温和灸对大鼠肛瘘术后创面组织修复中血管生成及微循环的影响

Effects of mild moxibustion on angiogenesis and microcirculation in wound repair after operation of anal fistula in rats

目的:观察温和灸对大鼠肛瘘术后创面修复中血管生成及微循环的影响并探讨其作用机制。方法:选用72只雄性 SD 大鼠用于模拟肛瘘术后模型,造模成功后,随机分为温和灸组、微波治疗组和空白对照组,每组24只。术后第1天起,温和灸组艾灸治疗创面15 min;微波治疗组予微波照射创面15 min;空白对照组不作任何处理。分别于术后第1、3、7和14天(治疗1、3、7和14 d,)从各组取出6只大鼠检测创面血流后处死,采集标本,免疫组织化学法测定创面肉芽组织中血管内皮生长因子(vascular endothelialgrowth factor,VEGF)表达及 CD34计数情况。结果:温和灸在创面修复初、中期能提高创面肉芽组织中 VEGF 表达及 CD34计数,增加创面局部血流,在术后第3天时开始增加,第7天达到高峰,然后开始下降;在创面修复后期(第14天),温和灸组和微波组创面局部血流和创面肉芽组织中 VEGF 表达及 CD34计数减少。治疗3、7和14 d 时,温和灸组大鼠创面局部血流、肉芽组织中 VEGF 表达及 CD34计数与空白对照组比较,差异有统计学意义(P<0.05)。治疗3、7 d时与微波组比较.温和灸组大鼠创面局部血流、肉芽组织中 VEGF 表达及 CD34计数明显升高(P<0.05),治疗14d 时明显下降(P<0.05).但 CD34计数比较差异无统计学意义。结论:温和灸对创面局部血流、创面肉芽组织中 VEGF 表达及 CD34计数具有较好的调节作用,可改善局部微循环,提高创面愈合质量。

Objective： To observe the effects of mild moxibustion on angiogenesis and microcirculation in wound repair after operation of anal fistula, and to explore the mechanism of action. Methods： Seventy-two SD male rats were made to bear an ＂acute, open, bleeding, Jnfected＂ wound surface and were divided randomly into mild moxibustion group, microwave group and control group （24 rats per group）. The wound surfaces of the treatment groups were treated for 15 min with mild moxibustion or microwave medical instrument from the first day after operation, and the control group was not given any treatment. At the first, third, seventh and fourteenth days after operation （1, 3, 7 and 14 days of treatment）, six rats in each group were sacrificed after examining the blood flow of the wound surface, and the samples of granulation tissues were collected. The numbers of CD3,4 and posi-tive expression of vascular endothelial growth factor （VEGF） in granulation tissues were detected.Results： In the early and middle stages of wound healing, mild moxibustion could obviously increase the expression of VEGF, the number of CD34, and the blood flow of the wound surface. And the expression of VEGF, the number of CD34, and the blood flow of the wound surface began to increase at the third day, and reached the peak level at the seventh day, and then began to decrease. In the late stage of wound healing （day 14）, mild moxibustion could decrease the expression of VEGF, the number of CD34, and decrease the blood flow of the wound surface. There were significant differences between the mild moxibustion group and the control group in the blood flow of the wound surface, the expression of VEGF and the numbers of CD34 in granulation tissues （P〈0.05） after treatment, and except the number of CD34 at 14-day treatment, there were also differences between the mild moxibustion group and the microwave group. Conclusion： Mild moxibustion has better regulative actions on blood flow of the wound surface and the number of CD34 and positive expression of VEGF in granulation tissues, and can regulate microcirculation in wound surface and promote the wound healing.