防治瘢痕外用复方中药对兔耳增生性瘢痕微血管及血流的影响

Effect of compound traditional Chinese medicine unguent on micro-vessel and its blood flow in rabbit's ears of hypertrophic scar

目的:观察一种防治瘢痕的外用复方中药对兔耳增生性瘢痕微循环的影响。方法:实验于2005-07/10在解放军第四军医大学西京医院整形外科中心实验室完成。①选用新西兰大耳白兔8只。进行兔耳增生性瘢痕动物模型的复制。实验分为2组:随机将每只兔子2只耳朵分别设为瘢痕膏组和对照组,每组8只兔耳,48个创面。瘢痕膏组和对照组于创面上皮化时即开始用药。瘢痕膏组涂抹瘢痕膏(本院自行研制的外用复方中药制剂。其主要成分为丹参酮、积雪甙、黄芩甙、甘草酸、苦参碱等,按3∶3∶2∶2∶1的比例加基质制作而成),对照组涂抹基质(制作瘢痕膏的基质)。将瘢痕膏及基质涂在瘢痕部位,并轻揉直到药物吸收,3次/d,连续用药28d。②第14天根据兔耳创面修复的颜色、质地等统计瘢痕块发生率;第28天观察两组瘢痕组织的外观形态(颜色、质地等);用PeriFlux5000激光多普勒血流仪测瘢痕组织微循环血流灌注;常规ABC免疫组织化学法染色,200倍光镜下微血管计数。③计量和计数资料差异比较分别采用t检验和χ2检验。结果:兔8只(16耳)均进入结果分析。①创面上皮化后14d,瘢痕膏组瘢痕块发生率明显低于对照组犤67%(32/48),85%(41/48),P<0.05犦。②用药28d后瘢痕膏组瘢痕略高出兔耳皮肤表面,颜色稍白,接近兔耳正常肤色,触之质软;对照组瘢痕明显高出兔耳皮肤表面,红色,质地硬。③用药28d后,瘢痕膏组兔耳瘢痕组织微循环血流灌注值明显低于对照组犤(20.78±2.47),(36.79±3.12)PU,P<0.05犦。④用药28d后,瘢痕膏组兔耳瘢痕组织微血管计数明显低于对照组犤(26.8±5.4),(42.7±7.2)个/mm2,P<0.05犦。结论:此外用复方中药对兔耳增生性瘢痕微血管形成、微循环血流有抑制作用,对增生性瘢痕有防治作用。

AIM： To investigate the effect of compound Chinese herb unguent on the microcirculation in rabbit＇s ears of hypertrophic scar （HS）. METHODS： The experiment was completed in the Laboratory of Department of Plastic Surgery, Xijing Hospital of the Fourth Military Medical University of Chinese PLA from July to October 2005. ① Eight New Zealand rabbits were chosen as experiment animals. The models of HS in ears were reproduced. Two ears of each rabbit were divided into scar group and control group with 8 rabbits in each group and 48 scared appearances. Medication was completed in scar group and control group after epithelization. Rabbits in scar group were smeared with scar unguent （provided by our hospital; the main components： dan-shen keton, asiaticosede, baiealin, glycyrrhizic acid, sophorcarpidine, etc.; according to the radio of 3：3：2：2：1）, but in control group were smeared with ground substance （ground substance of making scar unguent）. Scar unguent and ground substance were smeared on the scared sites and rubbed until the absorption of it, three times a day for 28 successive days. ② On the 14^th day, the incidence of HS was recorded on the basis of color and quality of scarred appearance. Twenty-eight days later, the appearance of scars was observed. Blood perfusion of microcirculation in scar tissue was detected with PeriFlux5000 laser Doppler blood equipment and stained with routine ABC immunohistochemistry, and micro-vessel number was counted under light microscope （×200）.③ Measurement data and enumeration data were compared with t test and χ^2 test respectively. RESULTS： Sixteen ears of 8 rabbits entered the result analysis. ① After 14-day epithelization, incidence of scar was lower in scar group than that in control group [67% （32/48）, 85% （41/48）, P 〈 0.05]. ②After 28-day medication, the scars in scar group became depauperate markedly, higher than the skin slightly, close to the normal skin in color and soft when touching; but they appeared proliferative in the control group and were higher than the skin obviously with red color and hard when touching. ③ Blood flow of micro circulation was lower in scar group than that in control group after 28-day medication [（20.78±2.47）, （36.79±3.12） PU, P 〈 0.05]. ④Micro-vessel counting was lower in scar group than that in control group [（26.8±5.4）; （42.7±7.2）/mm^2, P 〈 0.05]. CONCLUSION： This compound unguent can inhibit the blood flow and the formation of micro-vessels in the hypertrophic scars of rabbit＇s ears, and also has prevention and cure on hypertrophic scar.