点阵二氧化碳激光结合黄芩油膏对鼠尾增生性瘢痕的治疗作用

Therapeutic effect of fractional CO2 laser combined with radix scutellariae ointment in the rat tail with hypertrophic scar

目的 探讨点阵二氧化碳激光结合黄芩油膏对鼠尾增生性瘢痕的治疗作用。方法20只大鼠建立鼠尾增生性瘢痕模型,随机均分为模型对照组(A组)、点阵二氧化碳激光组(B组)、黄芩油膏组(C组)和点阵二氧化碳激光结合黄芩油膏组(D组);同时另选取5只大鼠作为正常对照组(E组)。采用温哥华瘢痕量表(VSS)评分评估瘢痕严重程度,HE和Masson染色观察瘢痕组织病理学变化,Western blot法检测诱导型一氧化氮合酶(iNOS)、核因子E2相关因子2(Nrf2)、血红素加氧酶1(HO-1)、磷酸化Smad3(p-Smad3)、磷酸化信号转导和转录激活因子3(p-STAT3)和角蛋白17蛋白表达。结果 A组VSS色泽、厚度和血管分布评分高于E组(P<0.05);D组VSS色泽、厚度和血管分布评分低于A组和C组(P<0.05)。HE和Masson染色结果显示,D组皮下血管组织恢复,上皮增生以及炎症细胞浸润减少,胶原纤维束排列整齐,皮下血管增多,皮肤结构重塑。A组iNOS、Nrf2、HO-1、p-Smad3、p-STAT3和角蛋白17蛋白表达高于E组(P<0.05);D组p-Smad3蛋白表达低于A组和B组(P<0.05),iNOS、HO-1、p-Smad3、p-STAT3和角蛋白17蛋白表达低于A组和C组(P<0.05)。结论 点阵二氧化碳激光结合黄芩油膏治疗鼠尾增生性瘢痕疗效显著,可促进创面愈合,减少色素沉着,重塑上皮结构。

Objective To investigate the therapeutic effect of fractional COlaser combined with radix scutellariae ointment on the rat tail with hypertrophic scar.Methods The hypertrophic scar model on the rat tail was established in twenty rats, which were then equally divided into four groups of A(model control),B(treated with fractional COlaser),C(treated with radix scutellariae ointment) and D(treated with fractional COlaser and radix scutellariae ointment).Another five rats were taken as the blank controls(group E).The severity of hypertrophic scar was evaluated by Vancouver scar scale(VSS) score.The histopathological change of hypertrophic scar was observed by HE and Masson staining.The protein expressions of inducible nitric oxide synthase(iNOS),nuclear factor E2-related factor 2(Nrf2),heme oxygenase-1(HO-1),phosphorylated Smad3(p-Smad3),phosphorylated signal transducer and activator of transcription 3(p-STAT3) and keratin 17 were detected by Western blot.Results The VSS scores of colour, thickness and vascularity in group A were higher than those in group E(P<0.05),which in group D were lower than those in groups of A and C(P<0.05).HE and Masson staining showed that the subcutaneous vascular tissues were recovered, epithelial hyperplasia and inflammatory cell infiltration were decreased, collagen bundle was neatly arranged, subcutaneous blood vessels were increased and skin structure was remodeled in group D.The protein expressions of iNOS,Nrf2,HO-1,p-Smad3,p-STAT3 and keratin 17 in group A were higher than those in group E(P<0.05).Compared with group D,the protein expression of p-Smad3 was increased in groups of A and B(P<0.05),and the protein expressions of iNOS,HO-1,p-Smad3,p-STAT3 and keratin 17 were increased in groups of A and C(P<0.05).Conclusion The fractional COlaser combined with radix scutellariae ointment has effective therapeutic effect on the rat tail with hypertrophic scar, which may promote the wound healing, reduce the hyperpigmentation and remodel the epithelial structure.