| Objective:Diabetic ulcer belongs to gangrene category of traditional Chinese medicine,is one of the chronic complications of diabetes, are caused by metabolic disorder of vascular lesions, neuropathy, combined with diabetes, impaired immune function secondary infection cause disease, is a kind of common chronic painless clinical wound.How to accelerate the healing of diabetes ulcer wound is the focus and difficulty, the occurrence and development of diabetic ulcers mechanism mainly related to the occurrence and development of diabetes and diabetic ulcers painless mechanism,chronic wound healing process needs a variety of cells, growth factors and extracellular matrix of collaborative participation, constitute a complex biological networks promote ulcer healing, lack of any of these cytokines or target cell receptor signal transduction "decoupling union" will lead to wound does not heal or delay healing, traditional Chinese medicine external treatment diabetic ulcers can obviously promote wound healing, but Chinese medicine external treatment still need to study how to control the corresponding target cells, traditional Chinese medicine compound ulcer oil is in the long-term clinical practice summarized, clinical type used in damp and hot accumulate knot diabetic ulcers, this topic through the study of clinical interventions for diabetes ulcer healing ulcer oil and experimental research to further clarify the mechanism of wound healing, to study the ulcer oil intervention diabetes ulcer with related pathways and cell factor in the process of effect and its curative effect in clinical.Methods:1. The experiment research:to choose 80-100g SPF SD male rats, according to random number table method were randomly divided into blank control group, model group, western medicine, Chinese medicine group.Then model group, western medicine, Chinese traditional medicine group according to the weight of 50 mg/kg of disposable fast solution intraperitoneal injection of STZ diabetic model, such as blank control group by intraperitoneal injection of one-time volume does not contain the STZ 0.1 mmol/L-citric acid sodium citrate buffer, in 3 days,7 days after the success of the anesthesia measuring caudal vein blood sugar, in two consecutive non fasting blood sugar> 16.7 mmol/L for diabetic rats model success, After the success of the model, under aseptic conditions respectively in rats back shearing modulus areas of skin, and wound topical glacial acetic acid, a week after forming defect skin ulcer model in rats.Diabetic ulcer of rats after the success of the building, four groups by iodine volts daily disinfection wound dressing,Chinese traditional medicine group topical ulcer oil, lactic acid in accordance with the western medicine group apply acridine solution, four-layer of medical sterile gauze bandage fixation.Respectively in 3,7,14 days after the medication,take proper amount of fixed, paraffin embedding subcutaneous tissue slice, HE staining for morphological observation, immunohistochemical staining detection in the organization which, PDGF, VEGF, content of PTP1B, and applied to the Image Pro Plus analysis of integral optical density value;In 3,7,14 days take a suitable amount of subcutaneous tissue after liquid nitrogen frozen by Western blot to determine which, PDGF, VEGF, PTP1B protein expression, scan film and analyze net optical density value.2. Clinical research:clinical,60 patients with diabetic ulcer of damp and hot accumulate knot type, randomly grouped into control group and treatment group, respectively in the two groups of patients admitted to hospital on the first day, collect basic data, the two groups after every day to iodine volts disinfection wound dressing, topical ulcer oil treatment group, control group topical lactic acid in sand acridine solution, four-layer of medical sterile gauze bandage fixation.In the treatment of 0,14 days of treatment group and control group respectively, evaluating the effect of TCM syndrome, detection, ESR, CRP, WBC, NE%,TGF-β, VEGF, PDGF and other indicators, finally through the statistical analysis results.Results:1. Experiment study:diabetic ulcer of rats after the success of the building, each wound blood osmotic solutions, a small amount of the surrounding tissue edema, blank control group rats in good condition, normal eating into the water, light color, sensitive activity, weight increases obviously, the model group, the ulcer oil, lactic acid in sand acridine group rats in poor condition, eat less, more water, color dark matt, hair damp, curled up to the cold, insensitive, weight gain is not obvious, polyuria, smell fishy.Four groups of rats after the success of the weight in front of the building and building basic belong to the same base on the third day, and on the third day of the building to 14 days, blank control group rats weight increases obviously, model group, the ulcer oil and lactic acid in sand acridine group weight growth is slow.Four groups of rats blood glucose in front of the building are at normal levels, blank control group in the building on the third day and on the seventh day, the 14th day blood sugar in a normal level, the model group, the ulcer oil and lactic acid in sand acridine group blood sugar above normal levels on the third day, meet the standard of diabetes model, the model group, the ulcer oil and lactic acid in sand acridine group on the seventh day the blood sugar, have reached the standard of diabetes model, on the 7 days to 14 days blood sugar levels tend to be stable at the levels of model rats successfully.Expression in immunohistochemical analysis in each group, which the amount of protein expression in the third day ulcer oil group was significantly lower than blank control group, model group, the lactic acid in sand acridine group, P< 0.05, the seventh day ulcer oil group was significantly higher than that of model group, P< 0.05, ulcer oil group and blank control group, the lactic acid in sand acridine group compared with no significant difference, P> 0.05,14 days, ulcer oil group was significantly lower than blank control group, P< 0.05, compared with the other two groups did not obvious difference, P> 0.05.Amount of PDGF protein expression in the third days ulcer oil group significantly higher than the blank control group, model group, the lactic acid in sand acridine group, P< 0.05, in the seventh day, and no significant difference was found in all 14 days. Amount of VEGF protein expression in the third day ulcer compared to oil the lactic acid in sand acridine group increased significantly, P< 0.05, the seventh day, 14 days ulcer oil group were significantly higher than that of lactic acid in sand acridine group, P< 0.01.PTP1B quantity of protein expression in the third day ulcer group oil was lower than that in model group, P< 0.01, in the seventh day of ulcer oil group significantly higher than the blank control group, model group, the lactic acid in sand acridine group, P< 0.01, the fourteenth day ulcer group oil was lower than that in model group, P< 0.01 and ulcer oil sand lactic acid in accordance with the above acridine group, P< 0.01.Western blot results show: which protein expression levels in four groups respectively, the third day ulcer oil group were lower than the blank control group, model group, the lactic acid in sand acridine group, the ulcer oil group was significantly lower than model group, P< 0.05, the seventh day ulcer oil group and model group did not see obvious difference, ulcer oil group was significantly higher than that of lactic acid in sand acridine group, P< 0.01,14 days did not obvious difference.PDGF in third days ulcer oil group is higher than the blank control group, model group, the lactic acid in sand acridine group, and ulcer of oil group was significantly higher than that of model group, P< 0.05, the seventh day, the day 14 ulcer oil group is higher than the blank control group, model group, the lactic acid in sand acridine group, but no significant difference.VEGF on the third day ulcer oil group is higher than the blank control group, model group, the lactic acid in sand acridine group, and ulcer of oil group is significantly higher than blank control group, P< 0.05, no significant difference on the seventh day, the 14th day.PTP1B in third days ulcer oil group is lower than the model group, the lactic acid in sand acridine group, on the seventh day, the day 14 ulcer oil group with no significant differences between the other groups.2. Clinical research:by observing the oil diabetic ulcer ulcer patients before and after treatment of TCM syndrome curative effect, the primary symptom integral visible in the control group and treatment group in 0 days did not see obvious difference, P> 0.05, in 14 days after treatment, the primary symptom score after treatment the treatment group was obviously lower than the control group, P< 0.01.Time the integral in the treatment of 0 days and no obvious difference was found1 in all 14 days, P> 0.05.Total disorder syndrome integral in the treatment of 0 days control group and treatment group no significant difference, P> 0.05, in 14 days after treatment, the treatment group total disorder syndrome score significantly lower than the control group, P< 0.01.Efficacy of syndromes, control group total effective rate was 86.67%, total effective rate in treatment group was 96.67%, total effective rate of treatment group is better than the control group.Inflammation related indicators, two groups before treatment leukocyte count, neutrophil percentage, CRP were no obvious difference, P> 0.05, blood sedimentation in front of the treatment group was lower than that in group therapy, P< 0.01.14 days after treatment, compared the control group and treatment group, leukocyte count, neutrophil percentage, CRP, ESR were treatment group was obviously lower than the control group, P< 0.01.Growth factor in the change of the two groups before and after treatment, PDGF, TGF- beta before treatment control group and treatment group no significant difference, P> 0.05, in 14 days after treatment, the treatment group were significantly higher than that of control group, P< 0.05.VEGF in 0 days very obvious differences in the control group and treatment group, P< 0.01, within 14 days, the treatment group and control group no significant difference, P> 0.05.Conclusion:Ulcer oil intervention diabetes ulcer rats can promote partial granulation tissue growth and promote microvascular formation, obviously accelerate wound healing and its mechanism may be related to ulcer oil can effectively inhibit AGEs and PTP1B, and can promote the growth of PDGF, VEGF.Ulcer oil topical treatment of damp and hot accumulate knot diabetes ulcer patients get better clinical curative effect, can significantly improve wound total effective rate, effective control of inflammation, can significantly improve the more in the process of wound repair factor PDGF, concentration of TGF-beta, accelerate wound healing, in diabetic ulcer of chronic wound healing and tissue regeneration has good promoting effect. |
PDF Full Text Request