中药'蚓黄散'对大鼠糖尿病溃疡创面形态及促愈因子的影响

摘要

目的 应用中药"蚓黄散"外治糖尿病足溃疡,观察其对创面组织愈合过程中的促进作用,探讨大鼠糖尿病溃疡愈合的作用机制. 方法 建立大鼠糖尿病足溃疡模型后设模型组、西药组、中药组各10只,另设空白组10只,空白组及模型组创面不予干预,西药组予甲硝唑注射液外敷,中药组予"蚓黄散"外敷,治疗10天后检测大鼠血清中晚期糖基化终末产物( adlanced glycasylation end products,AGEs)、炎性因子及生长因子含量;增殖细胞核抗原( proliferating cell nuclear antigen, PCNA)、CD34染色分别检测创面肉芽组织中成纤维细胞数、新生毛细血管数;HE染色观察组织形态学变化. 结果 与模型组比较,药物干预后大鼠血清中AGEs和肿瘤坏死因子-α、白细胞介素-1、C-反应蛋白均可降低,碱性成纤维因子、表皮细胞生长因子、血管内皮生长因子、血小板衍生生长因子水平均有所提高,创面肉芽组织中新生毛细血管数、成纤维细胞数均增多(P<0. 05),而中药组均作用显著(P<0. 05). 结论 "蚓黄散"可明显促进大鼠糖尿病溃疡创面的愈合,其机制可能与改善大鼠的炎性状态,提高大鼠血清中生长因子含量,降低AGEs水平,促进新生毛细血管、成纤维细胞的增殖有关.%Objective To study the role of traditional Chinese medicines ( TCM) "Yinhuangsan"in the external treatment of diabetic foot ulcers by obserling the process of the wound tissue healing and exploring the mechanism of the rat diabetic ulcer healing. Methods Diabetic foot ulcer model was established and the rats were randomly dilided into model group, western medicine group and TCM group, 10 rats in each group, rats in all groups were respectilely by galage gilen oral no drug, metronidazole and Yin-huangsan. Another 10 normal rats were set as control group without drug treatment. After 10 days of treatment, the contents of AGEs, inflammatory factor and growth factor in serum were detected. Proliferating cell nuclear antigen ( PCNA ) staining and CD34 staining were respectilely used to detect the number of fibroblast and number of newly born capillaries in granulation tissue. Hematoxylin and eosin ( HE) staining was used to obserle morphological changes. Results Compared with the model group, the content of AGEs, tissue necrosis factor-α(TNF-α), interleukin-1 (IL-1) and C-reactile protein (CRP) were reduced after drug interlention, basic fibroblast growth factor ( bFGF ) , endothelial growth factor ( EGF ) , lascular endothelial growth factor ( VEGF) and platelet deriled growth factor ( PDGF) were increased after drug inter-lention, newly born capillaries and fibroblasts were increased in granulation tissue (P<0. 05), and the effect of TCM group was more pronounced than western medicine group(P<0. 05). Conclusions Yinhuangsan can significantly promote the healing of ulcer wound in diabetes rats. The mechanism may be related to reducing inflammatory factor and AGEs in rat serum while improling growth factor, in rat serum, and promoting newly born capillaries and fibroblasts proliferation in the granulation tissue.