2940 nm波长点阵铒激光联合雷公藤内酯软膏对兔耳增生性瘢痕VEGF表达影响的实验研究

Experimental study on the effects of 2940 nm fractional erbium laser combined with triptolide ointment on VEGF expression in hypertrophic scars in the rabbit ears

目的探讨2940 nm波长点阵铒激光联合雷公藤内酯软膏对兔耳增生性瘢痕的疗效及其对瘢痕组织中血管内皮生长因子(VEGF)表达的影响。方法制备40只大耳白兔耳缘增生性瘢痕模型,随机分为阴性对照组、地塞米松对照组、雷公藤治疗组、点阵激光治疗组、雷公藤激光联合治疗组。雷公藤组外搽雷公藤内酯软膏,激光组采用2940 nm波长点阵铒激光打孔,联合组两者联合使用,对照组涂地塞米松软膏。6个月后检测各组瘢痕厚度指数、重量、组织学改变及VEGF表达水平。结果联合治疗组瘢痕形态最佳,颜色、质地和充血情况接近正常皮肤;厚度指数为(1.15±0.14),重量(1.35±0.18)g,均低于其他组(P<0.05);成纤维细胞数量(165.63±22.98)个,VEGF表达(105.35±14.61)pg/mL,也低于其他组(P<0.05)。结论2940 nm波长点阵铒激光联合雷公藤内酯软膏可有效改善兔耳增生性瘢痕,疗效优于单一治疗,其作用机制可能与抑制VEGF表达、减少成纤维细胞增生有关。

Objective To investigate the efficacy of 2940 nm fractional erbium laser combined with triptolide ointment on hypertrophic scars in the rabbit ears and its effect on the expression of vascular endothelial growth factor(VEGF)in scar tissue.Methods A hypertrophic scar model was established on the ear margins of 40 large-ear white rabbits,which were randomly divided into the negative control group,dexamethasone control group,triptolide treatment group,fractional laser treatment group,and combined triptolide and laser treatment group.The triptolide treatment group was treated with external application of triptolide ointment,the fractional laser treatment group was treated with 2940 nm fractional erbium laser,and the combined group received both treatments,the control group was treated with dexamethasone ointment.Six months after treatment,scar thickness index,weight,histological changes,and VEGF expression levels were measured in each group.Results The scars in the combined treatment group exhibited the best morphology,with color,texture,and congestion close to normal skin.The thickness index in the combined treatment group was(1.15±0.14),and the weight was(1.35±0.18)g,both lower than those in the other groups(P<0.05).The number of fibroblasts in the combined treatment group was(165.63±22.98),and the VEGF expression level was(105.35±14.61)pg/mL,both lower than those in the other groups(P<0.05).Conclusion The combination of 2940 nm fractional erbium laser and triptolide ointment effectively improves hypertrophic scars in rabbit ears,with efficacy superior to monotherapy.The mechanism of action may be related to the inhibition of VEGF expression and reduction of fibroblast proliferation.