白竭散对肛瘘术后创面血管生成的调控机制研究

目的 观察白竭散对肛瘘术后创面新生血管生成的调控作用并探讨其调控机制。方法 将75例肛瘘患者随机分为白竭散组、贝复济组、对照组，每组25例，均予以肛瘘切开挂线术治疗，术后第2天开始分别用白竭散纱条、贝复济纱条、凡士林纱条换药。术后7、14 d，分别于光镜下观察新生毛细血管数，采用免疫组织化学法及Western blot法检测肉芽组织中血管内皮生长因子（vascular endothelial growth factor,VEGF）、血小板内皮细胞黏附分子（platelet endothelial cell adhesion molecules,PECAM 1/CD31）及第Ⅷ因子关联抗原（von willebrand factor,VWF）的表达水平。结果 术后7、14 d，贝复济组、白竭散组毛细血管数均较对照组显著增加（P＜0.05），白竭散组毛细血管数显著多于贝复济组（P＜0.05）。免疫组织化学法检测结果显示，与对照组比较，贝复济组和白竭散组的VEGF在胞浆内呈大量棕黄色颗粒，数量明显增多；CD31、VWF在胞浆内呈大量棕褐色颗粒，数量明显增多。Western blot检测发现，与对照组比较，术后7、14 d，贝复济组和白竭散组VEGF、CD31、VWF蛋白表达水平均显著增加（P＜0.05）；与贝复济组比较，术后14 d白竭散组VEGF、CD31、VWF蛋白表达水平显著增加（P＜0.05）。结论 白竭散通过增加创面VEGF、CD31、VWF蛋白表达，促进毛细血管新生，提高创面愈合速度。

Regulatory Mechanism of Baijie Powder in Wound Angiogenesis after Anal Fistula Surgery

Objective To investigate the regulatory effect of Baijie Powder on wound angiogenesis after anal fistula surgery and the related regulatory mechanism. Methods A total of 75 patients with anal fistula who were treated from November 2014 to May 2016 were enrolled and randomly divided into Baijie Powder group, Beifuji group, and control group, with 25 patients in each group. All patients were given the incision and thread drawing therapy, and Baijie Powder gauze, Beifuji gauze, or vaseline gauze was used for dressing change since day 2 after surgery. On days 7 and 14 after surgery, the number of new capillaries were observed under a light microscope, and immunohistochemistry and Western blot were used to measure the expression of vascular endothelial growth factor (VEGF), platelet endothelial cell adhesion molecules (PECAM 1 and CD31), and von Willebrand factor (VWF) in granulation tissues. Results On days 7 and 14 after surgery, the Beifuji group and the Baijie Powder group had a significant increase in the number of capillaries compared with the control group (P<0.05), and the Baijie Powder group had a significantly higher number than the Beifuji group (P<0.05). Immunohistochemistry showed that compared with the control group, the Beifuji group and the Baijie Powder group had significant increases in the number of brown granules of VEGF and dark brown granules of CD31 and VWF in the cytoplasm. Western blot showed that compared with the control group, the Beifuji group and the Baijie Powder group had significant increases in the protein expression of VEGF, CD31, and VWF on days 7 and 14 after surgery (P<0.05); compared with the Beifuji group, the Baijie Powder group had significant increases in the protein expression of VEGF, CD31, and VWF on day 14 after surgery (P<0.05). Conclusion Baijie Powder can increase the protein expression of VEGF, CD31, and VWF and the number of new capillaries in the wound and thus promote wound healing.