【摘要】 目的研究复方四黄液联合负压封闭引流技术(VSD)治疗感染创面的疗效及作用机制。方法将90只家兔随机分成3组,均采用改良全层皮肤切除感染法造模。造模成功后,A组给予复方四黄液联合VSD治疗,B组给予复方四黄液治疗,C组给予VSD治疗。在治疗后第5,10,15天测定外周血白细胞计数(WBC)及C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平;观察创面外观并行组织学观察,计算肉芽组织中成纤维细胞数及新生毛细血管数。结果治疗后第5天开始,A组WBC、CRP、IL-6、TNF-α水平均低于B组和C组(P均<0.05),并持续降低。治疗后第5天,A组PCT明显低于B组和C组(P均<0.05),治疗后第10天与B组比较差异无统计学意义,但均低于C组(P均<0.05)。创面外观评分各个时间段A组均优于B组和C组(P均<0.05);肉芽组织中成纤维细胞数、新生毛细血管数A组>B组>C组,且各组内在第10天时测得值最高。结论复方四黄液联合VSD治疗感染创面疗效更优,其机制可能在于二者联用能抑制病菌生长,减轻炎症反应,降低IL-6、TNF-α水平,刺激肉芽组织中成纤维细胞和新生毛细血管生长。更多还原

【Abstract】 Objective It is to observe the curative effect and the mechanism of Fufang Sihuangye combined with vacuum sealing drainage technique( VSD) in the treatment of wound infection. Methods 90 cases of rabbits were randomly divided into3 groups and treated with modified full-thickness skin excision for wound infection model. After the success of model making,the animals were treated with Fufang Sihuangye combined with VSD in group A,with Fufang Sihuangye in group B,and with VSD in group C. The levels of WBC,CRP,PCT,IL- 6,TNF- α were detected in the 5th,10 th and 15 th day after treatment,then observed outward appearance of the wound,and calculated the number of the granulation tissue fibroblasts and new capillary. Results From the 5th day after treatment,the WBC,CRP,IL- 6 and TNF- α of group A were lower than those in group B and group C( all P < 0. 05),and continued to reduce. At the 5th day after treatment,the PCT of group A was significantly lower than that in group B and group C,the differences with B group disappear at the 10 th day after treatment,and they were lower than those in group C( all P < 0. 05). The outward appearance of the wound score of group A was more than in group B and group C( all P < 0. 05); the number of granulation tissue fibroblasts and new capillary in group A > in group B >in group C,and the value of all groups was the highest at the 10 th day after treatment. Conclusion The curative effect of Fufang Sihuangye combined with VSD in the treatment of wound infection is better. The mechanism may be that can inhibit bacteria growth,reduce inflammation reaction,reduce IL- 6,TNF- α,stimulate the granulation tissue fibroblasts and capillaries growth.更多还原