艾灸促进皮肤外伤愈合及对局部组织的修复作用
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摘要
目的:探讨艾灸促进创面愈合疗效及其对创伤不同阶段局部组织形态的修复作用。方法:28只成年雄性SD大鼠随机分为模型组和艾灸组,每组14只。采用直径8mm的取皮器从大鼠背部正中线肩胛下角2cm处钻取全层皮肤制备大鼠外伤模型。造模后即刻予艾灸干预,每日1次,每次25min,持续6d。观察并拍照记录创面的愈合情况,造模后第2天和第7天采用HE和Masson染色观察各组大鼠创伤局部组织形态学变化和胶原纤维生长情况。结果:与模型组比较,艾灸组干预2次后大鼠创口面积就显著减小(P<0.01,P<0.05),随着干预次数增加艾灸组愈合面积显著增加(P<0.01),艾灸组大鼠创伤局部组织中炎性细胞数量显著增多(P<0.01),新生胶原纤维显著增多(P<0.05);艾灸6次后,艾灸组较模型组创伤局部组织成纤维细胞数量和胶原纤维量明显增加,细胞和胶原纤维排列更加紧密,新生血管数量较多,受损部位的皮肤结痂较厚。结论:艾灸可以明显促进创伤局部胶原纤维生长和细胞增殖,促进外伤模型大鼠皮肤创面愈合。
Objective To explore the effects of moxibustion intervention on wound healing in rats with full-thickness cutaneous wounds.Methods A total of 28 adult SD male rats were randomly assigned to model group and moxibustion group(n=14 in each one).The skin wound model was established by removal of a piece of full-thickness skin from the median line of the rats'back(about 2 cm below the shoulder blade).Moxibustion intervention was applied to the surrounding area of the focus for 25 min,once daily for 6 days.The wound healing was observed and photographed after each moxibustion intervention.The wound tissues were harvested after transcardiac perfusion with 4% paraformaldehyde solution on the 2 nd and 7 thday after modeling,and stained with H.E.and Masson methods for displaying histopathological changes and collagen fiber growth status,respectively.Results After modeling,the cutaneous wound was healed gradually in both groups,and the wound area was significantly smaller from the 2 nd day to the 5 th day in the moxibustion group than in the model group(P<0.01,P<0.05).Correspondingly,the wound closure area was significantly bigger from the 2 nd to the 5 th day in the moxibustion group than in the model group(P<0.01).H.E.and Masson staining showed that the number of the inflammatory cells(monocytes,macrophages,neutrophile,etc.)and the collagen fiber area in the local wound tissue of the moxibustion group were significantly bigger than those of the model group on the 2 nd day after intervention(P<0.01).After 6 sessions of moxibustion intervention,the number of fibroblasts and collagen fibers in the moxibustion group were obviously increased than that in the model group,characterized by closer arrangement of fibroblasts and collagen fibers,more and larger of the new-born blood vessels,and thicker of the scab in the wound area.Conclusion Moxibustion can promote the wound healing by enhancing the growth of collagen fibers and cell proliferation in the traumatic cutaneous area in full-thickness cutaneous wound rats.
Objective To explore the effects of moxibustion intervention on wound healing in rats with full-thickness cutaneous wounds.Methods A total of 28 adult SD male rats were randomly assigned to model group and moxibustion group(n=14 in each one).The skin wound model was established by removal of a piece of full-thickness skin from the median line of the rats'back(about 2 cm below the shoulder blade).Moxibustion intervention was applied to the surrounding area of the focus for 25 min,once daily for 6 days.The wound healing was observed and photographed after each moxibustion intervention.The wound tissues were harvested after transcardiac perfusion with 4% paraformaldehyde solution on the 2 nd and 7 thday after modeling,and stained with H.E.and Masson methods for displaying histopathological changes and collagen fiber growth status,respectively.Results After modeling,the cutaneous wound was healed gradually in both groups,and the wound area was significantly smaller from the 2 nd day to the 5 th day in the moxibustion group than in the model group(P<0.01,P<0.05).Correspondingly,the wound closure area was significantly bigger from the 2 nd to the 5 th day in the moxibustion group than in the model group(P<0.01).H.E.and Masson staining showed that the number of the inflammatory cells(monocytes,macrophages,neutrophile,etc.)and the collagen fiber area in the local wound tissue of the moxibustion group were significantly bigger than those of the model group on the 2 nd day after intervention(P<0.01).After 6 sessions of moxibustion intervention,the number of fibroblasts and collagen fibers in the moxibustion group were obviously increased than that in the model group,characterized by closer arrangement of fibroblasts and collagen fibers,more and larger of the new-born blood vessels,and thicker of the scab in the wound area.Conclusion Moxibustion can promote the wound healing by enhancing the growth of collagen fibers and cell proliferation in the traumatic cutaneous area in full-thickness cutaneous wound rats.
引文
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[10]李杰辉,王丽,席丽红,等.艾灸对糖尿病性皮肤溃疡大鼠创面愈合的影响及其作用机制[J].广西医学,2015,37(12):1700-1704.
[11]孙忠人,王迪,尹洪娜,等.艾灸对大鼠皮肤创伤成纤维细胞和KGF表达的影响[J].针灸临床杂志,2014,30(4):70-72.
[12]RICHARDSON R,SLANCHEV K,KRAUS C,et al.Adult zebrafish as a model system for cutaneous wound-healing research[J].J Invest Dermatol,2013,133(6):1655-1665.
[13]SEIFERT A W,MONAGHAN J R,VOSS S R,et al.Skin regeneration in adult axolotls:a blueprint for scar-free healing in vertebrates[J].PLoS One,2012,7(4):e32875.
[14]XIA C Q,KAO K J.Effect of CXC chemokine platelet factor4on differentiation and function of monocyte-derived dendritic cells[J].Int Immunol,2003,15(8):1007-1015.
[15]KASPER B,BRANDT E,ERNST M,et al.Neutrophil adhesion to endothelial cells induced by platelet factor 4requires sequential activation of Ras,Syk,and JNK MAP kinases[J].Blood,2006,107(5):1768-1775.
[16]VON HUNDELSHAUSEN P,KOENEN R R,SACK M,et al.Heterophilic interactions of platelet factor 4and RANTESpromote monocyte arrest on endothelium[J].Blood,2005,105(3):924-930.
[17]KIM S J,JENNE C N.Role of platelets in neutrophil extracellular trap(NET)production and tissue injury[J].Semin Immunol,2016,28(6):546-554.
[18]GANTWERKER E A,HOM D B.Skin:histology and physiology of wound healing[J].Clin Plast Surg,2011,39(1):85-97.
[19]RODERO M P,KHOSROTEHRANI K.Skin wound healing modulation by macrophages[J].Int J Clin Exp Pathol,2010,3(7):643-653.
[20]WANG J,WANG X,CHEN H,et al.Distinctively expressed cytokines by three different inflammation cells and their interaction with keratinocytes in wound healing[J].Inflammation,2017,40(6):2151-2162.
[2]SEN C K,GORDILLO G M,ROY S,et al.Human skin wounds:a major and snowballing threat to public health and the economy[J].Wound Repair Regen,2009,17(6):763-771.
[3]冯晶晶,王小万,靖瑞锋.控制抗生素滥用的国际经验及启示[J].中国抗生素杂志,2014,39(1):14-18.
[4]ZHANG Q H,YUE J H,LI C R,et al.Moxibustion for the treatment of pressure ulcers:study protocol for a pilot,multicentre,randomised controlled trial[J].BMJ Open,2014,4(12):e006423.
[5]ZHANG Q H,SUN Z R,YUE J H,et al.Traditional Chinese medicine for pressure ulcer:a meta-analysis[J].Int Wound J,2013,10(2):221-231.
[6]洪霞,江雪英,罗烨,等.艾灸盒温灸预防缺血性脑卒中患者压疮效果探讨[J].护理学杂志,2016,31(3):47-49.
[7]李明,王建民,唐昆,等.艾灸对肛裂术后创面愈合的促进作用观察[J].中医药临床杂志,2012,24(10):964-965.
[8]祝亚男,唐娅琴,汪永坚.艾灸促进乳腺癌术后创面愈合临床观察[J].上海针灸杂志,2014,33(2):151-152.
[9]孙琦,孙忠人,张秦宏,等.艾灸对大鼠创伤皮肤组织血管内皮细胞和血管内皮生长因子表达的影响[J].中国针灸,2014,34(7):679-684.
[10]李杰辉,王丽,席丽红,等.艾灸对糖尿病性皮肤溃疡大鼠创面愈合的影响及其作用机制[J].广西医学,2015,37(12):1700-1704.
[11]孙忠人,王迪,尹洪娜,等.艾灸对大鼠皮肤创伤成纤维细胞和KGF表达的影响[J].针灸临床杂志,2014,30(4):70-72.
[12]RICHARDSON R,SLANCHEV K,KRAUS C,et al.Adult zebrafish as a model system for cutaneous wound-healing research[J].J Invest Dermatol,2013,133(6):1655-1665.
[13]SEIFERT A W,MONAGHAN J R,VOSS S R,et al.Skin regeneration in adult axolotls:a blueprint for scar-free healing in vertebrates[J].PLoS One,2012,7(4):e32875.
[14]XIA C Q,KAO K J.Effect of CXC chemokine platelet factor4on differentiation and function of monocyte-derived dendritic cells[J].Int Immunol,2003,15(8):1007-1015.
[15]KASPER B,BRANDT E,ERNST M,et al.Neutrophil adhesion to endothelial cells induced by platelet factor 4requires sequential activation of Ras,Syk,and JNK MAP kinases[J].Blood,2006,107(5):1768-1775.
[16]VON HUNDELSHAUSEN P,KOENEN R R,SACK M,et al.Heterophilic interactions of platelet factor 4and RANTESpromote monocyte arrest on endothelium[J].Blood,2005,105(3):924-930.
[17]KIM S J,JENNE C N.Role of platelets in neutrophil extracellular trap(NET)production and tissue injury[J].Semin Immunol,2016,28(6):546-554.
[18]GANTWERKER E A,HOM D B.Skin:histology and physiology of wound healing[J].Clin Plast Surg,2011,39(1):85-97.
[19]RODERO M P,KHOSROTEHRANI K.Skin wound healing modulation by macrophages[J].Int J Clin Exp Pathol,2010,3(7):643-653.
[20]WANG J,WANG X,CHEN H,et al.Distinctively expressed cytokines by three different inflammation cells and their interaction with keratinocytes in wound healing[J].Inflammation,2017,40(6):2151-2162.