| Objective:Through the observation of the therapeutic effect of Modified heibu ointment on mild hyperplastic acne scar and the experimental study of its effect on the contents of IL-1β and bFGF in the serum of SD rats,the therapeutic mechanism and cytokine mechanism of Modified heibu ointment on mild hyperplastic acne scar were discussed.Methods:1.Clinical study: 76 patients with mild hypertrophic acne scar who meet the inclusion criteria were randomly divided into control group and treatment group,36 cases in each group.The control group and treatment group were treated by topical application of retinoic acid cream and Modified heibu ointment once a night,and the two groups were treated by topical application of polysulfonate mucopolysaccharide cream(xilitol)twice a day for 8 weeks.After 2,4,6 and 8 weeks of treatment,the improvement of the patients’ condition was recorded,and the patients in the two groups were followed up one month after the end of treatment to observe the recurrence of the disease.2.Experimental study: 62 SD rats were randomly divided into 6 groups: blank group,model group,positive control group(retinoic acid cream group)and Modified heibu ointment low,medium and high dose group,with 10 rats in each group except model group,Except blank group,the other 5 groups established compound acne model of rat auricle,that is,apply100% oleic acid solution evenly at the opening of right auricle ear duct every day,1ml/time,once/D,the next day Propionibacterium acnes was injected into the auricle of rats,and the model was finished 3 weeks later.After 4 weeks of continuous administration to the right auricle of rats,the morphology of the skin lesions,the histopathological changes of the right auricle of rats in each group and the contents of IL-1β and bFGF in the serum of SD rats were observed.Results:1.Clinical research:(1)The VSS scores of the control group and the treatment group decreased after the 2th,4th,6th and 8th week of treatment respectively,indicating that the patients in the two groups had curative effect in the course of treatment,but there was significant difference between the two groups after treatment by independent sample t-test statistical analysis(t= 8.90,P<0.001).(2)The total effective rate of the control group was 71.43%,including 5 cases ofrecovery,13 cases of significant effect,7 cases of effectiveness and 10 cases of ineffectiveness;the total effective rate of the treatment group was 94.44%,including 8 cases of recovery,19 cases of significant effect,7 cases of effectiveness and 2 cases of ineffectiveness.There was significant difference between the two groups(z=-2.21,P< 0.05).The total effective rate of the treatment group was better than that of the control group.(3)In the course of treatment,there were 8 cases of mild adverse reactions in the two groups,including 5 cases in the control group and 3 cases in the treatment group,which showed local skin redness and irritation.The incidence of adverse reactions in the control group was 14.29% and that in the treatment group was 8.33%.There was no significant difference between the two groups(z=-0.79,P> 0.05).(4)One month after the treatment,the recurrence rate was 33.33% in the control group(6cases)and 7.41% in the treatment group(27 cases).The recurrence rate of the two groups was statistically significant(2=4.97,P<0.05).The recurrence rate of the treatment group was lower than that of the control group.2.Experimental research:(1)After treatment,the changes of auricle lesions in each group were observed by naked eyes: compared with the model group,the auricle lesions in each dose group and the positive control group were improved,but the improvement was most obvious in the high dose group of Modified heibu ointment.(2)After treatment,the histopathological observation results of each group’s ears:compared with the model group,the cuticle and fibrous tissue of each dose group and the positive control group of Modified heibu ointment became thinner,the keratinized substances in the hair follicle mouth and funnel were reduced,and the amount of inflammatory cells in the dermis was reduced,but the improvement was most obvious in the high dose group of Modified heibu ointment.(3)Comparison of serum IL-1β,bFGF content of rats in each group: compared with the model group: the content of IL-1β,bFGF in each dose group and the positive control group of Modified heibu ointment decreased in varying degrees,the difference was statistically significant(P<0.05),but the highest dose group of Modified heibu ointment decreased most significantly.Conclusions:In terms of recurrence rate and adverse reaction rate,the effect of Modified heibu ointment was significantly lower than that of the control group.The mechanism of Modifiedheibu ointment in the treatment of mild hyperplastic acne scar may be related to the regulation of the content of IL-1β and bFGF in serum.It can achieve the effect of treating mild hyperplastic acne scar by reducing the content of bFGF and inflammatory mediators and reducing the inflammatory reaction. |
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