不同针刺方法对糖尿病小鼠皮肤创伤愈合的影响

Encircling needling is superior to“Bangci”(focal center-side needling)in promoting wound healing in diabetic mice

目的:观察不同针刺方法对糖尿病小鼠皮肤创伤愈合时间及局部血流灌注量的影响,探讨不同针刺方法在糖尿病创伤修复中的作用差异。方法:将C57BL/6N小鼠随机分为模型组、傍刺组、围刺组和正常组,每组8只。腹腔注射链脲佐菌素制备糖尿病模型小鼠,利用打孔器在糖尿病小鼠背部切取全层皮肤制备糖尿病皮肤创伤模型。傍刺组在创面中心和边缘各针刺1针,围刺组在创面边缘上、下、左、右各针刺1针,针尖均向伤口方向刺入,针刺后两组均给予微电流刺激,共干预11 d。皮肤创伤造模后第3、5、7、9、11天测量创面面积并监测针刺干预前后创面血流灌注量的变化。结果:各时间点模型组创面渗出、炎性反应及瘢痕均较两个针刺组严重,治疗后围刺组创面肉芽组织的颜色及覆盖情况均优于傍刺组。模型组在各时间点的创面收缩率明显小于两针刺组(P<0.05);与傍刺组比较,围刺组创面愈合所需时间更短(P<0.05)。与正常组比较,造模后第1~9天创面部位血流灌注量显著升高(P<0.01);经干预后两针刺组血流灌注量均呈现出先降低后升高的趋势,且围刺组在第9天血流灌注量明显高于傍刺组(P<0.01),第11天血流灌注量明显高于模型组和傍刺组(P<0.01);两针刺组在各时间点针刺后即刻血流灌注量均较针刺前显著增加(P<0.01,P<0.05),且围刺组针刺前后的血流灌注量差值较傍刺组更大(P<0.01)。结论:傍刺法和围刺法均可明显缩短糖尿病小鼠皮肤伤口愈合的时间,增加创面的血流灌注量,促进皮肤创伤修复,其中围刺法的疗效优于傍刺法。

Objective To compare the therapeutic effects of"Bangci"(focal center-side needling)and encircling needling in promoting skin wound healing and local blood perfusion in diabetic mice.Methods Thirty-two male C57 BL/6 N mice were randomized into normal,diabetic model,focal center-side needling and encircling needling groups(n=8 in each group).The skin wound model was prepared by cutting a piece of full-thickness skin at the mouse’s back by using a puncher.One hour after modeling,two acupuncture needles were respectively inserted into the center of the wound and the spot at the normal skin about 0.5 cm away from the edge of the wound for mice of the focal center-side needling group,followed by EA(0.5 mA,0.5 Hz)for 30 min.For mice of the encircling needling group,4 acupuncture needles were respectively inserted into the upper,lower,left and right normal marginal skin around the wound,followed by EA stimulation with the same parameters as those of the center-side needling group.The wound conditions,diameter and area of the wound were monitored,and the wound blood perfusion volume was measured by using a laser speckle flowmeter.Results The wound shrinkage rates were significantly higher at the time-points of 3,5,7,9 and 11 d after modeling in both focal center-side needling and encircling needling groups than in the model group(P<0.05),and on day 3,5,7 and 9 in the encircling needling group than in the focal center-side needling group(P<0.05).The wound healing time was obviously earlier in both focal center-side needling and encircling needling groups than in the model group(P<0.05),and in the encircling needling group than in the focal center-side needling group(P<0.05).Following modeling,the volume of wound blood perfusion was considerably higher from day 1 to 9 and markedly lower on day 11 in the model group than in the normal group(P<0.01),and after the intervention,the blood perfusion volume was considerably decreased on day 3,5,7 and 9 in both the focal center-side needling and encircling needling groups(P<0.05,P<0.01),and obviously increased on day 11 in the encircling needling group relevant to the model group(P<0.01).Comparison between post-and pre-EA stimulation showed that the immediate blood perfusion volume was significantly increased from day 1 to 11 after EA stimulation in both the focal center-side needling and encircling needling groups(P<0.01,P<0.05).The therapeutic effect of the encircling needling group was significantly superior to that of the focal center-side needling group in lowering blood perfusion volume from day 3 to 7,and in increasing blood perfusion volume on day 9 and 11(P<0.01).Under the naked eyes,the conditions of exudation and inflammatory reaction,and the scar and granulation tissue were relatively milder and better respectively in both the center-side needling and encircling needling groups than in the model group.Conclusion Both focal center-side needling and encircling needling can promote the skin wound healing by increasing the blood perfusion in diabetic mice,and the therapeutic effect of the encircling needling method was significantly superior to that of the focal center-side needling method.