• 四川大學(xué)華西醫(yī)院燒傷整形科（成都，610041）;

【摘要】　目的　 探討中成藥參附注射液對(duì)大鼠深Ⅱ度燒傷創(chuàng)面愈合的影響。　方法　 選用16只Sprague-Dawley（SD）大鼠，隨機(jī)分為實(shí)驗(yàn)組、對(duì)照組，每組各8只，建立20%體表面積深Ⅱ度燙傷模型。燙傷后即刻及此后每天，實(shí)驗(yàn)組大鼠以參附注射液20 mL/kg腹腔注射給藥，1次/d，連續(xù)給藥5 d；對(duì)照組給予注射等劑量的生理鹽水。分別于致傷后的7、14 d取創(chuàng)面組織塊，光學(xué)顯微鏡觀察成纖維細(xì)胞及膠原纖維生長(zhǎng)情況，電子顯微鏡觀察致傷后14 d成纖維細(xì)胞細(xì)胞器情況，分別計(jì)算燒傷后第7、14天兩組的創(chuàng)面愈合率，并觀察比較兩組創(chuàng)面愈合的時(shí)間。　結(jié)果　 所有選入實(shí)驗(yàn)的SD大鼠均存活至實(shí)驗(yàn)結(jié)束。實(shí)驗(yàn)組、對(duì)照組術(shù)后第7天創(chuàng)面愈合率分別為（36.34±2.55）%及（33.13±2.62）%，兩組差異有統(tǒng)計(jì)學(xué)意義（t=2.486，P=0.027）；實(shí)驗(yàn)組、對(duì)照組術(shù)后第14天創(chuàng)面愈合率分別為（75.71±2.29）%及（72.36±2.85）%，兩組差異有統(tǒng)計(jì)學(xué)意義（t=2.590，P=0.022）；實(shí)驗(yàn)組、對(duì)照組創(chuàng)面愈合時(shí)間分別為（20.88±1.36）、（22.94±2.16） d，兩組差異有統(tǒng)計(jì)學(xué)意義（t=-2.286，P=0.0395）。傷后7、14 d創(chuàng)面組織塊切片光學(xué)顯微鏡觀察發(fā)現(xiàn)，實(shí)驗(yàn)組肉芽組織及膠原纖維較多，排列更有序，表皮基底細(xì)胞增殖活躍，炎癥反應(yīng)較輕；傷后14 d時(shí)電子顯微鏡觀察發(fā)現(xiàn)，實(shí)驗(yàn)組成纖維細(xì)胞的細(xì)胞器更豐富，分泌膠原更多，實(shí)驗(yàn)組創(chuàng)面愈合情況優(yōu)于對(duì)照組。　結(jié)論　 腹腔注射參附注射液可以促進(jìn)燒傷創(chuàng)面的愈合，其可能的機(jī)制為清除氧自由基，抗脂質(zhì)過氧化。
【Abstract】　Objective　 To explore the effect of Shenfu injection on promoting healing of deep partial-thickness burn wound in rats. 　Methods　 Sixteen Sprague-Dawley (SD) rats were randomly selected, and deep partial-thickness burn with 20% of the body surface was inflicted. The rats were randomly divided into experimental group and control group with eight in each group. Rats in the experimental group were treated with abdominal injection of Shenfu injection at a dose of 20 mL/(kg?d) for five days continually, and rats in the control group were treated with the same dose of 0.9% saline solution. The growth of granulation tissue and collagen fibers were evaluated under light microscope at the seventh and the fourteenth day. The growth of fibroblast was observed under transmission electron microscope at the fourteenth day. The cure rate of both groups of rats at the seventh and fourteenth day was calculated. Then we compared their healing time and the cure rate of the traumatic wound respectively.　Results　 All rats had survived until wound healing. The cure rate at the seventh day for the experimental group and the control group was (36.34±2.55)% and (33.13±2.62)%, and their difference was statistical (t=2.486, P=0.027); At the fourteenth day, the cure rate was respectively (75.71±2.29)% and (72.36±2.85)% with a significant difference between each other (t=2.590, P=0.022). The healing time of the experimental group (20.88±1.36) was significantly shorter than that of the control group (22.9±2.16) (t=-2.286, P=0.040). At the seventh and fourteenth day, light microscope observation showed that the growth of granulation tissue and collagen fibers for rats in the experimental group were much more than that in the control group, the basale cell proliferation was more active, and inflammation was slighter. Through transmission electron microscope, we observed more fibroblast and collagen in the experimental group, which showed a better cure than the control group.　Conclusion　 Shenfu injection can significantly promote wound healing of deep partial-thickness burn. It may possibly get this effect through anti-oxidation.

引用本文： 張艷閣,岑瑛. 參附注射液對(duì)大鼠深Ⅱ度燒傷創(chuàng)面愈合的影響. 華西醫(yī)學(xué), 2011, 26(4): 547-550. doi: 復(fù)制

1. 　Clark RA. Cutaneous tissue repair: basic biologic considerations[J]. J Am Acad Dermatol, 1985, 13(5 Pt l): 701-725.
2. 　Haycock JW, Ralston DR, Morris B, et al. Oxidative damage to protein and alterations to antioxidant levels in human cutaneous thermal injury[J]. Burns, 1997, 23(7-8): 533-540.
3. 　Sayan H, Ozacmak VH, Ozen OA, et al. Beneficial effects of melatonin on reperfusion injury in rat sciatic nerve[J]. J Pineal Res, 2004, 37(3): 143-148.
4. 　Thang PT, Patrick S, Teik LS, et al. Anti-oxidant effects of the extracts from the leaves of Chromolaena odorata on human dermal fibroblasts and epidermal keratinocytes against hydrogen peroxide and hypoxanthine-xanthine oxidase induced damage[J]. Burns, 2001, 27(4): 319-327.
5. 　鄭世營, 張曉膺, 王志剛, 等. 參附注射液對(duì)離體大鼠缺氧/復(fù)氧心肌的保護(hù)作用[J]. 中國急救醫(yī)學(xué), 2004, 24(6): 425-427.
6. 　Cao J, Zheng CD, Zhang GX, et al. Protective effect of Shenfu injection on mitochondria injured by ischemia-reperufsion in Rabbits[J]. Chin Medl J (Engl), 2005, 118(6): 505-507.
7. 　孟慶濤, 夏中元, 賈一帆, 等. 參附注射液對(duì)大鼠腸缺血再灌注時(shí)腸上皮細(xì)胞casapses-3、bcl-2基因表達(dá)的影響[J]. 武漢大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2004, 25(3): 275-278.
8. 　張璟瑜, 唐作磊, 納雪晴, 等. 參附注射液對(duì)行顱內(nèi)動(dòng)脈瘤夾閉術(shù)患者血清SOD, MDA, S-100β蛋白的影響[J]. 華西醫(yī)學(xué), 2009, 24(4): 975-977.
9. 　Zheng CD, Min S. Cardioprotection of Shenfu Injection against myocardial ischemia/reperfusion injury in open heart surgery[J]. Chin J Integr Med, 2008, 14(1): 10-16.
10. 　李揚(yáng), 楊博, 陳紹洋, 等. 參附注射液預(yù)處理對(duì)大鼠腦缺血-再灌注損傷后HSP70和HSP90 表達(dá)的影響[J]. 臨床麻醉學(xué)雜志, 2010, 26(1): 51-53.
11. 　蘇泓潔, 向小勇, 趙興吉, 等. 參附注射液對(duì)大鼠心肌缺血再灌注損傷保護(hù)作用的實(shí)驗(yàn)研究[J]. 重慶醫(yī)科大學(xué)學(xué)報(bào), 2010, 35(1): 60-64.
12. 　馮世杰, 花蘭女, 金曙雯, 等. 大鼠燙傷模型的制作[J]. 上海第二醫(yī)科大學(xué)學(xué)報(bào), 1995, 15(2): 195-197.
13. 　孫同柱, 付小兵, 顧小曼, 等. 重組人表皮生長(zhǎng)因子促進(jìn)兔燙傷創(chuàng)面愈合的實(shí)驗(yàn)研究[J]. 實(shí)驗(yàn)動(dòng)物科學(xué)與管理, 2000, 17(4): 12-14.
14. 　Arturson GP. Pathophysiology of the burn wound[J]. Ann Chir Gynaecol, 1980, 69(5): 178-190.
15. 　吳靜, 胡森, 汪劍威, 等. 維生素C對(duì)燙傷休克大鼠腸內(nèi)補(bǔ)液時(shí)腸組織氧自由基損傷的影響[J]. 解放軍醫(yī)學(xué)雜志, 2008, 33(6): 646-648.
16. 　Tanaka H, Matsuda T, Miyagantani Y, et al. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study[J]. Arch Surg, 2000, 135(3): 326-331.
17. 　Horton JW. Free radicals and lipid peroxidation mediated injury in burn trauma: the role of antioxidant therapy[J]. Toxicology, 2003, 189(1-2): 75-88.
18. 　Vorauer-Uhl K, Fürnschlief E, Wagner A, et al. Topically applied liposome encapsulated superoxide dismutase reduces postburn wound size and edema formation[J]. Eur J Pharm Sci, 2001, 14(1): 63-67.
19. 　萬敬枝, 程夢(mèng)琳, 吳基良. 參附注射液對(duì)局灶性腦缺血再灌注大鼠腦組織NO、MDA含量和SOD活性的影響[J]. 中國中醫(yī)急癥, 2004, 13(6): 381-382.
20. 　吳洋, 夏中元. 參附注射液對(duì)腸缺血再灌注大鼠腎組織HO-1與iNOS表達(dá)的影響[J]. 中華中醫(yī)藥雜志, 2010, 25(7): 1024-1027.
21. 　Zhang XJ, Song L, Zhou ZG, et al. Effect of shenfu injection on gastrointestinal microcirculation in rabbits after myocardial ischemia-reperfusion injury[J]. World J Gastroenterol, 2006, 12(27): 4389-4391.
  1. 1. 　Clark RA. Cutaneous tissue repair: basic biologic considerations[J]. J Am Acad Dermatol, 1985, 13(5 Pt l): 701-725.
  2. 2. 　Haycock JW, Ralston DR, Morris B, et al. Oxidative damage to protein and alterations to antioxidant levels in human cutaneous thermal injury[J]. Burns, 1997, 23(7-8): 533-540.
  3. 3. 　Sayan H, Ozacmak VH, Ozen OA, et al. Beneficial effects of melatonin on reperfusion injury in rat sciatic nerve[J]. J Pineal Res, 2004, 37(3): 143-148.
  4. 4. 　Thang PT, Patrick S, Teik LS, et al. Anti-oxidant effects of the extracts from the leaves of Chromolaena odorata on human dermal fibroblasts and epidermal keratinocytes against hydrogen peroxide and hypoxanthine-xanthine oxidase induced damage[J]. Burns, 2001, 27(4): 319-327.
  5. 5. 　鄭世營, 張曉膺, 王志剛, 等. 參附注射液對(duì)離體大鼠缺氧/復(fù)氧心肌的保護(hù)作用[J]. 中國急救醫(yī)學(xué), 2004, 24(6): 425-427.
  6. 6. 　Cao J, Zheng CD, Zhang GX, et al. Protective effect of Shenfu injection on mitochondria injured by ischemia-reperufsion in Rabbits[J]. Chin Medl J (Engl), 2005, 118(6): 505-507.
  7. 7. 　孟慶濤, 夏中元, 賈一帆, 等. 參附注射液對(duì)大鼠腸缺血再灌注時(shí)腸上皮細(xì)胞casapses-3、bcl-2基因表達(dá)的影響[J]. 武漢大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2004, 25(3): 275-278.
  8. 8. 　張璟瑜, 唐作磊, 納雪晴, 等. 參附注射液對(duì)行顱內(nèi)動(dòng)脈瘤夾閉術(shù)患者血清SOD, MDA, S-100β蛋白的影響[J]. 華西醫(yī)學(xué), 2009, 24(4): 975-977.
  9. 9. 　Zheng CD, Min S. Cardioprotection of Shenfu Injection against myocardial ischemia/reperfusion injury in open heart surgery[J]. Chin J Integr Med, 2008, 14(1): 10-16.
  10. 10. 　李揚(yáng), 楊博, 陳紹洋, 等. 參附注射液預(yù)處理對(duì)大鼠腦缺血-再灌注損傷后HSP70和HSP90 表達(dá)的影響[J]. 臨床麻醉學(xué)雜志, 2010, 26(1): 51-53.
  11. 11. 　蘇泓潔, 向小勇, 趙興吉, 等. 參附注射液對(duì)大鼠心肌缺血再灌注損傷保護(hù)作用的實(shí)驗(yàn)研究[J]. 重慶醫(yī)科大學(xué)學(xué)報(bào), 2010, 35(1): 60-64.
  12. 12. 　馮世杰, 花蘭女, 金曙雯, 等. 大鼠燙傷模型的制作[J]. 上海第二醫(yī)科大學(xué)學(xué)報(bào), 1995, 15(2): 195-197.
  13. 13. 　孫同柱, 付小兵, 顧小曼, 等. 重組人表皮生長(zhǎng)因子促進(jìn)兔燙傷創(chuàng)面愈合的實(shí)驗(yàn)研究[J]. 實(shí)驗(yàn)動(dòng)物科學(xué)與管理, 2000, 17(4): 12-14.
  14. 14. 　Arturson GP. Pathophysiology of the burn wound[J]. Ann Chir Gynaecol, 1980, 69(5): 178-190.
  15. 15. 　吳靜, 胡森, 汪劍威, 等. 維生素C對(duì)燙傷休克大鼠腸內(nèi)補(bǔ)液時(shí)腸組織氧自由基損傷的影響[J]. 解放軍醫(yī)學(xué)雜志, 2008, 33(6): 646-648.
  16. 16. 　Tanaka H, Matsuda T, Miyagantani Y, et al. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study[J]. Arch Surg, 2000, 135(3): 326-331.
  17. 17. 　Horton JW. Free radicals and lipid peroxidation mediated injury in burn trauma: the role of antioxidant therapy[J]. Toxicology, 2003, 189(1-2): 75-88.
  18. 18. 　Vorauer-Uhl K, Fürnschlief E, Wagner A, et al. Topically applied liposome encapsulated superoxide dismutase reduces postburn wound size and edema formation[J]. Eur J Pharm Sci, 2001, 14(1): 63-67.
  19. 19. 　萬敬枝, 程夢(mèng)琳, 吳基良. 參附注射液對(duì)局灶性腦缺血再灌注大鼠腦組織NO、MDA含量和SOD活性的影響[J]. 中國中醫(yī)急癥, 2004, 13(6): 381-382.
  20. 20. 　吳洋, 夏中元. 參附注射液對(duì)腸缺血再灌注大鼠腎組織HO-1與iNOS表達(dá)的影響[J]. 中華中醫(yī)藥雜志, 2010, 25(7): 1024-1027.
  21. 21. 　Zhang XJ, Song L, Zhou ZG, et al. Effect of shenfu injection on gastrointestinal microcirculation in rabbits after myocardial ischemia-reperfusion injury[J]. World J Gastroenterol, 2006, 12(27): 4389-4391.