,两组间比较具有差异,差异有统计学意义(P<0.05);A组中的MDA含量低于C组,两组间比较具有差异,差异有统计学意义(P<0.05);A组中的MDA含量与D组比较有明显差异,差异具有统计学意义(P<0.05)。烫后第7天,A、B、C、D组组织块中MDA含量进一步降低,组间两两比较均具有差异,其差异有统计学意义(P<0.05)。(2)烫伤后第1天,A、B、C、D组烫伤猪创面皮肤组织中SOD活性升高,各组间比较无明显差异,差异无统计学意义(P>0.05);用药后,与D组比较,A、B、C组组织块中的SOD活性均逐渐增高。烫伤后第2天,A组中的SOD活性低于B组,两组间比较具有差异,差异具有统计学意义(P<0.05);A组中的SOD活性高于C组,两组间比较具有差异,差异具有统计学意义(P<0.05),A组中的SOD活性与D组比较有明显差异,差异有统计学意义(P<0.05)。烫后第7天,A、B、C、D组组织块中SOD活性进一步升高,组间两两比较均具有差异,其差异具有统计学意义(P<0.05)。(3)烫伤后第1天,A、B、C、D组烫伤猪血清中IL-6含量均升高,各组间比较无差异,差异无统计学意义(P>0.05)。用药后,与D组比较,A、B、C组血清中的IL-6含量均逐渐降低。烫伤后第2天,A组中的IL-6含量高于B组,两组间比较具有差异,差异有统计学意义(P<0.05);A组中的IL-6含量低于C组,两组间比较具有差异,差异有统计学意义(P<0.05);A组中的IL-6含量与D组比较有明显差异,差异有统计学意义(P<0.05)。烫后第7天,A、B、C、D组血清中IL-6含量进一步降低,组间两两比较,差异均有统计学意义(P<0.05)。(4)烫伤后第1天,A、B、C、D组烫伤猪血清中TGF-p含量均降低,各组间比较无差异,差异无统计学意义(P>0.05)。用药后,与D组比较,A、B、C组血清中的TGF-p含量均逐渐增高。烫伤后第2天,A组中的TGF-p含量低于B组,两组间比较具有差异,差异有统计学意义(P<0.05);A组中的TGF-p含量高于C组,两组间比较具有差异,差异有统计学意义(P<0.05),A组中的TGF-p含量与D组比较有明显差异,差异有统计学意义(P<0.05)。烫后第7天,A、B、C、D组血清中TGF-p含量进一步降低,组间两两比较,差异均有统计学意义(P<0.05)。(5)烫伤后第1天,A、B、C、D组烫伤猪血清中内毒素含量均升高,各组间比较无差异,差异无统计学意义(P>0.05)。用药后,与D组比较,A、B、C组血清中的内毒素含量均逐渐降低。烫伤后第2天,A组中的内毒素含量高于B组,两组间比较具有差异,差异有统计学意义(P<0.05);A组中的内毒素含量低于C组,两组间比较具有差异,差异有统计学意义(P<0.05),A组中的内毒素含量与D组比较有明显差异,差异有统计学意义(P<0.05)。烫后第7天,A、B、C、D组血清中IL-6含量进一步降低,组间两两比较,差异均有统计学意义(P<0.05)。结论:1、热风枪装置烫伤9秒钟能够制作出稳定的猪深Ⅱ°烫伤模型。2、复方中药油膏能提高创面组织中的SOD活性、降低组织中的MDA含量。3、复方中药油膏能降低血清中内毒素含量,抑制炎症介质IL-6释放。4、复方中药油膏能刺激血清中转化生长因子p分泌增加。5、复方中药油膏能明显促进猪深Ⅱ度烫伤愈合,能良好的保护烫伤模型。

【Abstract】 BackgroundNowadays there is an obvious increase of accidental injuries in the society; We could see the number increase in scalds, chemical burns, electrical injury as well as other diseases. As for the treatment of the diseases mentioned above, there are amounts of treatments, of which Western medicine, traditional Chinese medicine, for external use dressings and folk remedies are the main approaches. However, there may be some deficiencies in the treatment process.For instance:there is a wide use of various antibiotics in clinical western treatments, which could easily cause drug resistance of bacterium and double infection when used for a long term. Besides, most antibiotics could bring with adverse drug reaction easily and have difficulty in killing super bacterium. In addition, State management of the use of antibiotics has become more and more strict. Therefore, there should be a sharp decrease in the application of antibiotics during the process of treatment.In the clinic treatment of traditional Chinese therapy, the curative effect is unconspicuous and the course of treatment is comparatively long.At present, the use of topical treatment of dressing, such as silver ions dressing and Medical fault pig skin has a better effect but the expense is extremely high. Some patients give up the treatment because of the high hospitalizaed costs.The folk prescriptions that handed down for ancestors hardly have any effect and lack effective scientific proof, which may delay the disease and in turn cause serious side effects.As for the shortcomings mentioned above in recent years, during the process of burning treatments, more importance has been attached on the exploitation and application of Chinese medicine paste. Chinese medicine paste is based on solid science, besides; it has the advantages of convenient preparation, significant effect, low cost and less side effects.ObjectiveCompound Chinese medicine ointment are compound preparation made up of many kinds of Chinese medicine. In order to study their effect on the process of burn wound healing, this study choose turok swine deep Ⅱ burn model in an objective test design. Observe swine deep Ⅱ degree burn wound, Under the action of drugs of the wound, measure MDA content and SOD activity in the tissue. In the meanwhile, The IL-6, endotoxin and the content of TGF were measured in serum. Observed were also the wound healing speed and healing quality. In order to discuss the effect of Compound Chinese medicine ointment on burn wound healing. Compared was its effect with Sulfadiazine silver at the same time.Summarized was the changing rule of the drugs on burn wound healing, the relationship between the burn wound healing and factors involved. Provided was necessary theoretical basis of the laboratory for the treatment of skin disease deep Ⅱ degree burn wound.In the process of experiment, we will explored a simple method of swine skin deep Ⅱ degree burn model.MethodsPrepare deep Ⅱ degree burn model with the symmetrical parts on the bake of12swines. The burn wound is4cm in diameter. Divided them were into four groups at randomly. Group A:daub Compound Chinese medicine ointment on the wound; group B:daub Sulfadiazine silver Ointment on the wound; group C:daub Jing wanhong on the wound. Group D:use normal saline to clean the wound every day, no any medical paste, with three swine’s in each group. Observe wound changes of the burn wound continuously. Used rotary drill was take2pieces of the wound tissues with the same size from every wound on each swine on the1st day, the7st day, the14th-day, and the21st day, the sample should have a distance of0.5cm from the wound edge.Extract2ml blood from ear vein and inject it into the sterile EP tube.Smash and centrifuge one piece. The content of MDA in the tissue and the vitality of SOD were measured, The blood and measure IL-6,TGF-βand endotoxin were centrifuged, the mechanism of burn wound healing was discussed, its speed and its quality.Fasten another piece in10%formaldehyde solution, then dehydrate and embed it into wax pieces. After the petrolin embed the tissue section, observe the changes of pathological histology in the process of burn wound healing in each group via HE stain.Results1. The content of MDA in each group, in the pig skin tissue of burn wound, is not obvious on the first day (P>0.05). After the use of medicine, the content of MDA in each tissue block is increasingly decreasing in comparison with that in the model set. The content of MDA in the group A is comparatively higher than group B on the second day. There exist great different between the two group (P<0.05).The content of MDA in the group A is lower than that of group C. There is great different between the two group (P<0.05), obvious difference exist as well compared with group D (P<0.05).MDA content in every tissue block reduced a bit and the difference are significant among groups.2. The vitality of SOD in wound pig skin tissue increases in every group on the first day, there is no obvious difference among groups (P>0.05).After treatment, the SOD vitality of tissue block in the treatment group is increasingly higher in comparison with that of model set. On the second day, SOD vitality in the group A is lower than group B. There are great differences between the two groups (P<0.05). SOD vitality in the group A is higher than group C. There are great differences between the two groups (P<0.05).There also exist great differences compared with group D (P<0.05).On the seventh day, the SOD vitality of tissue block continuingly increase, there are great differences in each group.3. The first day after burn, the content of IL-6in wound pig serum is apparently high er in each group than before but with no obvious difference compared with other groups. After treatment, the content of IL-6in experimental group is lower.On the second day, the content of IL-6in the group A is higher than that of group B, there are great differences between them (P<0.05). While the content of IL-6in the group A is lower than that of group C, there are great differences between them (P<0.05).There are also great difference when it is compared with group D (P<0.05).On the seventh day, the content of IL-6in wound pig serum decreases in each group, There are also great differences among groups.4. The content of TGF-βin wound pig serum is apparently lower in each group than before, there are no significant differences (P>0.05). After treatment, the content of TGF-p in drug groups is increasingly higher that of model set group. On the second day, the content of TGF-βin group A is lower than group B, there are significant differences (P<0.05). the content of TGF-P in group A is higher than group C, there are significant differences between the two groups (P<0.05), There are also great difference when it is compared with group D (P<0.05). On the seventh day, the content of TGF-βin each group continues to decrease; there are also great differences among groups (P<0.05)5.The content of endotoxin in wound pig serum is apparently higher in each group than before, there are no significant differences (P>0.05). After treatment, the content of endotoxin in drug group is increasingly lower in comparison with group D. On the second day, the content of endotoxin in group A is higher than group B, there are significant differences (P<0.05). the content of endotoxin in group A is lower than group C, there are significant differences between the two groups (P<0.05), There are also great difference when it is compared with group D (P<0.05). On the seventh day, the content of endotoxin in each group continues to decrease; there are also great differences among groups (P<0.05) Conclusion1.The stable swine’s scald wound with deep Ⅱ degree model can be produced by the heat gun in9seconds.2. Compound Chinese medicine ointment can promote the healing process of swine deep two degree burn and protect scald model properly.3. Compound Chinese medicine ointment can raise the vitality of SOD in wound tissue and decrease the content of MAD. It also has an significant effect in antioxidant.4. Compound Chinese medicine ointment can decrease the content of endotoxin in serum and control the release of IL-6inflammatory mediators level.5. Compound Chinese medicine ointment can stimulate βtransforming growth factor increase in serum

  • 【网络出版投稿人】 郑州大学
  • 【网络出版年期】2013年 11期
  • 【分类号】R644;R285.5
  • 【被引频次】2
  • 【下载频次】144
  • 攻读期成果
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