中西药局部用药对大鼠体表瘘模型术后创面愈合影响的实验研究
发布时间：2018-08-19 16:55
【摘要】：目的:通过中西药创面局部联合用药对大鼠体表瘘模型术后创面影响的实验研究,是为了将此方法运用于临床,促进高位复杂性肛瘘患者术后创面的愈合。方法:通过埋置弹簧纱条,制作大鼠体表瘘模型。成功建立大鼠体表瘘术后模型后,随机分为A组(空白对照生理盐水组)、B组(阿米卡星洗剂组)、C组(龙血竭组)及D组(龙血竭+阿米卡星洗剂组)各20只,单笼饲养。各组大鼠创面分别、同时于造模成功术后第二天开始予以相对应的治疗换药,1次/日。分别于造模成功术后第3天、第7天、第14天每组随机选取5只大鼠创面,采用HE染色方法观察大鼠创面组织的炎症变化情况,采用Masson三色染色观察大鼠创面肉芽组织中胶原纤维增生情况,采用CD34染色观察大鼠创面肉芽组织中新生血管数量;余下各组大鼠分别记录创面完全愈合即创面达上皮化的时间和创面愈合率。结果:(1)创面愈合率,分别对比不同观察时间各组大鼠创面平均愈合率,D组与A组、B组、C组相比,均得到P0.05;(2)HE染色法分别观察创面术后第3天炎症反应情况,D组较A组、B组、C组炎症反应较轻,有一定量的新生血管和成纤维细胞及纤维组织增生;术后第7天D组较A组、B组、C组可见大量新生血管增生,成纤维细胞数量较多;术后第14天可见少量炎性细胞浸润,成纤维细胞数量较多,纤维组织面积扩大,创面处可见结痂。(3)Masson三色染色法观察不同观察时间创面胶原纤维数量,术后第3天,D组、B组与A组相比,P0.05;术后第7天,D组、B组及C组与A组相比,P0.05,D组、C组与B组相比,P0.05,D组与C组相比,P0.05;术后第14天,D组与A组、B组、C组相比,P0.05。(4)CD34染色法分别检测不同观察时间点创面新生血管数量,术后第3天,D组、B组及C组与A组相比,P0.05,D组、C组与B组相比,P0.05;术后第7天,D组、B组及C组与A组相比,P0.05,D组、C组与B组相比,P0.05,D组与C组相比,P0.05;术后第14天,D组、B组及C组与A组相比,P0.05,D组与B组相比,P0.05。(5)愈合时间,D组与A组、B组级C组相比,P0.05。结论:龙血竭联合阿米卡星洗剂局部外用于感染创面组织有利于促进伤口愈合,缩短创面愈合的时间。其作用机理可能与血竭中黄酮类有效成分能促进成纤维细胞增殖,从而增加胶原纤维的合成有关;同时,血竭中多酚类有效成分具有抗炎、杀菌等一定的作用,对感染创面炎症的消退有促进作用。联合阿米卡星洗剂的运用,加大了对感染创面组织抗感染能力,减轻创面炎症反应,为新生肉芽组织增生提供良好的增生环境。故二者联合局部外用于高位复杂性肛瘘术后创面,减少了创面分泌物,提高了创面愈合率,明显缩短了创面愈合的时间,并能一定程度减少术后复发,是完全可行的。
[Abstract]:Objective: to study the effect of local combined use of traditional Chinese and western medicine on the wound surface of rats after operation in order to apply this method to clinical practice and promote the wound healing of patients with high complex anal fistula. Methods: the rat model of surface fistula was made by embedding spring gauze. After successful establishment of the model after operation, the rats were randomly divided into two groups: group A (control saline group), group B (amikacin lotion group), group C (Dragon's blood solution group) and group D (Armikacin lotion group). The wounds of each group were treated with the corresponding treatment and dressing change once a day after successful operation. On the 3rd, 7th and 14th day after successful operation, 5 rats in each group were randomly selected, and the inflammatory changes of the wound tissue were observed by HE staining. The proliferation of collagen fibers in granulation tissue was observed by Masson staining and the number of neovascularization in granulation tissue was observed by CD34 staining. The time of complete wound healing and wound healing rate were recorded. Results: (1) the average wound healing rate of each group was compared with that of group A and B, respectively. (2) the inflammatory reaction in group D was lighter than that in group A and B on the 3rd day after operation, and there were a certain amount of neovascularization, fibroblast and fibrous tissue proliferation. On the 7th day after operation, a large number of neovascularization and fibroblasts were observed in group D as compared with those in group A and B, and a small number of inflammatory cells were observed in group D on the 14th day after operation, the number of fibroblasts was more and the area of fibrous tissue was enlarged. (3) Masson trichrome staining method was used to observe the number of collagen fibers in wound at different observation time. On the 3rd day after operation, group D and group A were compared with group A (P 0.05); group D (group D) and group C (group C) were compared with group A (P 0.05) on the 7th day after operation; group C (group C) was compared with group B (group B) compared with group C (P 0.05); group D (group D) was compared with group C (group C) by P0.05 (P 0.05); group D (group D) was compared with group A (group C) by CD34 staining on the 14th day after operation. Do not detect the number of neovascularization at different observation time points, On the 3rd day after operation, group B and group C were compared with group A and group A, group C and group B were compared with group B, and group B and group C were compared with group A on the 7th day after operation (P 0.05D and group C compared with group A; P 0.05D vs group C; P 0.05D vs group C; 14 days after operation). (5) the healing time of group D was higher than that of group A (P 0.05), and that of group B (group C) was higher than that of group B (P 0.05), and that of group C (group C) was higher than that of group B (P < 0.05). Conclusion: the combination of Dragon's Blood and Amikacin lotion can promote wound healing and shorten wound healing time. The mechanism may be related to the effect of flavonoids on fibroblast proliferation and collagen synthesis, and the anti-inflammatory and bactericidal effects of polyphenols. It can promote the subsiding of infection wound inflammation. Combined with Amikacin lotion, the anti-infection ability of infected wound tissue was increased, the inflammatory reaction of wound was alleviated, and a good proliferative environment was provided for the proliferation of neonate granulation tissue. Therefore, it is feasible to combine the two methods to reduce wound secretion, improve wound healing rate, shorten wound healing time and reduce postoperative recurrence to a certain extent.
【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.16;R-332
本文编号：2192259
[Abstract]:Objective: to study the effect of local combined use of traditional Chinese and western medicine on the wound surface of rats after operation in order to apply this method to clinical practice and promote the wound healing of patients with high complex anal fistula. Methods: the rat model of surface fistula was made by embedding spring gauze. After successful establishment of the model after operation, the rats were randomly divided into two groups: group A (control saline group), group B (amikacin lotion group), group C (Dragon's blood solution group) and group D (Armikacin lotion group). The wounds of each group were treated with the corresponding treatment and dressing change once a day after successful operation. On the 3rd, 7th and 14th day after successful operation, 5 rats in each group were randomly selected, and the inflammatory changes of the wound tissue were observed by HE staining. The proliferation of collagen fibers in granulation tissue was observed by Masson staining and the number of neovascularization in granulation tissue was observed by CD34 staining. The time of complete wound healing and wound healing rate were recorded. Results: (1) the average wound healing rate of each group was compared with that of group A and B, respectively. (2) the inflammatory reaction in group D was lighter than that in group A and B on the 3rd day after operation, and there were a certain amount of neovascularization, fibroblast and fibrous tissue proliferation. On the 7th day after operation, a large number of neovascularization and fibroblasts were observed in group D as compared with those in group A and B, and a small number of inflammatory cells were observed in group D on the 14th day after operation, the number of fibroblasts was more and the area of fibrous tissue was enlarged. (3) Masson trichrome staining method was used to observe the number of collagen fibers in wound at different observation time. On the 3rd day after operation, group D and group A were compared with group A (P 0.05); group D (group D) and group C (group C) were compared with group A (P 0.05) on the 7th day after operation; group C (group C) was compared with group B (group B) compared with group C (P 0.05); group D (group D) was compared with group C (group C) by P0.05 (P 0.05); group D (group D) was compared with group A (group C) by CD34 staining on the 14th day after operation. Do not detect the number of neovascularization at different observation time points, On the 3rd day after operation, group B and group C were compared with group A and group A, group C and group B were compared with group B, and group B and group C were compared with group A on the 7th day after operation (P 0.05D and group C compared with group A; P 0.05D vs group C; P 0.05D vs group C; 14 days after operation). (5) the healing time of group D was higher than that of group A (P 0.05), and that of group B (group C) was higher than that of group B (P 0.05), and that of group C (group C) was higher than that of group B (P < 0.05). Conclusion: the combination of Dragon's Blood and Amikacin lotion can promote wound healing and shorten wound healing time. The mechanism may be related to the effect of flavonoids on fibroblast proliferation and collagen synthesis, and the anti-inflammatory and bactericidal effects of polyphenols. It can promote the subsiding of infection wound inflammation. Combined with Amikacin lotion, the anti-infection ability of infected wound tissue was increased, the inflammatory reaction of wound was alleviated, and a good proliferative environment was provided for the proliferation of neonate granulation tissue. Therefore, it is feasible to combine the two methods to reduce wound secretion, improve wound healing rate, shorten wound healing time and reduce postoperative recurrence to a certain extent.
【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.16;R-332
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