基于p38MAPK通路的电针扬刺对全层皮肤缺损创面早期血管化及触觉改善的影响

Effect of electroacupuncture and pricking based on p38MAPK pathway on early vascularization and tactile improvement of full-thickness skin defect wounds

目的探讨基于p38MAPK通路下的电针扬刺法对大鼠全层皮肤缺损创面早期血管化及触觉改善的影响。方法选择健康SD大鼠40只,将其按随机数字表法随机分为4组,分别为模型组、电针组、抑制组和电针+抑制组,每组各10只。模型组制备全层皮肤缺损SD大鼠模型后每天只给予碘伏消毒包扎。电针组给予模型处理后,当日即开始电针扬刺治疗,其后1次/d,共14次。抑制组在造模前10 min腹腔注射SB2035805 mg/kg,其后1次/d。电针+抑制组在每次电针扬刺治疗前10 min腹腔注射SB2035805 mg/kg。术后每天对4组大鼠进行一般行为观察,术后3 d、14 d对4组大鼠创面愈合面积,创面相关血管标志物(CD31、VEGF、vWF)和触觉感知标志物CK20表达进行比较。结果①一般行为:在精神状况、反应能力、摄食量等方面,术后第2天4组均恢复至术前水平。②创面愈合面积:3 d后4组创面均有所愈合,但不明显,差异均无统计学意义(P>0.05)。14 d后电针组的创面愈合面积比其他3组更高,且随着时间推移,创面愈合面积逐渐提高,差异有统计学意义(P<0.01)。③创面相关血管标志物:电针组3 d创面CD31、VEGF、vWF表达量最多,而14 d表达量最少,与其他3组比较,差异均有统计学意义(P<0.01)。④触觉感知标志物:14 d后电针组CK20的表达量相对较多,与其他3组比较,差异均有统计学意义(P<0.05)。结论电针扬刺可抑制p38MAPK通路过度活化,提高创面CD31、VEGF、vWF和CK20表达,在整体上促进皮肤缺损创面血供与触觉修复,最终加速创面愈合。

Objective To explore the effect of electroacupuncture and pricking based on p38MAPK pathway on early vascularization and tactile improvement of full-thickness skin defect wounds in rats.Methods Forty healthy SD rats were selected and randomly divided into 4 groups according to the random number table method,including model group,electroacupuncture group,inhibition group and electroacupuncture+inhibition group,with 10 rats in each group.In the model group,SD rats with full-thickness skin defects were prepared and treated with iodophor for daily dressing.After the model was made in the electroacupuncture group,electroacupuncture and pricking treatment was started on the same day,and then once a day,with a total of 14 times.In the inhibition group,SB2035805 mg/kg was injected intraperitoneally 10 minutes before the model was made,and then once a day.In the electroacupuncture+inhibition group,SB2035805 mg/kg was intraperitoneally injected 10 minutes before each electroacupuncture treatment.Every day after operation,the general behaviors of the four groups of rats were observed.The wound area healing,and the ex pression of wound-related vascular markers(CD31,VEGF,vWF)and tactile perception marker CK20 at 3 d and 14 d after operation between four groups were compared.Results①General behavior:The mental status,reaction ability,food intake,etc.of the 4 groups recovered to the preoperative level on the second day after surgery.②Wound healing area:After 3 days,the wounds in all 4 groups healed a little,but not obvious,the difference was not statistically significant(P>0.05).After 14 days,the wound healing area of the electroacupuncture group was higher than that of the other three groups,and the wound healing gradually increased with time,and the difference was statistically significant(P<0.01).③Wound-related vascular markers:After 3 days,the expression of CD31,VEGF,and vWF in the electroacupuncture group was the highest,while that on the 14th day was the least,which was statistically different from the other three groups(P<0.01).④Tactile perception markers:After 14 days,the expression of CK20 in the electroacupuncture group was relatively high and the difference with the other three groups was statistically significant(P<0.05).Conclusion Electroacupuncture and pricking can inhibit the excessive activation of p38MAPK pathway,increase the expression of CD31,VEGF,vWF and CK20 on the wound surface,promote the blood supply and tactile repair of skin defect wounds on the whole,and finally accelerate the wound healing.