中藥玉紅膏治療豬深度燙傷效應之研究

Effects of Chinese Medicine (Yu-Hoitg-Gao) on Wound Healing of Deep Degree Burn in the Pig

中醫臨床上常用於癰疽瘡毒潰瘍收口期的外用藥玉紅膏首見於明‧陳實功的《外科正宗》，具有和血生肌、促進傷口癒合的效果。為了探討玉紅膏對燙傷創口外敷的促進傷面癒合效果，與西醫慣用處理方式之療效比較，本研究探用豬的深度燙傷模型，共三隻豬，每隻豬左、右背部各三個創面，將燙傷創面分為對照組、西藥外敷組及中藥外敷組等三組，並利用重複拉丁方陣設計（repeated Latin-square design）方法進行實驗設計與分組。於第1、2、3、4週時，描繪傷口未癒合之面積，以變異數分析法進行統計分析。同時於第3天及第1、2、4週時，進行切片採樣，藉此觀察不同用藥處理對組織癒合之影響。外敷中藥玉紅膏對於豬深度燙傷的創面癒合之影響，結果顯示在燙傷後第3週時較不敷藥與外敷西藥Silver sulfadiazine有顯著的促創面癒合作用。而在組織病理觀察上外敷中藥玉紅膏對燙傷創面後期癒合上可以促進表皮再生的生長線位移，亦可促進過度增生的細胞趨於成熟化，同時降低纖維母細胞浸潤程度。除此之外，外敷中藥玉紅膏在組織修復過程有著顯著促進血管新生的作用與減輕燙傷創面炎症反應的效應，且所誘發的炎症反應主要以淋巴球為主，與其促「生肌」能力相符。 For assessing and comparing the effect of Yu-Hong-Gao and western medicine on wound healing of deep degree bum, a deep degree porcine bum model with repeated Latin-square design experiment method was used. Three bums were inflicted on both the flanks of the three pigs used in the present study. These bum wounds were divided into a control group, a western medicine group and a Chinese medicine group. Rate of reepithelialization was calculated at 7, 14, 21, 28 postbum days. Full thickness biopsies were taken at 3, 7, 14 and 28 postbuxn days for histopathological evaluation. As a result, the rate of reepithelialization of bum wounds which were treated with Yu-Hong-Gao was significantly increased as compared to that of the control group as well as the western medicine group at 21 postburn days. Comparing the Yu-Hong-Gao-txeated bums and Silver Sulfadiazine-treated bums, we concluded that (1) Both Yu- Hong-Gao and Silver Sulfadiazine could not improve the disintegration of the crust; (2) Yu-Hong-Gao could promote the epidermal regeneration at late phase of wound healing; (3) Yu-Hong-Gao could reduce the degree of fibroblast infiltration at late phase of wound healing; (4) Yu-Hong-Gao could enhance the neovascularization of the wounded area during the process of wound healing; (5) Yu-Hong-Gao could alleviate the reaction of inflammation.