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目的:观察清利活血汤配合三黄生肌纱条对糖尿病足溃疡大鼠肉芽组织中内皮素-1(ET-1)、一氧化氮(NO)、血管内皮生长因子(VEGF)含量的影响,探讨其促进溃疡愈合的作用机理。方法:32只雄性Wistar大鼠随机分为模型组、正常组、治疗组、对照组4组,除正常组外,余组均用高脂饲料喂养4周后,腹腔注射STZ30mg/Kg制作2型糖尿病模型,成功后4组动物以10%水合氯醛1ml/100g体重腹腔注射麻醉下大鼠背部脊柱左侧相同部位制作直径2cm溃疡,分笼饲养。各组从术后第1天开始灌胃给药及溃疡换药,分别为:治疗组:清利活血汤14.5g/kg.d,三黄生肌纱条换药1次/d;对照组:盐酸二甲双胍片72.4mg/kg.d,凡士林纱条换药1次/d;模型组、正常组:生理盐水2ml/次.d;生理盐水纱条换药1次/d。用药15天后处死大鼠,切取溃疡面肉芽组织,放射免疫法测定ET-1含量,硝酸还原酶法测定NO含量,RT-PCR法测定VEGF含量。结果:与正常组比较,模型组大鼠ET-1含量均明显升高(P<0.01),NO、VEGF含量明显降低(P<0.01);与模型组比较,治疗组、对照组ET-1含量明显降低(P<0.01),NO、VEGF含量明显升高(P<0.01);与对照组比较,治疗组鼠ET-1含量均明显降低(P<0.05),NO、VEGF含量明显升高(P<0.05)。结论:清利活血汤配合三黄生肌纱条可下调糖尿病足溃疡大鼠肉芽组织ET-1含量,提高NO、VEGF含量从而加速溃疡愈合,其疗效优于二甲双胍+凡士林。
Objective: To observe the effect of Qingre Huoxue Decoction combined with Sanyangang sliver on the content of ET-1, NO and VEGF in granulation tissue of diabetic foot ulcer rats , To explore its mechanism of promoting ulcer healing. Methods: Thirty-two male Wistar rats were randomly divided into 4 groups: model group, normal group, treatment group and control group. Except the normal group, the remaining groups were fed with high-fat diet for 4 weeks and then injected with STZ30mg / Diabetic model, after successful 4 groups of animals with 10% chloral hydrate 1ml / 100g body weight intraperitoneal injection anesthesia rat left spine left the same site making 2cm diameter ulcers, cage feeding. Each group from the first day after operation, oral administration and ulcer dressing change were as follows: treatment group: Qingliuhuoxue Decoction 14.5g / kg.d, Sanhuang Shengli gauze dressing 1 / d; control group : Metformin hydrochloride tablets 72.4mg / kg.d, Vaseline gauze dressing 1 / d; model group, normal group: saline 2ml / time .d; saline saline dressing 1 time / d. The rats were sacrificed 15 days after the administration, the granulation tissue of the ulcer was cut out, the content of ET-1 was determined by radioimmunoassay, the content of NO was determined by nitrate reductase method, and the content of VEGF was determined by RT-PCR. Results: Compared with the normal group, the content of ET-1 in the model group was significantly increased (P <0.01) and the content of NO and VEGF was significantly decreased (P <0.01). Compared with the model group, ET- (P <0.01). Compared with the control group, the content of ET-1 in the treated group was significantly decreased (P <0.05) and the contents of NO and VEGF were significantly increased (P <0.05). Conclusion: Qingliuhuoxue Decoction combined with Sanhuang Shengji gauze can reduce the content of ET-1 in granulation tissue of diabetic foot ulcer rats and increase the content of NO and VEGF to accelerate the healing of ulcer. The curative effect is superior to metformin + petrolatum.