1. 天津中医药大学第二附属医院中医外科,天津,300250
2. 天津中医药大学研究生院,天津,300193
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徐强, 王婉莹, 刘婷婷, 等. 护场理论指导下的箍围法对皮肤脓肿大鼠PCT、CRP、MMP-2及不同位置组织病理的影响[J]. 上海中医药杂志, 2018,52(6):78-82.
XU Qiang, WANG Wanying, LIU Tingting, et al. Effects of therapy of encircling lesion with drugs under guidance of defended field theory on levels of PCT,CRP,MMP-2 and histopathology at different locations in rats with skin abscess[J]. Shanghai Journal of Traditional Chinese Medicine, 2018,52(6):78-82.
徐强, 王婉莹, 刘婷婷, 等. 护场理论指导下的箍围法对皮肤脓肿大鼠PCT、CRP、MMP-2及不同位置组织病理的影响[J]. 上海中医药杂志, 2018,52(6):78-82. DOI: 10.16305/j.1007-1334.2018.06.023.
XU Qiang, WANG Wanying, LIU Tingting, et al. Effects of therapy of encircling lesion with drugs under guidance of defended field theory on levels of PCT,CRP,MMP-2 and histopathology at different locations in rats with skin abscess[J]. Shanghai Journal of Traditional Chinese Medicine, 2018,52(6):78-82. DOI: 10.16305/j.1007-1334.2018.06.023.
目的:观察护场理论指导下的箍围药红肿消酊外用对皮肤脓肿大鼠血浆C反应蛋白(CRP)、降钙素原(PCT)、分泌物基质金属蛋白酶-2(MMP-2)以及脓肿周围不同位置组织病理的影响。 方法:将40只SD大鼠分为空白组、预治疗组、治疗组、对照组、模型组,除空白组外,其余4组皮下注射金黄色葡萄球菌造成皮下脓肿模型,采用不同药物换药治疗。分别于治疗3、7、14 d每组大鼠行心脏取血1.5 ml,同时采用100 μl 0.9%NaCl溶液冲洗除空白组外的大鼠创面后回收伤口分泌物,酶联免疫吸附(ELISA)法检测血浆内CRP、PCT以及分泌物中MMP-2的含量,14 d后处死大鼠,提取大鼠脓肿周围1 cm、2 cm、3 cm皮下组织制成切片,Masson染色,镜下观察大鼠脓肿周围不同位置皮肤及肌肉组织炎细胞浸润、血管增生及毛细血管扩张情况。 结果:治疗期间模型组、对照组、预治疗组及治疗组在各时期血浆CRP及PCT含量均呈下降趋势且高于空白组,并在治疗末期趋于稳定。在治疗期间,采用红肿消酊剂外用的预治疗组及治疗组血浆CRP及PCT含量均不同程度低于对照组及模型组,在治疗早期(3 d、7 d)时采用莫匹罗星软膏外用的对照组血浆CRP及PCT含量与预治疗组及治疗组相比差异有统计学意义(P<0.05,P<0.01),在治疗14 d时预治疗组及治疗组血浆CRP及PCT含量与对照组接近,差异无统计学意义(P>0.05)。在治疗中后期(7 d、14 d)时,预治疗组及治疗组创面分泌物MMP-2含量低于模型组与对照组,差异有统计学意义(P<0.05,P<0.01)。镜下观察脓肿周围组织显示治疗组及预治疗组距离脓肿不同位置皮下肌肉组织炎细胞浸润显著低于对照组及模型组。 结论:应用红肿消酊箍围治疗大鼠皮肤脓肿,能够通过降低血浆内CRP及PCT含量,同时能够降低分泌物MMP-2含量,减轻脓肿周围组织炎性浸润,改善全身及局部感染,从而为护场形成提供有利条件。
Objective: To observe the effects of external application of Hongzhongxiao Tincture,a drug for encircling lesion,on the C reactive protein(CRP)and procalcitonin(PCT)in plasma and matrix metalloproteinase-2(MMP-2)in secretion and the histopathology at different locations around the abscess in rats with skin abscess under the guidance of defended field theory. Methods40 rats were divided into the blank group,pretreatment group,treatment group,control group and model group. Except the blank group,the subcutaneous abscess model was established by subcutaneous injection of Staphylococcus aureus in the other four groups. After modeling,the rats were treated with different drugs. On the 3rd,7th and 14th day of treatment,the cardiac blood at volume of 1.5 ml was collected in each group. Except the rats in the control group,100 μl 0.9% NaCl solution was used for other rats to rinse the wound and then the wound secretion was recycled. The levels of CRP and PCT in plasma and MMP-2 in secretion were detected by enzyme linked immunosorbent assay(ELISA). The rats were sacrificed after treatment for 14 days,and the subcutaneous tissues at 1 cm,2 cm and 3 cm around abscess were extracted respectively and made into sections for Masson staining. The inflammatory cell infiltration,vascular proliferation and telangiectasia in skins and muscles at different locations around abscess were observed under the microscope. Results:In different treatment periods,the plasma levels of CRP and PCT in the model group,control group,pretreatment group and treatment group showed the decreasing tendency and were higher than those in the blank group,and tended to be stable at the end of the treatment. During the treatment periods,the plasma levels of CRP and PCT in the pretreatment group and treatment group(both treated with Hongzhongxiao Tincture by external application)were lower than those in the control group and model group to varying degrees. In the early stage of the treatment(3rd and 7th day),there were statistically significant differences on the plasma levels of CRP and PCT between the control group(treated with Mupirocin Ointment by external application)and pretreatment group or treatment group(P<0.05,P<0.01). On the 14th day of treatment,the plasma levels of CRP and PCT in the pretreatment group and treatment group were close to those in the control group,with no statistically significant differences(P>0.05). In the middle and late stage of the treatment(7th and 14th day),the MMP-2 level in wound secretion in the pretreatment group and treatment group was lower than that in the model group and control group,with statistically significant differences(P<0.05,P<0.01). The pathology of tissues around abscess under the microscope showed that the inflammatory cells infiltration in the subcutaneous muscle at different locations around abscess in the treatment group and pretreatment group was significantly lower than that in the control group and model group. Conclusion:The therapy of encircling lesion with Hongzhongxiao Tincture is applied in the treatment of rat skin abscess,which can alleviate inflammatory infiltration in tissue around abscess and improve the systemic and local infection by reducing the levels of CRP and PCT in plasma and MMP-2 level in secretion,and thus provide favorable conditions for the formation of defended field.
护场理论箍围法脓肿炎性因子大鼠
defended field theorytherapy of encircling lesion with drugsabscessinflammatory factorsrat
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