烫伤药水喷雾剂促进烫伤创面修复机理的临床及实验研究

发布时间：2018-11-03 06:55

【摘要】：烫伤药水是江苏省中医院外科临床常年使用的中医特色外用制剂,治疗小面积烫伤效果良好,临床发现具有止痛迅速、明显减少渗出、干燥创面、抗菌作用好、促进创面愈合、预防疤痕生成,效果优于同类药物。本课题是根据江苏省中医院老中医的经验方制成的本院制剂烫伤药水改进而成,结合了该产品在江苏省中医院应用多年的经验,运用中医药特色结合现代生物医药科技的方法,本课题包括了临床观察及动物实验两部分,对烫伤药水喷雾剂的疗效及其机理作更详细的研究。临床研究目的：观察烫伤药水喷雾剂对于小面积浅表烫伤的临床效果。方法：将30例小面积浅表烫伤的病人分为两组,治疗组15例,对照组15例,治疗组用烫伤药水外用,对照组使用凡士林纱布,每日换药1次,治疗开始后于第1,3,5天以相同焦距,相同距离拍摄创面的图片。辅以Image J软件,测算创面面积,然后计算创面愈合率。参照国家中医药管理局医政司制定的《中医临床病症诊断疗效标准》,治疗2周后进行评价疗效,观察本品治疗烫伤的综合疗效。采用、VAS疼痛评分法,评估其止痛效果。结果：在创面愈合率的指标检测中,治疗组的第一天及第五天创面愈合率相比对照组,具有明显统计学差异,且随着时间的推移,创面愈合率差异更加明显。在综合疗效评分的观察中,治疗组相对于对照组,患者第一天和第三天的疗效评分治疗组远高于对照组,且随着时间的推移,两组的差异越发明显。在疼痛评分的观察中,治疗组的疼痛评分相对于对照组,具有显著的统计学意义。实验研究目的：研究烫伤药水喷雾剂与创面愈合及防治疤痕生成的关系。方法：分为两部分,第一部分：观察烫伤药水喷雾剂对大鼠烫伤创面愈合的影响。方法：将150只SD大鼠采用浅Ⅱ度烫伤模型,随机分为五组,实验高、中、低剂量组(烫伤药水喷雾剂),阳性对照组(磺胺嘧啶银软膏),阴性对照组(基质软膏)。检测创面组织含水量及新生毛细血管数。第二部分：采用大鼠深II度烫伤模型。喷涂烫伤药水(第一部分实验的中剂量组),并用磺胺嘧啶银作疗效对比,用基质软膏作空白对照。创伤后于第3,7,14天麻醉下分别取皮,送至病理科。分别测试(1).组织内Ⅰ、Ⅲ型胶原检测,(2).凋亡细胞计数组织内TGF-β1的表达；(3)并用Tunnel法测凋亡指数。结果：烫伤药水在组织含水量的测定中,实验组低于阳性对照组,在新生的毛细血管的数目测定中实验组高于阳性对照组,烫伤药水对TGF-β1表达,实验组随时间逐渐减少,磺胺嘧啶银组及阴性组随时间渐渐增加,第14天无明显下降。Ⅰ型胶原、Ⅲ型胶原在第3、14天实验组与阴性组相比,含量高于阴性组,实验组的I型胶原随时间逐渐增多,而Ⅲ型胶原随时间逐渐减少。优于阴性组。结论：烫伤药水喷雾剂能促进创面愈合,减少疼痛,控制感染,预防疤痕生成的作用。
[Abstract]:Scalding medicine is a traditional Chinese medicine special external preparation used in surgery of Jiangsu Provincial Hospital of traditional Chinese Medicine for many years. It has a good effect in treating small area scalding. It is found that it can relieve pain quickly, obviously reduce exudation, dry wound, have good antibacterial effect, and promote wound healing. Prevention of scar formation, the effect is better than the same drug. This subject is based on the experience of the traditional Chinese medicine of Jiangsu Provincial traditional Chinese Medicine Hospital, which has been improved by the scalding solution of this hospital. It combines the experience of the application of this product in Jiangsu traditional Chinese Medicine Hospital for many years, and the method of combining the characteristics of traditional Chinese medicine with modern biomedical science and technology. This paper includes two parts, clinical observation and animal experiment, to study in detail the curative effect and mechanism of scald solution spray. Objective: to observe the clinical effect of scalding liquid spray on small area superficial burn. Methods: thirty patients with small area superficial scalding were divided into two groups: the treatment group (n = 15) and the control group (n = 15). The treatment group was treated with scalding solution, the control group was treated with vaseline gauze, and the control group was treated with vaseline gauze once a day. The wounds were photographed at the same focal length and at the same distance for 5 days. With Image J software, the wound area was calculated and the wound healing rate was calculated. According to the criteria for the diagnosis of clinical symptoms of traditional Chinese medicine formulated by the Department of Medical and political Affairs of the State Administration of traditional Chinese Medicine, the curative effect was evaluated after 2 weeks of treatment, and the comprehensive efficacy of this product in the treatment of scalds was observed. VAS pain score was used to evaluate the analgesic effect. Results: the rate of wound healing in the treatment group was significantly different from that in the control group on the first day and the fifth day, and with the passage of time, the difference of the wound healing rate was more obvious. Compared with the control group, the curative effect score of the treatment group on the first day and the third day was much higher than that of the control group, and the difference between the two groups became more and more obvious with the passage of time. In the observation of pain score, the pain score in the treatment group was significantly higher than that in the control group. Objective: to study the relationship between scald spray and wound healing and scar formation. Methods: two parts were divided. The first part was to observe the effect of scald solution spray on wound healing of scalded rats. Methods: 150 SD rats were randomly divided into five groups: high, middle and low dose groups (scalded liquid spray), positive control group (silver sulfadiazine ointment) and negative control group (matrix ointment). The water content of wound tissue and the number of neonate capillaries were measured. The second part: the model of deep II scald in rats. Spray scald solution (middle dose group of the first part of the experiment), using silver sulfadiazine as the curative effect contrast, using the matrix ointment as the blank control. The skin was taken under anesthesia on the 3rd day and sent to the pathology department. Test respectively (1). Detection of collagen 鈪，

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