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目的研究清热利湿外洗方(虎杖、蒲公英、苦参、黄柏)及虎杖苷对SD大鼠肛旁创面愈合的影响。方法以SD大鼠肛旁创面模型为研究对象,随机分为清热利湿外洗方组(简称“清热利湿组”)、虎杖苷组、生理盐水组,每组45只,给予相应干预。在术后第3、7、11天通过伊文氏蓝染色法观察创面毛细血管通透性情况;肉眼及电镜观察创面渗出、炎症及愈合情况;电镜下观察血管内皮细胞紧密连接及胶原纤维合成、分布情况。结果造模后第3天,清热利湿组与虎杖苷组伊文氏蓝渗出情况差异无统计学意义(P>0.05),但两者渗出均少于生理盐水组(P<0.05);第7、11天,各组伊文氏蓝渗出差异无统计学意义(P>0.05)。肉眼观察发现,造模后第3、7、11天各组创面分泌物渗出差异无统计学意义(P>0.0167)。术后第3、7天清热利湿组肉芽增生及上皮爬行优于生理盐水组(P<0.0167),但与虎杖苷组差异无统计学意义(P>0.0167);虎杖苷组与生理盐水组差异均无统计学意义(P>0.0167)。术后第11天,3组创面愈合情况差异均无统计学意义(P>0.0167)。光镜结果可见清热利湿组肉芽组织无明显水肿,新生毛细血管丰富且成纤维细胞排列整齐,虎杖苷组与之接近,两者愈合情况均优于生理盐水组。电镜结果可见清热利湿组血管内皮细胞紧密连接将相邻细胞紧密嵌合;胶原纤维分布致密、规则,纤维束排列紧密。结论清热利湿方与虎杖苷均能降低血管通透性,控制创面炎性渗出,但清热利湿方能更有效地促进上皮爬行、加快肉芽组织内各成分再生。
Objective To study the effect of clearing away dampness and dampness (Polygonum cuspidatum, dandelion, Sophora flavescens, Cortex Phellodendri) and polydatin on healing of perianal wounds in SD rats. Methods The model of perianal wound on SD rats was randomly divided into two groups: nourishing heat and dampness washing group (referred to as “clearing heat dampness group”), polydatin group and normal saline group, with 45 rats in each group Intervention. The wound capillary permeability was observed by Evan’s blue staining on the 3rd, 7th and 11th postoperative days. The wound exudation, inflammation and healing were observed by naked eye and electron microscope. The tight junctions of vascular endothelial cells and the synthesis of collagen fibers ,Distribution. Results On the 3rd day after modeling, there was no significant difference in the exudation of Evans Blue between Qingreliu group and PDZ group (P> 0.05), but the exudation of both was less than that of saline group (P <0.05). On the 7th and 11th days, there was no significant difference in Evans Blue exudation in each group (P> 0.05). Macroscopically, we found there was no significant difference in exudation of wound secretions on the 3rd, 7th and 11th day after modeling (P> 0.0167). Granuloma proliferation and epithelial creeping in heat-clearing and dampness groups on day 3 and 7 were better than those on saline groups (P <0.0167), but there was no significant difference between them (P> 0.0167) The difference was not statistically significant (P> 0.0167). On the 11th postoperative day, there was no significant difference in the wound healing between the three groups (P> 0.0167). The results of light microscopy showed no obvious edema in the heat - dampness group granulation tissue, fresh capillaries and fibroblasts neatly arranged, with the close to the corticosteroid group, the healing of the two were better than the saline group. Electron microscopy results showed that the close connection of the vascular endothelial cells in the heat-clearing and dampness-removing group tightly bound adjacent cells; the distribution of collagen fibers was dense and regular, and the arrangement of the fiber bundles was close. Conclusion Both Qingre Lishi and Polydatin can reduce vascular permeability and control inflammatory exudation, but Qingre Lishi can promote epithelial creep more effectively and accelerate the regeneration of various components in granulation tissue.