探討黑玉生肌散對於燒燙傷之治療作用

Therapeutic Effects of Black Jade Shengjisan on Rats with Burn Injury

現行燒燙傷藥膏大多為抗菌性藥品，常用於避免傷口感染，但並無抑制發炎或止痛類型藥物被應用在燒燙傷外用上，所以在臨床治療中，如何治療傷口並同時緩解疼痛已成為一重要研究課題。我們依據中醫藥典所載之學理，調配青黛混合石膏、珍珠與冰片，以製成粉劑黑玉生肌散應用於燒燙傷治療。本研究利用大白鼠背部皮膚燒燙傷模式，探討黑玉生肌散對於燒燙傷之治療效果；配合影像定量方法，評估黑玉生肌散對於傷口面積癒合速率的影響。以及透過測量體重減少之情形，評估黑玉生肌散是否緩解燒燙傷所引起之疼痛。研究結果證實黑玉生肌散確實具有促進傷口癒合速率之能力，並可抑制組織發炎，同時亦能緩解因燒燙傷所造成之疼痛。黑玉生肌散除了可以改善燒燙傷組織新生表皮（epidermis）的增厚與不平滑、真皮（dermis）和橫紋肌（striated muscle）組織的變薄之受損病徵，亦能抑制如嗜中性白血球（neutrophil）和巨噬細胞（macrophage）等白血球的大量聚集等組織發炎情形。而免疫組織化學染色法（immunohistochemistry）之分析結果顯示，黑玉生肌散可有效促進傷口組織進行復原反應，諸如血管內皮生長因子（vascular endothelial growth factor， VEGF）和第一型膠原蛋白（collagen type I）的大量表現。本研究說明黑玉生肌散有極高藥用價值而可被應用於治療燒燙傷，而其鎮痛消炎機轉值得深入探索。

Most of the existing burn drugs, which are antimicrobial drugs, can prevent infection caused by burns. However, no anti-inflammatory or analgesic drugs are available for the topical treatment of burns. Therefore, treatment of burn wounds and alleviation of the associated pain have become important research topics in the clinical treatment of burns. On the basis of a theory found in traditional Chinese medicine books, we invented a new type of herbal compositiontermed Black Jade Shengjisan, which comprises a mixture of gypsum, Qing Dai, pearl, and borneol, for the treatment of burn injury. In this study, we investigated the therapeutic effects of Black Jade Shengjisan on a rat model of burninduced skin injuries on the back. To determine the effect of Black Jade Shengjisan on the wound healing rate, quantitative image analysis of the area of the burn wound was performed. Further, weight loss was measured to assess whether the pain caused by burn injury was relieved by Black Jade Shengjisan. The results of these examinations indicated that Black Jade Shengjisan promoted the wound healing rate, inhibited tissue inflammation, and eased the pain caused by burns. Treatment with Black Jade Shengjisan reduced the effects of burn injury, such as inflammatory cell infiltrates, e.g., neutrophils and macrophages, in the dermis, thickening of the epidermis, and thinning of the dermis and striated muscles. These immunohistochemistry results revealed that the cellular mechanisms underlying the woundhealing effect of Black Jade Shengjisan were involved with the upregulation of vascular endothelial cell growth factor (VEGF) and collagen type I. Our results indicate that Black Jade Shengjisan is a potential therapeutic agent for burn injury and suggest that it is important to further investigate the properties of the anti-inflammatory and analgesic effects of this drug.