叶绿素衍生物对痔病术后创面愈合的作用和炎性水肿、组织血管生成因子表达的影响

Effect of chlorophyll derivatives on wound healing,inflammatory edema and expression of tissue angiogenic factors after hemorrhoid surgery

目的:观察叶绿素衍生物对痔病术后创面愈合的作用和炎性水肿、组织血管生成因子表达的影响。方法:选择2020年5月—2021年5月治疗的100例痔疮患者为研究对象,按随机数字表法将患者分为试验组和对照组,每组50例。2组患者均给予自动弹力套扎术治疗,术后给予阿奇霉素分散片抗感染,在此基础上试验组给予叶绿素衍生物治疗,对照组给予重组牛碱性成纤维细胞生长因子治疗。术后1、7、14天换药时取患者创面肉芽组织,采用RT-PCR技术检测2组患者血管内皮生长因子(VEGF)、碱性成纤维生长因子(bFGF)、Ⅲ型胶原蛋白(COLⅢ)mRNA表达水平,采用酶联免疫吸附法检测患者血清可溶性细胞间黏附分子-1(sICAM-1)、白细胞介素-1β(IL-1β)、白细胞介素-10(IL-10)水平。术后3、7、14天观察患者肉芽组织生长情况,并给予患者肛缘水肿程度评分及创面分泌物评分,术后1、7、14天给予患者视觉模拟评分(VAS)评价,记录2组患者创面愈合时间,比较2组临床疗效。结果:试验组患者总有效率明显高于对照组(P<0.05)。术后7、14天,试验组VEGF、bFGF、COLⅢmRNA、IL-10水平明显高于对照组(P<0.05),sICAM-1、IL-1β水平明显低于对照组(P<0.05);试验组肉芽生长评分明显高于对照组(P<0.05),水肿、创面分泌物、VAS评分明显低于对照组(P<0.05),创面愈合时间明显短于对照组(P<0.05)。结论:对于痔病术后患者,叶绿素衍生物可抑制患者炎症,提升组织血管VEGF、bFGF、COLⅢmRNA表达水平,减轻炎性水肿及创面分泌物,促进肉芽组织形成,缓解患者疼痛,促进患者创面愈合,提升疗效。

Objective:To observe the effect of chlorophyll derivatives on wound healing,inflammatory edema and expression of tissue angiogenic factors after hemorrhoid surgery.Methods:A total of 100 patients with hemorrhoids treated from May 2020 to May 2021 were selected.The patients were divided into experimental group(50 cases) and control group(50 cases) according to the random number table method.Patients in both groups were treated with automatic elastic ligation.After the operation,Azithromycin Dispersible tablets were given to fight infection.On this basis,patients in the experimental group were treated with chlorophyll derivatives and patients in the control group were treated with recombinant bovine basic fibroblast growth factor.At the time of dressing change 1,7,and 14 days after the operation,the granulation tissues of the patients’ wounds were taken,and the mRNA expression levels of vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF),and type Ⅲ collagen(Col Ⅲ) were detected by RT-PCR.The levels of serum soluble intercellular adhesion molecule-1(sICAM-1),interleukin-1β(IL-1β),and interleukin-10(IL-10) were detected by enzyme-linked immunosorbent assay.The growth of granulation tissue was observed on the 3 rd,7 th,and 14 th day after the operation,and the degree of anal edema and wound secretion were given.The visual analog score(VAS) was given on the 1 st,7 th,and 14 th day after the operation,and the wound healing time of the two groups was recorded.The clinical effects of the two groups were compared.Results:The total effective rate of patients in the experimental group was significantly higher than that in the control group(P<0.05).At 7 and 14 days after the operation,the levels of VEGF,bFGF,COL Ⅲ mRNA,and IL-10 in the experimental group were significantly higher than those in the control group(P<0.05),and the levels of sICAM-1 and IL-1β were significantly lower than those in the control group(P<0.05).The granulation growth score in the experimental group was significantly higher than that in the control group(P<0.05).The edema,wound secretion and VAS scores in the experimental group were significantly lower than those in the control group(P<0.05).The wound healing time in the experimental group was shorter than that in the control group(P<0.05).Conclusion:Chlorophyll derivatives can inhibit inflammation,increase the expression levels of VEGF,bFGF,and COL Ⅲ mRNA in blood vessels,reduce inflammatory edema and wound secretion,promote granulation tissue formation,relieve pain,promote wound healing,and improve the curative effect.