Medicine Cured Rot Myogenic, And Promote Wound Healing Clinical And Experimental Studies Of The Mechanism Of Action And Drug Laws

"The therapy of removing slough, promoting growth of tissue regeneration" (QFSJ therapy) is one of importent drug therapy methods for chronic wounds in surgical treatment of TCM. It has been widely used in clinic for it's good clinical effects. However, domestic reports are mainly concentrated in clinic effects. Absenting of objective research for mechanisms of this therapy lead to limitation of widespread of this therapy method. So we system analysis this therapy by representative drugs named ShengJi YuHong Ointment (SJYHO) and ShengJi HongFen Ointment (SJHFO) which were prepared according to traditional theory and experience of doctor Guodong Li. We hope to explain the mechanisms and principle of using drugs of this therapy by theory research, clinic reaserch and experiment research. These works will offer objective theory base on this therapy in the future.1 Theory researchObjective: Summary the theory of etiology and pathogenesis of TCM, the clinical principle and regulation for QFSJ therapyMethod: According to ancient literature of TCM and our clinical experience we lead to following opinions: The basic pathological mechanisms of chronic wounds is unbalance of Ying and Yang, which lead to irregular funtion of the QI. Interaction between poisons, sloughs, blood stasis, deficiency of QI, which direct lead to formation of chronic wounds. The most important pathological mechanism for using this therapy method is domination of pathogenic slough. So we treat the chronic wounds with this therapy by two ways: (1) Broking the pathological chain between poisons, sloughs, blood stasis and deficiency of QI by "removing slough " drugs, (2) Using "promoting growth of tissue regeneration" drugs after using removing slough " drugs, which can adjust the balance of YING and YANG, QI and blood of body, to accelerate the recovery of Vital activity. The principle and regulation of QFSJ therapy include five aspects: (1) Using the "removing slough " drugs as early as possible. (2) The "removing slough " drugs can not be used for long time. (3) Stop using the "removing slough " drugs after the color of granulation tissues became more fresh. (4) Using "promoting growth of tissue regeneration" drugs after using "removing slough " drugs. (5) Using "removing slough " drugs with "clearing away heat-toxin" drugs and "removing blood stasis and activating blood flow" drugs together.2 Experiment researchObjective: Researching the effect mechanisms of QFSJ therapy Method: We preparing the SJHFO by traditional Chinese medicine "HongFeng" and the SJYHO, and observing clinic effects and effect mechanisms of this drugs. There are four experiment groups: (1) bFGF groups(cases as FJ groups); (2) The "Therapy of removing slough , promoting growth of tissue regeneration" groups(include 15%SJHFO and SJYHO, cases as QF groups) (3)SJYHO groups (cases as YH groups) (4) Vaseline group(cases as FS groups). The skin-deficit infection medal were made on New Zealand rabbits, four wounds on one rabbit back, which was dressed change by the prefer four drugs seperetly. We observed the several objects after dressing change for 3, 7? 14 * 21 days. In addition, we prepared the HF ointment into different concentrations, such as 10%? 15%? 20%, 30%, to observe the dose-effect relationship of different concentrations. We discussed the possible mechanism of the therapy by five aspects as follow according to theory of TCM:(1) Detoxication functionTo discussing Ihe possible mechanisms of QF therapy in detoxication by following ways, such as bacteriostasis, testing function of macrophages in mouse abdominal cavity. Testing content of C3 and IL-1 P in mouse serum, testing the content of lysosomes of macrophages in wound tissues. Result: HF groups were more effective than YH groups and FS groups (PO.05) on staphylococcus aureus, epidermic staphycoccus, streptococcus, and better than erythrocin onitment groups on bacillus proteus, colibacillus in bacteriostasis test (PO.05). HF groups have more activation effects on functions of mouse abdominal cavity macrophages than YH groups and FS groups(P<0.01). It can rising the content of C3 in mouse serum by giving dose on skin of the mouse directly. However no significant effect on the content of IL-1 P. QF groups can also improve the content of the lysosomes compared to FS groups and FJ groups. There have no obvious dose-effect relationship in HF ointment.(2) Removing sloughTo test the follow index after dressing change for 3 > 7> 14 days, to discuss the effect of pus on wound healing by following ways, such as testing PH, content of protein, content of IL-1 P in seceretion of wounds. On the other hand, we test the content of matrix metalloproteinase-l(MMP-l) and MMP-3 and observe the Apoptosis in the wound tissues. Result: HF ointment can acid the seceretion of wounds; it can also rise the content of IL-1 P in the seceretion of wounds after 7 days. QF groups can rise content of MMP-1 and MMP-3 in wound tissues after 3, 7days, so does Apoptosis inwound tissues. Conclusion :QF therapy can promote the growth of tissue regeneration by adjust the PH and content of IL-1 P in wounds. QF groups can enhance the removing slough functions by rising the content of matrix metalloproteinase in wound tissues or improve the apoptosis of wound tissue cells.(3) promoting regeneration of tissueChange of protein content and Hydroxyproline (OHP) content in wound tissues, depth of granulation tissue and epithelia tissue tested by microscope, wound healing time, wound-healing ratio, were all observed and measured in 3* 7> 14, 21days, to evaluate effect of the function of the wound tissue regeneration by QF therapy. Result: QF therapy can improve the protein content of wound tissues, also add the depth of granulation tissue and epithelia tissue in 7 days compare to FS groups. Wound-healing time is shorter than FS and YH groups, wound-healing ratio is better than FS and YH groups, there is no significant different between QF groups and FJ groups. Conclusion: The QF therapy has good effect on regeneration of tissue. (4) Adjusting activity of QIChange of bFGF and it's receptor content and TGF- P i content in wound tissues, blood capillary numbers and sum area of cross section of blood capillary in wound tissues are measured in 3* 7? 14 > 21 days. Also auricle of mouse ear testing has been done. Result: there were no change in bFGF content of each group, but the area of bFGF receptor distribution were more wide than other groups in 3? 7days(P<0.05). the content of TGF- P i in QF groups was more higher than other groups. Giving dose by mouse ear skin directly enlarge the micro-arteria and micro-vein. Result of histopafhologic observation induced that the QF groups can improve the supply of blood and adjust bFGF and their receptors content, which can prompt activity of QI.(5) Abnormal effectsMercury content of liver tissue and kidney tissue, liver function and renal function index in mouse serum were measured after directly give dose by skin with different concentrations of 10%> 15%? 20% > 30% HF ointment Also observed the pathological section of mouse kidney. FS groups were normal control groups. Result: The content of mercury of liver tissue and kidney tissue were rise according to the concentration of the HF ointment, and the test results of 30% HF groups were much higher than those in 10% and 20% HF groups (PO.05). But there were no significant different between each groups in content of liver function and renal function index in mouse serum. One case of 30%HF group mouse was founded to be serious kidney impairment. It was...