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【目的】观察在药疮交互作用理论指导下的偎脓长肉法对大鼠皮肤慢性溃疡愈合过程中肉芽组织内相关因子的影响。【方法】将24只大鼠随机分为正常组、模型组、对照组、治疗组4组,每组6只。正常组无创面,正常喂养;对其他3组大鼠采用“激素干预—皮肤缺损—细菌感染”复合因素叠加法复制慢性皮肤溃疡模型,造模结束后,模型组给予生理盐水换药,对照组给予凡士林纱条外敷,治疗组给予生肌象皮膏外敷,每日换药1次,共14d。各组大鼠均以左背部创面用于取材,右背部创面用于观察疗效。分别治疗3、7、14d后,观察大鼠创面分泌物、肉芽情况,采用酶联免疫吸附(ELISA)法检测溃疡创面肉芽组织内血管内皮细胞生长因子(VEGF)、诱导性一氧化氮合酶(iNOS)、精氨酸-1(Arg-1)、Notch1等的表达情况。【结果】治疗组应用偎脓长肉法治疗14d后创面基本愈合,与模型组、对照组比较,差异有统计学意义(P<0.05或P<0.01)。在创面修复早期(3d),治疗组创面组织VEGF、Arg-1表达水平升高,Notch1表达水平降低,与模型组、对照组比较,差异均有统计学意义(P<0.05)。在创面修复晚期(14d),治疗组创面组织iNOS表达水平升高,与模型组比较,差异有统计学意义(P<0.05)。【结论】偎脓长肉法可促进大鼠慢性皮肤溃疡创面愈合,改善大鼠全身情况,其机制可能与其早期抑制M1型巨噬细胞诱导的iNOS表达,再促进M2型巨噬细胞表型指标Arg-1表达升高,并调节肉芽组织VEGF和Notch1表达有关。
【Objective】 To observe the effect of snail pang meat method on the related factors in granulation tissue during the healing process of chronic skin ulcer in rats under the guidance of the interaction between drug and sore. 【Methods】 Twenty-four rats were randomly divided into normal group, model group, control group and treatment group, with 4 rats in each group. In the other three groups, the chronic skin ulcer model was duplicated with the combination of “hormone intervention - skin defect - bacterial infection”. After the model was finished, the model group was given physiological saline dressing, The control group was given Vaseline gauze topical, the treatment group was given myogenic elephant skin paste topical, dressing 1 day, a total of 14d. The rats in each group were taken from the left back wound and the right back wound was used to observe the curative effect. After treated for 3, 7 and 14 days, the wound secretions and granulation were observed. The levels of vascular endothelial growth factor (VEGF), inducible nitric oxide synthase (iNOS), Arginine-1 (Arg-1), Notch1 and so on. 【Results】 The wounds healed basically on the 14th day after treatment with the method of flesh nostril flesh. Compared with the model group and the control group, the difference was statistically significant (P <0.05 or P <0.01). In the early stage of wound healing (3d), the expression of VEGF, Arg-1 and Notch1 in the wound surface of the treatment group were significantly lower than those in the model group and the control group (P <0.05). In the late stage of wound healing (14d), the expression of iNOS in the wound surface of the treatment group increased significantly compared with the model group (P <0.05). 【Conclusion】 Nocturnal meat flesh method can promote the healing of chronic skin ulcer in rats and improve the whole body condition in rats. The mechanism may be related to its inhibition of the iNOS expression induced by M1 macrophages and the promotion of the phenotype of M2 macrophages Arg-1 expression increased, and regulate granulation tissue VEGF and Notch1 expression.