增生性瘢痕的生物学基础及药物应用的研究进展

Advances on the Biological Basis and the Application of Drugs in Hypertrophic Scar

增生性瘢痕由于其发病率较高,治疗方法多样且目前尚无确切的根治方法而成为临床研究探讨的重点之一。因影响瘢痕产生的因素较多,只有建立在产生瘢痕的生物学基础上的治疗才能对其进行有效防治。本文总结分析最新关于瘢痕产生的生物学基础的研究报道,试图探寻有效防治瘢痕的方法。最新研究显示,非手术方法治疗瘢痕应从抑制成纤维细胞增殖和调整胶原代谢异常来进行药物干预,临床常用药物有激素类、抗肿瘤药、钙离子拮抗剂、P物质抑制剂、抗组胺药、胶原酶和中药等,作用机理也已能从细胞、分子学水平上进行阐明,且临床证实有效。但给药途径不同效果也有差异,为探究提高药效的给药方法,临床正在尝试包括使用微针、超声、压力疗法等治疗大面积增生性瘢痕。

Hypertrophic scar has become one of the focuses of clinical research because of its high incidence and various treatment methods and there is no definite radical treatment method at present.Because there are many factors that affect the occurrence of scar,only treatment based on the biological basis of scar production can be relatively effective in preventing and controlling the scar.Recent studies have shown that non-surgical treatment of scarring should start from inhibiting fibroblast proliferation and regulating abnormal collagen metabolism.The commonly used drugs in clinical practice include Hormonal drugs,antineoplastic,calcium ion antagonist,substance P inhibitor,antihistamine,collagenase and traditional Chinese medicine.The mechanism of action has also been elucidated from the cellular molecular level,and has been proved effective in clinic.However,there are also differences in the effects of different drug delivery methods.In order to explore the ways to improve the efficacy of drug delivery,clinical trials are being carried out,including the use of micro-needle ultrasonic pressure waveguide to treat large area hypertrophic scar.