摘要
目的:探讨乌蔹莓软膏对肛瘘术后小鼠感染性创面愈合的影响及机制。方法:将40只小鼠按随机数表法分为空白组、模型组、阳性对照组、乌蔹莓软膏组各10只。将所有小鼠采用综合法构建肛瘘术后创面感染模型。于每天换药前0.5 h在空白组小鼠创面滴加0.2 mL生理盐水,在模型组、阳性对照组、乌蔹莓软膏组小鼠创面滴加0.2 mL菌液,模拟排便状态。先用碘伏清理各组小鼠创面,后用无菌纱布覆盖空白组、模型组小鼠创面,分别用复方多黏菌素B软膏、乌蔹莓膏浸润的纱布覆盖阳性对照组、乌蔹莓软膏组小鼠创面,用医用胶带固定。每天于固定时间换药1次,连续14 d。分别于术后第3、7、14天计算每组小鼠创面愈合率;用苏木精-伊红(HE)染色评估各组创面肉芽组织的形态学改变;酶联免疫吸附试验(ELISA)检测各组创面肉芽组织中炎症介质[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]和生长因子[血管内皮生长因子(VEGF)、成纤维细胞生长因子(FGF)]水平;采用平板计数法检测创面菌载量。结果:术后第7、14天,乌蔹莓软膏组小鼠创面愈合率均高于模型组(均P<0.05),与阳性对照组比较差异无统计学意义(P>0.05);乌蔹莓软膏组小鼠创面肉芽组织炎症细胞浸润较模型组减少,与阳性对照组效果相当;乌蔹莓软膏组小鼠创面组织TNF-α、IL-6水平低于模型组(均P<0.05),生长因子VEGF、FGF水平随时间递增,显著高于模型组(均P<0.05),与阳性对照组比较差异无统计学意义(P>0.05)。乌蔹莓软膏组菌量低于临床感染阈值(5 log10 CFU/g),且较阳性对照组进一步降低22.4%(P<0.05)。结论:乌蔹莓软膏可通过减少炎症反应、发挥抗菌活性、加快肉芽组织生成,促进肛瘘术后小鼠创面愈合。
Objective:To investigate the effects and underlying mechanisms of Cayratia japonica ointment on the healing of infected wounds in mice after anal fistula surgery.Methods:Forty mice were randomly divided into four groups(n=10 per group)using a random number table:blank group,model group,positive control group,and C.japonica ointment group.An infected postoperative wound model of anal fistula was established in all mice using a combined modeling method.At 0.5 h before daily dressing changes,0.2 mL of normal saline was applied dropwise to the wounds of mice in the blank group,while 0.2 mL of bacterial suspension was applied to the wounds of mice in the model,positive control,and C.japonica ointment groups to simulate defecation conditions.After wound cleansing with iodophor,sterile gauze was used to cover the wounds of mice in the blank and model groups,whereas gauze impregnated with compound polymyxin B ointment or C.japonica ointment was applied to the wounds of mice in the positive control and C.japonica ointment groups,respectively,and fixed with medical adhesive tape.Dressings were changed once daily at a fixed time for 14 consecutive days.On postoperative days 3,7,and 14,wound healing rates were calculated for each group.Morphological changes in wound granulation tissue were evaluated by hematoxylin-eosin(HE)staining.Levels of inflammatory mediators[tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)]and growth factors[vascular endothelial growth factor(VEGF)and fibroblast growth factor(FGF)]in granulation tissue were measured by enzyme-linked immunosorbent assay(ELISA).Wound bacterial load was determined using the plate counting method.Results:On postoperative days 7 and 14,wound healing rates in the C.japonica ointment group were significantly higher than those in the model group(all P<0.05),with no statistically significant differences compared with the positive control group(P>0.05).Inflammatory cell infiltration in wound granulation tissue was reduced in the C.japonica ointment group compared with the model group,with effects comparable to those of the positive control group.Levels of TNF-αand IL-6 in wound tissue were lower in the C.japonica ointment group than in the model group(all P<0.05).Levels of VEGF and FGF increased over time and were significantly higher than those in the model group(all P<0.05),with no statistically significant differences compared with the positive control group(P>0.05).The bacterial load in the C.japonica ointment group was below the clinical infection threshold(5 log 10 CFU/g)and was further reduced by 22.4%compared with the positive control group(P<0.05).Conclusion:C.japonica ointment promotes wound healing in mice after anal fistula surgery by reducing inflammatory responses,exerting antibacterial activity,and accelerating granulation tissue formation.
作者
周勉
周雨婷
兰青
张兴德
殷莉娜
皇甫少华
郑雪平
ZHOU Mian;ZHOU Yuting;LAN Qing;ZHANG Xingde;YIN Lina;HUANGFU Shaohua;ZHENG Xueping(Nanjing University of Chinese Medicine,Nanjing 210029,China;Second Affiliated Hospital of Soochow University,Suzhou 215000,China;School of Pharmacy,Nanjing University of Chinese Medicine,Nanjing 210038,China;Jiangsu Province Hospital of Chinese Medicine(Lianyungang Hospital),Lianyungang 222000,China;Affiliated Nanjing Hospital of Chinese Medicine,Nanjing University of Chinese Medicine,Nanjing 210001,China)
出处
《世界中医药》
北大核心
2025年第24期4432-4439,4445,共9页
World Chinese Medicine
基金
国家自然科学基金项目(82004365)
江苏省中医临床医学创新中心研究项目(GCCXZX-2021-YJXM5)
2024年江苏省研究生实践创新计划(SJCX24_1102)
南京市“十三五”规划名中医工作室建设项目(ZXP-2019-NJ)
南京市卫生科技发展项目(YKK21197)
第六批南京市老中医药专家学术经验继承项目(2024NJLPSC-ZXP)。
关键词
乌蔹莓软膏
肛瘘术后
感染性创面
创面愈合
炎症反应
肉芽组织
血管生成与组织修复
抗菌活性
Cayratia japonica ointment
Postoperative anal fistula
Infected wound
Wound healing
Inflammatory response
Granulation tissue
Angiogenesis and tissue repair
Antibacterial activity
