Clinical Observation And Regulatory Mechanism Study Based On TGF-?1,Smad3 Signaling Pathway Of MEBT/MEBO Treating Diabetic Foot Ulcers

Objective: To observe the clinical efficacy of MEBT / MEBO on diabetic foot ulcer wound;To explore the mechanism of MEBT/MEBO promoting diabetic foot ulcers wound healing in rats using Western-blot and histopathological technology.Methods:(1)Clinical study: 60 patients with diabetic foot ulcers were randomly divided into a observation group and a blank control group,30 patients in each.Observation group was dressed with MEBO,blank control group was dressed with the bovine basic fibroblast growth factors(bFGF).After 7 days,14 days,28 days of treatment,recorded respectively the wound healing rate of the patients of the two groups.To observe the clinical efficacy of two groups 42 days later and the wound healing time.To evaluate its efficacy and safety.(2)Animal experiments:One handred SPF male SD rats were randomly divided into a blank control group(20)and a diabetes model group(80).Diabetes rat models were prepared in the diabetes model group by intraperitoneal injection of the streptozotocin(STZ)and 60 diabetic rats were selected randomly to be divided into MEBO group,the bovine basic fibroblast growth factors(bFGF)group and model group(20 rats in each).After the foot ulcer models were established in rats of all the four groups,the blank control group and model group were dressed with normal saline,while MEBO group was dressed with MEBO and bFGF group was dressed with the bovine basic fibroblast growth factors.Five and fourteen days later,10 rats were put to death each group respectively.Ulcer morphological structure was observed by using transmission optical microscope and the expression level of Protein TGF-?1,Smad3 and P-smad3 were detected using Western-blot.Result:(1)Clinical study: After 14 days and 28 days of treatment,compared with control group,the observation group was improved in wound healing rate(P < 0.05).42 days later,the clinical efficacy of observation group was better than the control group(P<0.05).Compared with the control group,the wound healing time of observation group was shortened(P < 0.05).(2)Animal experiments: After 5 day of continuous dressing,the expression levels of Protein Smad3 in the four groups didn't differ significantly(P > 0.05),the expression levels of Protein TGF-?1 and P-Smad3 in MEBO group were obviously higher compared with model group(P<0.01),while the expression levels of Protein TGF-?1 and P-Smad3 in MEBO group and bFGF group didn't differ significantly(P>0.05)?One the day 14,the expression levels of Protein Smad3 in the four groups didn't differ significantly(P > 0.05),the expressions of Protein TGF-?1 and P-Smad3 were significantly lower than that in model group(P<0.01),while the expressions of Protein TGF-?1 and P-Smad3 in MEBO group and bFGF group didn't differ significantly(P>0.05)?After 5 day of continuous dressing,fibroblasts and capillary growth in MEBO group,blank control group and bFGF group was better than that in the model group,but was less inflammatory cells than that in model group.While fibroblasts were not well aligned in blank control group.One the day 14,fibroblasts and collagen fibers in MEBO group,bFGF group and blank control group formed a dense arrangement.Visible skin adnexal proliferation.collagen fibers in MEBO group were proliferated obviously but arrangement was disordered.Collagen fibers in the model group also showed slug hyperplasia.Conclusion: MEBT/MEBO can promote diabetic foot ulcer wound healing by dynamically adjusting the expression of Protein TGF-?1 and P-smad3,as well as reduce scarring to some extent.The results of the study show that MEBT/MEBO has a certain effect in the treatment of diabetic foot ulcer.