【作者】 贾宇博；

【导师】 刘达恩；

【作者基本信息】 广西医科大学 ， 外科学， 2008， 硕士

【摘要】 目的:探讨瘢痕膏对创面是否有促进愈合作用,对瘢痕是否有防治作用,为其临床应用提供理论和实践依据。方法:①实验一:选用新西兰大耳白兔12只,适应性喂养24小时,建立兔耳瘢痕模型,每只兔耳建立6个创面,共计72个创面,随机分为三组,分别为实验组,药物对照组和空白组,实验组和药物对照组于瘢痕模型建立后24小时开始用药,实验组采用瘢痕膏涂抹创面(瘢痕膏为一种外用中药制剂。其主要成分为丹参酮、积雪甙、黄芪甙、甘草酸、苦参碱等,按3:3:2:2:1的比例加基质制作而成),对照组采用湿润烧伤膏涂抹,空白对照组涂抹基质。连续用药30天,于动物模型建立后第7、14、21、28天切取创面,制作标本。分别观察创面愈合情况,观察组织学结构,对生长因子(EGF、bFGF)进行检测。②实验二:选用新西兰大耳白兔8只,适应性喂养24小时,建立兔耳增生瘢痕模型,每只兔耳建立6个创面,共计48个创面,随机分为两组,分别为实验组和远期疗效组,实验组于瘢痕模型建立后24小时开始用药,远期疗效组于创面上皮化(即模型建立后第21天)开始用药,两组都采用瘢痕膏涂抹创面,连续用药90天。于第90天用游标卡尺测量瘢痕增生厚度,第90天用Periflux5000激光多普勒血流仪检测瘢痕组织微循环血流灌注,第90天切取创面,制作标本,进行VG染色。分别观察瘢痕增生情况,瘢痕微血管计数,瘢痕胶原面面积比的测定。结果:实验一:①用药第28天,实验组瘢痕略高于兔耳皮肤表面,颜色稍红,接近兔耳正常皮肤颜色,触之质软;其余两组明显高于兔耳皮肤表面,颜色较红,质地硬;②用药第24天,实验组兔耳的创面愈合情况要好于其他两组;③用药第14天和第28天,三组间创面的白细胞计数没有差别;④用药第21天的EGF检测,实验组和药物对照组无差别,但这两组都高于空白组;对bFGF检测,第7、14、21天的数据显示,实验组和药物对照组皆无差别,这两组计数都高于空白组。实验二:①用药第90天,实验组和远期疗效组的瘢痕增生厚度之间没有差别;②用药第90天,实验组和远期疗效组瘢痕微血管计数之间无差别;③用药第90天,实验组和远期疗效组瘢痕组织的胶原面面积之间无差别。结论:①此外用中药在创伤早期应用,对创面的愈合具有促进作用。②尚不能证实何时应用瘢痕膏对增生性瘢痕的抑制作用最为理想。更多还原

【Abstract】 Objective:To investigate the effect of Compound Traditional Chinese Medicine Unguent on the wound surface and scar.Methods:1.①To choose 12 New Zealand rabbits(3-4 months years old)as experiment animals.②The models of hypertrophic scar(HS)in ears were reproduced.Compartmentalizemeasure off the 12 rabbits to 3 groups randomly,the groups are experiment group,medicine control group and blank group.There are 8 ears(48 wound surfaces)in every group.③On the 7,14,21, 28 day after the model setting up,taking the scar and flatting exemplar.④To observe the condition of wounds,the architectonic of histology and the growth factor(EGF,bFGF). 2.①To choose 8 New Zealand rabbits(3-4 months years old)as experiment animals.②The models of hypertrophic scar(HS)in ears were reproduced.Compartmentalizemeasure off the 8 rabbits to 2 groups randomly,the groups are experiment group and prostecdtive efficacy group.There are 8 ears(48 wound surfaces)in every group.③On the 90 day after the model setting up,the micro-circulation of scars are detected with laser Doppler flowmetry.To observe the condition of wounds,the architectonic of histology and the areas of collagen.Results:1.①Change of appearance:After use of the drug,the scars of the experiment group became depauperate markedly,higher than the skin slightly,close to the normal skin in colour and soft when touching;but they appeared proliferative in the other groups and were higher than the skin obviously with red colour and hard when touching.②Condition of wound surfaces:The experiment group is better than the other groups.③Lencocyte count:There is no difference from the three groups.④EGF:There is no difference from the experiment group and medicine control group,but their numbers are more than the blank group on the 21 day;bFGF:There is no difference from the experiment group and medicine control group,but their numbers are more than the blank group.2.①The thickness of the scars:There is no difference from the three groups.②Micro-vessel counting:There is no difference from the three groups.③The area density of collagen fibers:There is no difference from the three groups.Conclusions:①The Traditional Chinese Unguent can promote the wound surfaces to heal if using it early.②It can’t find the best time when use The Traditional Chinese Unguent.更多还原