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目的探讨消毒愈肌膏对糖尿病足患者创面肉芽组织血管内皮生长因子(VEGF)/基质细胞衍生因子1a(SDF-1a)/趋势化因子受体4(CXCR4)蛋白表达的影响。方法将56例糖尿病足患者依据Wagner分级法患者足部病变的范围及程度进行评价分为治疗组和对照组,治疗组27例,对照组29例。对照组采用进行基础治疗抗感染、控制血糖、抗凝、清创术、引流术等治疗;治疗组在对照组治疗的基础上外用消毒愈肌膏治疗,在治疗8周后观察创面愈合情况和应用免疫组织化学(S-P法)与Western blot检测创面肉芽组织VEGF/SDF-1a/CXCR4含量和蛋白表达变化。结果治疗后2、4、8周治疗组创面愈合率明显高于对照组,差异有统计学意义(P<0.05);治疗后8周创面肉芽组织VEGF/SDF-1a/CXCR4含量(IOD值)比较,及创面肉芽组织VEGF/SDF-1a/CXCR4蛋白表达比值比较,对照组均明显低于治疗组(P<0.05)。结论消毒愈肌膏治疗作用可能与促进VEGF、SDF-1a及CXCR4蛋白表达有关,从而促进新血管生成,加快创面愈合。
Objective To investigate the effect of Jie Du Yu Ji Ointment on the expression of vascular endothelial growth factor (VEGF) / stromal cell-derived factor 1 (SDF-1a) / chemokine receptor 4 (CXCR4) in wound granulation tissue of diabetic foot patients. Methods Fifty-six patients with diabetic foot were divided into treatment group and control group according to the range and extent of foot lesions in patients with Wagner grading. The treatment group and the control group were 27 and 29, respectively. The control group was treated with anti-infection, blood glucose control, anticoagulation, debridement and drainage. The treatment group was treated with external disinfection and healing muscle extract on the basis of the control group. After 8 weeks of treatment, the wound healing and The expression of VEGF / SDF-1a / CXCR4 and protein in wound granulation tissue were detected by immunohistochemistry (SP method) and Western blot. Results The wound healing rate of the treated group was significantly higher than that of the control group at 2, 4 and 8 weeks after treatment (P <0.05), and the contents of VEGF / SDF-1a / CXCR4 (IOD) Compared with the control group, the expression of VEGF / SDF-1a / CXCR4 protein in wound granulation tissue was significantly lower than that in the treatment group (P <0.05). Conclusion The therapeutic effect of disinfecting Yuji Ointment may be related to promoting the expression of VEGF, SDF-1a and CXCR4, so as to promote neovascularization and accelerate wound healing.