托里消毒饮联合象皮生肌膏治疗慢性皮肤溃疡的疗效及对创面组织TNF-α、IL-6、VEGF表达的影响
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摘要
目的观察托里消毒饮联合象皮生肌膏治疗慢性皮肤溃疡的疗效及对创面组织肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)、白介素6(interleukin-6, IL-6)、血管内皮生长因子(vascular endothelial growth factor, VEGF)表达的影响。方法将60例慢性皮肤溃疡患者随机分为观察组30例和对照组30例。两组均予以象皮生肌膏外敷,观察组同时口服托里消毒饮。两组患者均连续治疗4周。观察比较两组的创面愈合率、治疗前后创面组织VEGF、TNF-α及IL-6含量及不良反应。结果观察组的创面愈合率为49.3%,对照组为30.1%,观察组疗效优于对照组(P<0.05);治疗后两组创面肉芽组织TNF-α、IL-6含量降低(P<0.05),VEGF含量升高(P<0.05),且观察组改善优于对照组(P<0.05)。两组患者在治疗过程中均未出现明显的不良反应。结论托里消毒饮联合象皮生肌膏治疗慢性皮肤溃疡,能降低创面组织TNF-α、IL-6,提高VEGF表达,促进创面修复,且具有较高的安全性,疗效满意。
Objective To observe the curative effect of Tuoli Xiaodu Decoction on chronic skin ulcer and its effects on the expression of tumor necrosis factor-α(TNF-α), interleukin 6(IL-6) and vascular endothelial growth factor(VEGF) in wound tissue. Methods A total of 60 patients with chronic skin ulcer were randomly divided into the observation group(30 cases) and the control group(30 cases). Both groups were given external application of Xiangpi Shengji ointment. The observation group took Tuoli Xiaodu Decoction orally. Both groups were treated for 4 weeks. The wound healing rate,concentration of VEGF, TNF-α and IL-6 in wound tissue, and toxicity and side effects were observed and compared. Results The wound healing rate of the observation group was 49.3%, and that of the control group was 30.1%. The curative effect of the observation group was better than that of the control group(P<0.05). After treatment, the contents of TNF-α and IL-6 in granulation tissue of the wound decreased(P<0.05), and the contents of VEGF increased(P<0.05). And the observation group was better improved than the control group(P<0.05). No obvious adverse reactions were occurred in the treatment process for the 2 groups. Conclusion Tuoli Xiaodu Decoction combined with Xiangpi Shengji ointment can reduce TNF-α and IL-6,increase the expression of VEGF, and promote wound repair in the treatment of chronic skin ulcer. This treatment has high security, and satisfactory curative effects.
Objective To observe the curative effect of Tuoli Xiaodu Decoction on chronic skin ulcer and its effects on the expression of tumor necrosis factor-α(TNF-α), interleukin 6(IL-6) and vascular endothelial growth factor(VEGF) in wound tissue. Methods A total of 60 patients with chronic skin ulcer were randomly divided into the observation group(30 cases) and the control group(30 cases). Both groups were given external application of Xiangpi Shengji ointment. The observation group took Tuoli Xiaodu Decoction orally. Both groups were treated for 4 weeks. The wound healing rate,concentration of VEGF, TNF-α and IL-6 in wound tissue, and toxicity and side effects were observed and compared. Results The wound healing rate of the observation group was 49.3%, and that of the control group was 30.1%. The curative effect of the observation group was better than that of the control group(P<0.05). After treatment, the contents of TNF-α and IL-6 in granulation tissue of the wound decreased(P<0.05), and the contents of VEGF increased(P<0.05). And the observation group was better improved than the control group(P<0.05). No obvious adverse reactions were occurred in the treatment process for the 2 groups. Conclusion Tuoli Xiaodu Decoction combined with Xiangpi Shengji ointment can reduce TNF-α and IL-6,increase the expression of VEGF, and promote wound repair in the treatment of chronic skin ulcer. This treatment has high security, and satisfactory curative effects.
引文
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[9]尚峰,何志旭,汪浩文,等.血管内皮生长因子基因转染的骨髓间充质干细胞移植对大鼠肺动脉高压的治疗作用[J].中华医学杂志,2011,91(26):1847-1851.
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[12]张云杰.中医药治疗慢性皮肤溃疡研究概况[J].山东中医杂志,2014,33(12):1040-1042.
[2] NAKAYAMA M, NAKAYAMAA, VAN LESSEN M, et al. Spatialregulation of VEGF receptor endocytosis in angiogenesis[J].Nat Cell Biol, 2013,15(3):249.
[3]李晓庆,杨博华.脉络舒通颗粒外洗促进糖尿病足慢性溃疡愈合的研究[J].现代中西医结合杂志,2015,24(5):481-483.
[4]张学军.皮肤性病学[M].北京:人民卫生出版社,2013:22.
[5]中华医学会创伤学分会组织修复专业委员会(组).慢性伤口诊疗指导意见[M].北京:人民卫生出版社,2011:2-7.
[6]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:45.
[7]蔡源源,李光早.血管内皮生长因子的调控及其作用研究进展[J].组织工程与重建外科杂志,2011,7(1):51-54.
[8]陈小永,王自闯,宋军营,等.糖肾1号方对糖尿病肾病腹膜透析患者VEGF活性及炎症因子的影响[J].湖南中医药大学学报,2017,37(7):767-769.
[9]尚峰,何志旭,汪浩文,等.血管内皮生长因子基因转染的骨髓间充质干细胞移植对大鼠肺动脉高压的治疗作用[J].中华医学杂志,2011,91(26):1847-1851.
[10] KIM O J, HONG S H, OH S H, et al. Association between VEGF poly-morphismas and homocysteine levels in patients with ischemic stroke and silent brain in farction[J]. Stroke, 2011,42(9):2393-2402.
[11]郭敏,徐祥,黄宏.巨噬细胞在创面愈合中的作用研究进展[J].成都医学院学报,2010,5(3):223-227.
[12]张云杰.中医药治疗慢性皮肤溃疡研究概况[J].山东中医杂志,2014,33(12):1040-1042.