【摘要】：燙傷藥水是江蘇省中醫(yī)院外科臨床常年使用的中醫(yī)特色外用制劑,治療小面積燙傷效果良好,臨床發(fā)現(xiàn)具有止痛迅速、明顯減少滲出、干燥創(chuàng)面、抗菌作用好、促進創(chuàng)面愈合、預防疤痕生成,效果優(yōu)于同類藥物。本課題是根據(jù)江蘇省中醫(yī)院老中醫(yī)的經(jīng)驗方制成的本院制劑燙傷藥水改進而成,結(jié)合了該產(chǎn)品在江蘇省中醫(yī)院應用多年的經(jīng)驗,運用中醫(yī)藥特色結(jié)合現(xiàn)代生物醫(yī)藥科技的方法,本課題包括了臨床觀察及動物實驗兩部分,對燙傷藥水噴霧劑的療效及其機理作更詳細的研究。臨床研究目的：觀察燙傷藥水噴霧劑對于小面積淺表燙傷的臨床效果。方法：將30例小面積淺表燙傷的病人分為兩組,治療組15例,對照組15例,治療組用燙傷藥水外用,對照組使用凡士林紗布,每日換藥1次,治療開始后于第1,3,5天以相同焦距,相同距離拍攝創(chuàng)面的圖片。輔以Image J軟件,測算創(chuàng)面面積,然后計算創(chuàng)面愈合率。參照國家中醫(yī)藥管理局醫(yī)政司制定的《中醫(yī)臨床病癥診斷療效標準》,治療2周后進行評價療效,觀察本品治療燙傷的綜合療效。采用、VAS疼痛評分法,評估其止痛效果。結(jié)果：在創(chuàng)面愈合率的指標檢測中,治療組的第一天及第五天創(chuàng)面愈合率相比對照組,具有明顯統(tǒng)計學差異,且隨著時間的推移,創(chuàng)面愈合率差異更加明顯。在綜合療效評分的觀察中,治療組相對于對照組,患者第一天和第三天的療效評分治療組遠高于對照組,且隨著時間的推移,兩組的差異越發(fā)明顯。在疼痛評分的觀察中,治療組的疼痛評分相對于對照組,具有顯著的統(tǒng)計學意義。實驗研究目的：研究燙傷藥水噴霧劑與創(chuàng)面愈合及防治疤痕生成的關(guān)系。方法：分為兩部分,第一部分：觀察燙傷藥水噴霧劑對大鼠燙傷創(chuàng)面愈合的影響。方法：將150只SD大鼠采用淺Ⅱ度燙傷模型,隨機分為五組,實驗高、中、低劑量組(燙傷藥水噴霧劑),陽性對照組(磺胺嘧啶銀軟膏),陰性對照組(基質(zhì)軟膏)。檢測創(chuàng)面組織含水量及新生毛細血管數(shù)。第二部分：采用大鼠深I(lǐng)I度燙傷模型。噴涂燙傷藥水(第一部分實驗的中劑量組),并用磺胺嘧啶銀作療效對比,用基質(zhì)軟膏作空白對照。創(chuàng)傷后于第3,7,14天麻醉下分別取皮,送至病理科。分別測試(1).組織內(nèi)Ⅰ、Ⅲ型膠原檢測,(2).凋亡細胞計數(shù)組織內(nèi)TGF-β1的表達；(3)并用Tunnel法測凋亡指數(shù)。結(jié)果：燙傷藥水在組織含水量的測定中,實驗組低于陽性對照組,在新生的毛細血管的數(shù)目測定中實驗組高于陽性對照組,燙傷藥水對TGF-β1表達,實驗組隨時間逐漸減少,磺胺嘧啶銀組及陰性組隨時間漸漸增加,第14天無明顯下降。Ⅰ型膠原、Ⅲ型膠原在第3、14天實驗組與陰性組相比,含量高于陰性組,實驗組的I型膠原隨時間逐漸增多,而Ⅲ型膠原隨時間逐漸減少。優(yōu)于陰性組。結(jié)論：燙傷藥水噴霧劑能促進創(chuàng)面愈合,減少疼痛,控制感染,預防疤痕生成的作用。
[Abstract]:Scalding medicine is a traditional Chinese medicine special external preparation used in surgery of Jiangsu Provincial Hospital of traditional Chinese Medicine for many years. It has a good effect in treating small area scalding. It is found that it can relieve pain quickly, obviously reduce exudation, dry wound, have good antibacterial effect, and promote wound healing. Prevention of scar formation, the effect is better than the same drug. This subject is based on the experience of the traditional Chinese medicine of Jiangsu Provincial traditional Chinese Medicine Hospital, which has been improved by the scalding solution of this hospital. It combines the experience of the application of this product in Jiangsu traditional Chinese Medicine Hospital for many years, and the method of combining the characteristics of traditional Chinese medicine with modern biomedical science and technology. This paper includes two parts, clinical observation and animal experiment, to study in detail the curative effect and mechanism of scald solution spray. Objective: to observe the clinical effect of scalding liquid spray on small area superficial burn. Methods: thirty patients with small area superficial scalding were divided into two groups: the treatment group (n = 15) and the control group (n = 15). The treatment group was treated with scalding solution, the control group was treated with vaseline gauze, and the control group was treated with vaseline gauze once a day. The wounds were photographed at the same focal length and at the same distance for 5 days. With Image J software, the wound area was calculated and the wound healing rate was calculated. According to the criteria for the diagnosis of clinical symptoms of traditional Chinese medicine formulated by the Department of Medical and political Affairs of the State Administration of traditional Chinese Medicine, the curative effect was evaluated after 2 weeks of treatment, and the comprehensive efficacy of this product in the treatment of scalds was observed. VAS pain score was used to evaluate the analgesic effect. Results: the rate of wound healing in the treatment group was significantly different from that in the control group on the first day and the fifth day, and with the passage of time, the difference of the wound healing rate was more obvious. Compared with the control group, the curative effect score of the treatment group on the first day and the third day was much higher than that of the control group, and the difference between the two groups became more and more obvious with the passage of time. In the observation of pain score, the pain score in the treatment group was significantly higher than that in the control group. Objective: to study the relationship between scald spray and wound healing and scar formation. Methods: two parts were divided. The first part was to observe the effect of scald solution spray on wound healing of scalded rats. Methods: 150 SD rats were randomly divided into five groups: high, middle and low dose groups (scalded liquid spray), positive control group (silver sulfadiazine ointment) and negative control group (matrix ointment). The water content of wound tissue and the number of neonate capillaries were measured. The second part: the model of deep II scald in rats. Spray scald solution (middle dose group of the first part of the experiment), using silver sulfadiazine as the curative effect contrast, using the matrix ointment as the blank control. The skin was taken under anesthesia on the 3rd day and sent to the pathology department. Test respectively (1). Detection of collagen 鈪，

本文編號：2307033