苦参碱对人增生性瘢痕治疗作用的临床研究

Clinical observation of hypertrophic scar treated with topical application of matrine

目的研究苦参碱(Matrine,Mat)对人增生性瘢痕治疗中成纤维细胞(fibroblast,FB)增生和凋亡的影响。方法以20例患者深Ⅱ度烧伤创面愈合后增生性瘢痕为研究对象,局部注射Mat后,利用DNA末端标记技术(TdT-mediateddUTPnick-endlabelingmethod,TUNEL),检测其FB的凋亡数量及其标记指数;利用免疫组织化学法检测其FB的增殖细胞核抗原(Proliferatingcellnuclearantigen,PCNA)的表达和其标记指数。结果增生性瘢痕局部注射Mat后与自身未经Mat治疗的增生性瘢痕对照组比,前者其FB凋亡数量明显增加,凋亡指数14d分别为0.32和0.07,28d分别为0.54和0.11;治疗组PCNA表达明显弱于对照组,PCNA标记指数14d分别为0.28和0.5,28d分别为0.54和0.75。结论Mat明显增加人增生性瘢痕FB的凋亡数量,降低其增殖活性,促进增生性瘢痕FB凋亡,使增生性瘢痕尽早地趋于非增生状态。

Objective To study the effect of Matrine on human hypertrophic scar with topical injection of matrine.Method To exploit human hypertrophic scarring tissues of 20 cases by injecting the matrine to compare the apoptosis of fibroblasts via TdT mediated dUTP nick end labeling method,to compare the expression of proliferating cell nuclear antigen, its labeling index via immunohistochemistry stain method between Matrine groups and the controls.Results Matrine could induced the apoptosis of the fibroblasts of hypertrophic scarring tissues to make the apoptosic quantity of the fibroblasts increased which are 0.32/0.07,0.54/0.11,could decrease expression of proliferating cell nuclear antigen to make its labeling index are 0.28/0.5,0.54/0.75 after injection matrine 14 days,28days respectively between Matrine groups and the controls.Conclusion Matrine is able to accelerate the apoptosis on human hypertrophic scarring tissues and to make the decrease the proliferative activitity. significantly orientate the the hyoertrophic scarring tissues towards the stable scar tissues.