川青软膏对兔耳增生性瘢痕的影响及机制研究

Effects and Mechanism of Chuanqing Ointment Treatment with Rabbit Ear Hypertrophic Scars

目的：通过观察川青软膏对兔耳增生性瘢痕疗效及治疗过程中MMP-1、PDGFR-α、PDGFR-β中的阳性表达指数变化,探讨在治疗增生性瘢痕中PDGF对MMP-1的作用机制。方法：兔耳创伤造模成功后随机数字表达分为模型组、阳性对照组、川青软膏高、中、低剂量组,阳性组外涂康瑞保凝胶[0.5 g/（个·次）,2次/d],川青软膏高、中、低剂量组分别外涂（青藤碱与阿魏酸钠的含量分别为10%、5%、2.5%）川青软膏[0.5g/（个·次）,2次/d],模型组外涂等量的生理盐水（2次/d）,治疗14 d、28 d后分别测量瘢痕厚度计算瘢痕增生指数,制作HE染色计算瘢痕组织中成纤维细胞数、Masson染色统计瘢痕组织中胶原密度、免疫组织化学染色计算MMP-1、PDGFR-α、PDGFR-β在瘢痕组织中阳性表达指数,比较其变化。结果：（1）与模型组相比,各川青软膏组治疗兔耳增生性瘢痕14 d、28 d后,瘢痕增生指数、成纤维细胞数、胶原密度均降低,MMP-1、PDGFR-α、PDGFR-β在瘢痕组织中的阳性表达指数均下降,均有显著差异（P〈0.05）;（2）与阳性组相比,高剂量川青软膏组治疗兔耳增生性瘢痕14 d、28 d后瘢痕增生指数、成纤维细胞数、胶原密度均降低,MMP-1、PDGFR-α、PDGFR-β在瘢痕组织中的阳性表达指数均下降,均有显著差异（P〈0.05）。结论：川青软膏可治疗增生性瘢痕,其机制可能是通过调节PDGFR-α、PDGFR-β,进而影响MMP-1来降低成纤维细胞的过度增生和胶原的过度沉积,从而达到防治增生性瘢痕的作用。

Objective： Though observing efficacy of hypertrophic scars on rabbit ears,and the MMP-1,PDGFR-α,and PDGFR-β positve expressions with the Chuanqing ointment treatment of hypertrophic scars on rabbit ears to investigate the PDGF influence on MMP-1 in hypertrophic scars. Methods： After the modeling of rabbit ear trauma,we randomly divided them into model group,the positive control group,the Chuanqing Ointment groups with high,medium and low doses. The positive control group was treated by kangruibao gel（ 0. 5 g,bid）,the Chuanqing Ointment groups with Sinomenine and SF（ 10%,5%,2. 5%） and Chuanqing Ointment（ 0. 5 g,bid）. The model group was treated with normal saline（ bid）. After 14 d and 28 d,we measured the thickness of the scar and calculated scar index,made calculation of HE staining scar tissue fibroblast cells,collagen density of scar tissue by Masson staining and detected MMP-1,PDGFR-α,PDGFR-β expressions in scar tissue by immunohistochemistry. The results were compared. Results：（1）Compared with the model group,the scar index,the number of fibroblasts and collagen density of Chuanqing Ointment groups decreased. MMP-1,PDGFR-α and PDGFR-β expression levels decreased in scar tissues after 14 d and 28 d treatment（ P〈0. 05）.（2）Compared with the positive control group,scar index of hypertrophic scars,the number of fibroblasts and collagen density of high dose of Chuanqing Ointment group decreased. MMP-1,PDGFR-α and PDGFR-β expression levels decreased in scar tissue,and there were significant differences（ P〈0. 05）. Conclusion： Hypertrophic scars can be treated by Chuanqing Ointment. By adjusting the PDGFR-α and PDGFR-β,and affecting the MMP-1 to reduce excessive deposition into fibroblasts and collagen hyperplasia,Chuanqing Ointment can prevent and treat hypertrophic scars.