生肌玉红膏对增生性瘢痕的抑制作用

Shengjiyuhong ointment inhibits hypertrophic scar formation

背景:文献研究和临床使用中均发现生肌玉红膏具有减轻瘢痕的作用。目的:进一步验证生肌玉红膏对增生性瘢痕的作用。方法:36只日本大耳白兔,每只兔耳造4个直径1 cm圆形全层皮肤和软骨膜缺损创面,共288个创面随机分为6组,分别为模型组,基质组(不含生药),生肌玉红膏低浓度组(生药浓度为8.39%),中浓度组(生药浓度为25.18%),高浓度组(生药浓度为75.54%)和重组牛碱性成纤维细胞生长因子外用溶液阳性对照组。造模后除模型组不予处理外,其余分别给予相应药物涂抹或喷于整个创面,2次/d,直至创面愈合。造模后20,30 d根据温哥华瘢痕量表进行评分;瘢痕标本在显微镜40倍下测量并计算瘢痕增生指数,荧光定量PCR检测Ⅰ、Ⅲ型胶原、结缔组织生长因子、纤连蛋白和α-平滑肌肌动蛋白的mR NA表达,Western bloting检测Ⅰ、Ⅲ型胶原和α-平滑肌肌动蛋白的蛋白表达,免疫荧光染色检测α-平滑肌肌动蛋白的蛋白表达。结果与结论:(1)各组的温哥华瘢痕量表评分和瘢痕增生指数均于30 d显著上升(P<0.05)。与模型组比较,中、高浓度组和阳性对照组温哥华瘢痕量表评分和瘢痕增生指数显著改善(P<0.05,P<0.01),并显著低于基质组和低浓度组(P<0.05,P<0.01);(2)中浓度组和阳性对照组均显著抑制α-平滑肌肌动蛋白和Ⅰ、Ⅲ型胶原、结缔组织生长因子和纤连蛋白的m RNA表达,及α-平滑肌肌动蛋白和Ⅰ、Ⅲ型胶原的蛋白表达(P<0.01);(3)结果表明,生肌玉红膏可抑制肌成纤维细胞增殖,减少胶原沉积,从而减轻瘢痕增生。

BACKGROUND： Shengjiyuhong ointment has been reported to inhibit hypertrophic scarring. OBJECTIVE： To verify the effects of Shengjiyuhong ointment on hypertrophic scardng of in a rabbit ear model. METHODS： Each ear of thirty-six Japanese rabbits was used to make four 1-cm-diameter circular full-thickness skin wounds with the entire perichonddum removed. Finally, 288 wounds were made and randomly divided into 6 groups： model, negative control （no drugs ware administered）, low-, moderate-, high-crude herbal dose drugs （Shengjiyuhong ointment was administered topically at concentrations of 8.39%, 25.18%, and 75.54%）, and positive control （recombinant bovine basic fibroblast growth factor was administered topically）. Shengjiyuhong ointment was administered twice daily till wound healing. The wounds were evaluated by the Vancouver scar scale （VSS）. Scar elevation index （SEI） of scar specimens was calculated under a microscope at 40x magnification, mRNA expression levels of type I and III collagen, connective tissue growth factor, fibrenectin, and a-smooth muscle actin （a-SMA） were determined by fluorescent quantitative PCR. Protein expression levels of type I and III collagen and a-SMA ware detected by western blot assay, a-SMA immunoreactivity was determined by immunofluorescent staining. RESULTS AND CONCLUSION： VSS scores and SEI ware significantly increased in each group at 30 days （P 〈 0.05）. VSS scores and SEI were significantly decreased in the moderate- and high-crude herbal dose drug groups and positive control groups compared with the model, negative control, and low-crude herbal dose drug groups （P 〈 0.05 or P 〈 0.01）. mRNA expression levels of type I and III collagen, connective tissue growth factor and fibronectin, and protein expression levels of type I and III collagen and a-SMA were significantly inhibited after moderate-crude herbal dose Shengjiyuhong ointment and positive drug treatment （P 〈 0.01 ）. These findings suggest that Shengjiyuhong ointment can reduce hypertrophic scars by inhibiting fibroblast proliferation and collagen deposition.