紫连膏改善非哺乳期乳腺炎脓肿期创面炎症反应临床研究

Clinical Study on Improvement of Wound Inflammation in the Stage of Nonlactation Mastitis and Abscess with Zilian Ointment(紫连膏)

目的 探讨紫连膏对非哺乳期乳腺炎手术排脓后创面愈合与炎症反应的影响,为临床治疗提供研究基础。方法 将64例非哺乳期乳腺炎患者随机分为两组,分别为对照组与紫连膏组,每组32例,对照组术后使用甲泼尼龙治疗,紫连膏组在常规治疗的基础上外用紫连膏。统计治疗前及治疗2周、4周后各组患者的总有效率,观察比较两组患者之间乳房肿块大小,并对疼痛、乳房创面水肿及肉芽生长、皮肤颜色变化情况进行评分。分别于治疗前及治疗2周、4周后采集乳腺组织样本,HE染色观察两组样本组织病理学变化,分光光度计法检测组织中超氧化物歧化酶(SOD)、丙二醛(MDA)含量,ELISA法检测组织中白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)与肿瘤坏死因子-α(TNF-α)的含量,Western Blot法检测组织中MLK3、MKK3/6和p38蛋白表达水平。结果 紫连膏组总有效率为87.5%,明显高于对照组的68.8%(P<0.05);紫连膏组治疗4周后患者乳房肿块大小、疼痛评分、乳房创面水肿及肉芽生长评分、乳房皮肤颜色变化评分均低于对照组(P<0.01),乳腺组织中SOD含量高于对照组,MDA、IL-1β、IL-6、TNF-α含量与MLK3、MKK3/6、p38蛋白表达水平低于对照组(P<0.05或P<0.01)。结论 紫连膏能促进非哺乳期乳腺炎术后的创面愈合,减少乳房创面水肿,缓解疼痛与氧化应激失衡,减少炎症反应,作用机制与抑制MLK3-MKK3/6-p38通路有关,具有较高的临床价值。

Objective To explore the effect of Zilian Ointment(紫连膏)on wound healing and inflammatory response after purging pus in non-lactating mastitis,and provide a research basis for clinical treatment.Methods A total of 64 patients with non-lactation mastitis were randomly divided into two groups,the control group and the Zilian Ointment group,with 32 patients in each group.The conventional treatment group was treated with methylprednisolone after operation,while the Zilian Ointment group was treated with topical application on the basis of conventional treatment.The total effective rate of patients in each group before treatment,2 weeks and 4 weeks after treatment was counted.The size of breast lump,pain score,granulation growth on the breast wound and skin color change were observed and compared between the two groups.Breast tissue samples were collected before treatment,2 weeks after treatment and 4 weeks after treatment.Histopathological changes between the two groups were observed by HE staining,the contents of SOD and MDA in the tissues were detected by spectrophotometry,the contents of IL-1β,IL-6 and TNF-αin the tissues were detected by Elisa,and the expression levels of MLK3,MKK3/6 and p38 in the tissues were detected by Western Blot.Results The total effective rate of Zilian Ointment group was 87.5%,which was significantly higher than that of the conventional treatment group(68.8%)(P<0.05).The size of breast lump,pain score,granulation growth on the breast wound and skin color change in the Zilian Ointment group were all lower than those in the conventional treatment group(P<0.01).The levels of SOD oxidative stress factor in breast tissue were higher than those in the conventional treatment group,the levels of MDA oxidative stress factor,IL-1β,IL-6,TNF-α,MLK3,MKK3/6,and p38 in breast tissue were also lower than those in the conventional treatment group(P<0.05 or P<0.01).Conclusion Zilian Ointment can promote wound healing after surgical treatment of non-lactation mastitis,reduce wound edema,relieves pain,oxidative stress imbalance and inflammatory response.The mechanism of action is related to inhibition of MLK3-MKK3/6-p38 pathway,which has high clinical value.