烧伤创面愈合过程中胶原代谢与针刺作用的影响

Effect of collagen metabolism and acupuncture on burn wound healing

背景:针刺可促进烧伤创面愈合,但对创面组织胶原代谢的影响尚不清楚。目的:观察针刺对烧伤创面愈合过程中胶原代谢的影响。设计、时间及地点:随机对照动物实验,于1997-01/2005-12在广州市创伤外科研究所完成。材料:雌性新西兰大白兔27只,体质量2.0～2.5kg,用于制备深Ⅱ度烧伤模型。方法:每个兔背部脊柱两旁造成10个创面。实验分为3组,正常组(n=3):只背部剃毛备用;常规治疗组:伤后自由进食,创面外用25g/L的碘伏暴露;针刺组:在常规治疗的基础上,伤后24h内开始针刺治疗,取双侧"足三里(ST36)"穴,针刺后接电针仪,频率20Hz,时间30min,1次/d。伤后3,7,13,21d常规治疗组和针刺组各取3只动物处死,取组织待测。主要观察指标:各组动物不同时间点创面组织中羟脯氨酸水平。结果:27只大白兔均进入结果分析。烧伤后13d常规治疗组和针刺组创面组织中羟脯氨酸水平均低于正常皮肤组织(P<0.05)。伤后21d常规治疗组创面组织中羟脯氨酸达到正常皮肤组织水平,两组相比差异无显著性意义(P>0.05)。而针刺组创面组织中羟脯氨酸水平高于常规治疗组和正常皮肤组织(P<0.05)。结论:针刺可促进烧伤创面胶原的合成。

BACKGROUND： The acupuncture can enhance the burn wound healing, but the effect of acupuncture on wound collagen metabolism is unclear. OBJECTIVE： To explore the effect of acupuncture on mechanism in the process of wound healing. DESIGN, TIME AND SETTING： The randomized controlled experiment of animal was conducted at the Guangzhou Trauma Institutes from January 1997 to December 2005. MATERIALS： A total of 27 female, white, New Zealand rabbits, weighing 2.0-2.5 kg, were used for establish the burn animal model with deep Ⅱ burn. METHODS： Each rabbit in the experimental groups were made 10 wounds on the both sides of the spine. Rabbits were randomly divided to three groups： the normal group （n=3）; the routine treatment group （n=12）： eating and drinking freely after wounded, and the wound administered with 25 g/L iodophor; the acupuncture treatment group （n= 12）： based on the routine treatment, acupuncture the zusanli （ST36） point in 24 hours following injury. The wound tissue in both routine treatment group （n=3） and acupuncture treatment group （n=3） at time point of 3, 7, 13, 21 days after wounded were harvested. MAIN OUTCOME MEASURES： The content changes of hydroxyproline in wound tissue of each group were measured in various time points. RESULTS： Totally 27 rabbits were involved in the result analysis. The content of hydroxyproline of wound tissues in the normal and acupuncture treatment groups were lower than that of the normal group at 13 days after wounded （P 〈 0.05）. However, the content of hydroxyproline in the routine treatment group reached the level of the control group at 21 days after wounded, there had no significantly differences between two groups （P 〉 0.05）. The content of hydroxyproline in the acupuncture treatment group was greater compared with the routine treatment and the normal groups （P 〈 0.05）. CONCLUSION： The acupuncture can accelerate the collagen synthesis of burn wound.