1. 上海中医药大学附属岳阳中西医结合医院肛肠科,上海,200437
2. 上海中医药大学附属第七人民医院骨伤科,上海,200137
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杨豪杰, 曹涤平, 卢子瑄, 等. 清热利湿方及虎杖苷对SD大鼠肛旁创面愈合作用的研究[J]. 上海中医药杂志, 2017,51(5):86-92.
YANG Hao-jie, CAO Di-ping, LU Zi-xuan, et al. Effects of Qingre Lishi Recipe and polydatin on perianal wound healing in SD rats[J]. Shanghai Journal of Traditional Chinese Medicine, 2017,51(5):86-92.
目的:研究清热利湿外洗方(虎杖、蒲公英、苦参、黄柏)及虎杖苷对SD大鼠肛旁创面愈合的影响。 方法:以SD大鼠肛旁创面模型为研究对象,随机分为清热利湿外洗方组(简称“清热利湿组”)、虎杖苷组、生理盐水组,每组45只,给予相应干预。在术后第3、7、11天通过伊文氏蓝染色法观察创面毛细血管通透性情况;肉眼及电镜观察创面渗出、炎症及愈合情况;电镜下观察血管内皮细胞紧密连接及胶原纤维合成、分布情况。 结果:造模后第3天,清热利湿组与虎杖苷组伊文氏蓝渗出情况差异无统计学意义(P>0.05),但两者渗出均少于生理盐水组(P<0.05);第7、11天,各组伊文氏蓝渗出差异无统计学意义(P>0.05)。肉眼观察发现,造模后第3、7、11天各组创面分泌物渗出差异无统计学意义(P>0.0167)。术后第3、7天清热利湿组肉芽增生及上皮爬行优于生理盐水组(P<0.0167),但与虎杖苷组差异无统计学意义(P>0.0167);虎杖苷组与生理盐水组差异均无统计学意义(P>0.0167)。术后第11天,3组创面愈合情况差异均无统计学意义(P>0.0167)。光镜结果可见清热利湿组肉芽组织无明显水肿,新生毛细血管丰富且成纤维细胞排列整齐,虎杖苷组与之接近,两者愈合情况均优于生理盐水组。电镜结果可见清热利湿组血管内皮细胞紧密连接将相邻细胞紧密嵌合;胶原纤维分布致密、规则,纤维束排列紧密。 结论:清热利湿方与虎杖苷均能降低血管通透性,控制创面炎性渗出,但清热利湿方能更有效地促进上皮爬行、加快肉芽组织内各成分再生。
Objective:To explore the effects of Qingre Lishi Recipe for external application (Rhizoma Polygoni Cuspidati,Herba Taraxaci,Radix Sophorae Flavescentis,Cortex Phellodendri) and polydatin on perianal wound healing in SD rats. MethodsSD rat model of perianal wound was established. The rats were randomly divided into the Qingre Lishi Recipe group,polydatin group,normal saline group,45 rats in each group. Interventions were given in the corresponding groups. 3,7,11 days after operation,the wound capillary permeability was observed by evans blue staining,the wound exudation,inflammation and healing were observed by naked eye and electron microscope,the tight junction of vascular endothelial cells and synthesis and distribution of collagen fibrils were observed by electron microscope. Results:On 3rd day after modeling,there was no difference on the leakage of evans blue between the Qingre Lishi group and polydatin group(P>0.05),but the leakage in these two groups was less than that in the normal saline group(P<0.05). On 7th and 11th day,there were no differences on the leakage of evans blue among the groups(P>0.05). The observation by naked eye showed that there were no differences on the wound exudation among the groups on 3rd,7th,11th day after modeling(P>0.0167). On 3rd,7th day after operation,the granulation hyperplasia and epithelial migration in the Qingre Lishi group were better than those in the normal saline group(P<0.0167),but there were no statistically significant differences on the granulation hyperplasia and epithelial migration between the Qingre Lishi group and polydatin group(P>0.0167)as well as the polydatin group and normal saline group(P>0.0167). On 11th day,there were no differences on the wound healing among the groups(P>0.0167). The light microscopy results showed that there was no obvious edema of granulation tissue in the Qingre Lishi group,the new capillaries were abundant and the fibroblasts arranged in order. The light microscopy observation in the polydatin group was similar to that in the Qingre Lishi group,and the wound healing in these two groups was better than that in the normal saline group. The electron microscopy results showed that there were tight junction of vascular endothelial cells and close fitting with adjacent cells in the Qingre Lishi group,the collagen fibrils distribution was compact and regular,the fiber bundle arranged closely. Conclusion:Qingre Lishi Recipe and polydatin can reduce the permeability of blood vessel and control the inflammatory exudation of wound,but Qingre Lishi Recipe can more effectively promote the epithelial migration and accelerate the regeneration of various components in granulation tissue.
中药外治肛肠手术术后创面愈合清热利湿方虎杖苷
external treatment of Chinese medicineanorectal surgerypostoperativewound healingQingre Lishi Recipepolydatin
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