| 张海丽,回雪颖,孙凤娟,王 景,滕 林,郭伟光,于 洋.湿润烧伤膏联合全蝎软膏治疗糖尿病性皮肤溃疡的疗效观察[J].,2020,(14):2640-2645 |
| 湿润烧伤膏联合全蝎软膏治疗糖尿病性皮肤溃疡的疗效观察 |
| Therapeutic Effect of MEBO Combined with Scorpion Ointment on the Diabetic Cutaneous Ulcers |
| 投稿时间：2020-01-08 修订日期：2020-02-04 |
| DOI：10.13241/j.cnki.pmb.2020.14.008 |
| 中文关键词: 全蝎软膏 湿润烧伤膏 糖尿病皮肤溃疡 AGEs-RAGE信号通路 Smad 4蛋白 |
| 英文关键词: Scorpion ointment Moist exposed burn ointment Diabetic cutaneous ulcers AGEs-RAGE signal pathway Smad 4 protein |
| 基金项目:黑龙江省自然科学基金项目（H2017067）；黑龙江省中医药学会科研项目（ZHY19-052）；黑龙江中医药大学校基金项目（201812）；黑龙江省第一批省级名中医师承项目 黑龙江中医药大学附属第二医院孙申田青年人才基金（2019KY-03） |
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| 中文摘要: |
| 摘要 目的：评价湿润烧伤膏和全蝎软膏联用治疗糖尿病皮肤溃疡创面愈合的效果并探讨其作用机制。方法：选择Wistar大鼠建立糖尿病皮肤溃疡模型，采用随机数字表法将其分为对照组、模型组、全蝎软膏组、湿润烧伤膏组和联用组，以连续饲喂高脂饲料、腹腔注射链脲佐菌素（STZ）及皮肤损伤法制备糖尿病皮肤溃疡大鼠模型。造模后，分别在创伤处进行药物干预处理，空白组和模型组用PBS处理并计算创面愈合率；采用免疫组化、创面组织超微病理结构观察给药后3 d、7 d、10 d和14 d的创面肉芽组织，western-blot检测Smad4蛋白的表达。结果：糖尿病皮肤溃疡模型组的大鼠体重、血糖与正常组相比有统计学差异，成模率为95.45%；经14 d连续治疗后，各治疗组创面愈合率均高于模型组（P＜0.05），联用组创面愈合率与对照组水平接近。免疫组化染色结果显示与模型组相比，经药物干预后的创面组织内AGEs和RAGE的表达水平均明显下调（P＜0.05）；电镜观察结果表明联用湿润烧伤膏和全蝎软膏能够促进胞内细胞器恢复正常水平，其改善效果较单独药物干预组效果更显著；Western-blot检测结果表明各治疗组创面组织内Smad 4蛋白水平较模型组显著降低，但联用组中Smad4蛋白水平下调更显著（P<0.05）。结论：联合应用湿润烧伤膏和全蝎软膏能够有效促进大鼠糖尿病性皮肤溃疡创面的愈合，可能与调控组织中糖基化终末产物AGEs-RAGE信号通路及下调Smad4蛋白表达水平，抑制炎症反应有关。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the efficacy and mechanism of MEBO and scorpion ointment in the treatment of diabetic cutaneous ulcers (DCU). Methods: Wistar rats were selected to construct diabetic skin ulcer model. Firstly, the model group was divided into control group, model group, scorpion ointment group, MEBO group and combination group, respectively. Diabetic skin ulcer rat model was established by continuous feeding of high fat diet, intraperitoneal injection of streptozotocin (STZ) and skin injury. After the model was made, drug intervention was carried out at the wound site, and PBS was used in the blank group and the model group to calculate the wound healing rate. On the 3 d, 7 d, 10 d and 14 d after administration, the granulation tissue of the wound was observed by immunohistochemistry, ultrastructural observation and Western-blot detection of Smad4 protein. Results: The body weight and blood sugar of diabetic skin ulcer model group were significantly different from those of normal group, which model rate was 95.45%. After 14 days of continuous treatment, the wound healing rate of each treatment group was higher than that of the model group (P＜0.05). The results of electron microscopy showed that combination group could promote the normal level of intracellular organelles, and the effect of MEBO was more significant than that of single drug intervention group. The western-blot showed that the level of Smad4 protein in the wound tissue of each treatment group was significantly lower than that of the model group (P<0.05), but the down-regulation of Smad4 protein in the combination group was more significant. Conclusion: The combination of MEBO and scorpion ointment can effectively promote the healing of diabetic skin ulcer in rats, which inhibits inflammation and improves vascular function by regulating ages-rage signal pathway and down regulating Smad4 protein expression that provides a new way for clinical treatment of diabetic skin ulcer. |
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