益气活血生肌方对肛瘘术后急性感染性创面模型大鼠Vimentin、TNF-α和IL-4表达水平的影响

Effect of Yiqi Huoxue Shengji Decoction on Vimentin,TNF-α and IL-4 Expression Level in Rats with Acute Infectious Wound after Anal Fistula Operation

目的探讨益气活血生肌方对肛瘘术后急性感染性创面模型大鼠皮形蛋白(Vimentin)、肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)表达的影响。方法将造模后的112只大鼠按照随机数字表法均分为4组,分别为空白组(生理盐水清创,涂抹0.2 g凡士林膏)、模型组(生理盐水清创并以无菌纱布覆盖)、湿润烧伤膏组(用湿润烧伤膏油纱条覆盖创面)和益气活血生肌方组(用湿润烧伤膏油纱条覆盖创面,3 mL益气活血生肌方灌胃),每组28只,连续治疗两周。动态观察两组大鼠创面愈合率、创面分泌物、水肿及治疗3、7、14 d后大鼠创面组织中Vimentin、IL-4、TNF-α表达情况。结果治疗7、14 d后,湿润烧伤膏组和益气活血生肌方组的创面愈合率明显优于空白组(P<0.05),益气活血生肌方组的创面愈合率明显优于湿润烧伤膏组(P<0.05)。各组大鼠的肛瘘创面分泌物及水肿评分、创面肉芽评分对比无明显差异(P>0.05),湿润烧伤膏组和益气活血生肌方组的大鼠肛瘘创面分泌物及水肿评分、创面肉芽评分明显低于空白组(P<0.05),益气活血生肌方组的大鼠肛瘘创面分泌物及水肿评分、创面肉芽评分明显低于湿润烧伤膏组(P<0.05)。湿润烧伤膏组和益气活血生肌方组的创面TNF-α、IL-4水平明显低于空白组与模型组(P<0.05),益气活血生肌方组的创面TNF-α、IL-4水平显著低于湿润烧伤膏组(P<0.05)。湿润烧伤膏组和益气活血生肌方组的大鼠肛瘘创面Vimentin蛋白表达明显低于空白组(P<0.05),益气活血生肌方组的大鼠肛瘘创面Vimentin蛋白表达显著低于湿润烧伤膏组(P<0.05)。结论益气活血生肌方治疗肛瘘急性感染效果确切,可促进肛瘘术后创面愈合,减轻创面分泌物及水肿情况,改善创面Vimentin蛋白含量,降低创面组织中炎症因子TNF-α、IL-4水平,提高机体抗肛瘘感染的能力。

Objective:To investigate the effect of Yiqi Huoxue Shengji Decoction on the expression level of skin morphoprotein(vimentin),tumor necrosis factorα(TNF-α),and interleukin-4(IL-4)in rats with acute infectious wounds after anal fistula operation.Methods:A total of 112 experimental rats after modeling were evenly divided into 4 groups according to random number table method,namely the blank group(treated with saline cotton ball debridement covered and fixed with sterile gauze,and applied with 0.2 g of Vaseline ointment),the model group(treated with saline cotton ball debridement and covered and fixed with sterile gauze),the moist burn ointment group(MEBO,covered with moist burn ointment oil gauze,then covered with sterile gauze for fixation)and the Yiqi Huoxue Shengji Decoction group(covered with moist burn ointment oil gauze,then covered with sterile gauze for fixation,and treated with 3 m L Yiqi Huoxue Shengji Decoction by gavage),with 28 rats in each group.All were treated continuously for two weeks.Dynamic observation of wound healing rate,wound secretion and edema,as well as the expression levels of Vimentin protein,IL-4,and TNF-α in the wound tissue of rats 3,7,14 days after treatment were conducted.Results:On the 7th and 14th days after treatment,the wound healing rate of the MEBO group and the Yiqi Huoxue Shengji Decoction group was significantly better than that of the blank group(P<0.05),while the wound healing rate of the Yiqi Huoxue Shengji Decoction group was significantly better than that of the MEBO group(P<0.05);there was no significant differencein the scores of rat anal fistula wound secretion with wound edema and wound granulation among the groups(P<0.05).The scores of rat anal fistula wound secretion with wound edema and wound granulation in the MEBO group and the Yiqi Huoxue Shengji Decoction group were significantly lower than those in the blank group(P<0.05),while the scores of rat anal fistula wound secretion and wound edema in the Yiqi Huoxue Shengji Decoction group were significantly lower than those in the MEBO group(P<0.05);the expression levels of TNF-α and IL-4 in the MEBO group and Yiqi Huoxue Shengji Decoction group were significantly lower than those of the blank group and model group(P<0.05),and the Yiqi Huoxue Shengji Decoction group was significantly lower than those of the MEBO group(P<0.05);the expression levels of Vimentin protein in the anal fistula wound of rats in the MEBO group and the Yiqi Huoxue Shengji Decoction group were significantly lower than that in the blank group(P<0.05),while the expression level of vimentin protein in the anal fistula wound of rats in the Yiqi Huoxue Shengji Decoction group was significantly lower than that in the MEBO group(P<0.05).Conclusion:Yiqi Huoxue Shengji Decoction is effective in treating the acute infection of anal fistula,which can promote the wound healing after anal fistula operation,reduce the secretion and edema of the wound,improve the content of vimentin protein in the wound,reduce the expression of inflammatory factors TNF-α and IL-4 in wound tissues,and improve the recovery ability of fistula infection.