黄芪当归汤联合中医序贯疗法促进SD大鼠肛周脓肿术后创面愈合*
作者：张永丽1，2，钱海华2，孙林梅1，张欣颖1，宫丹丹1，胡建生1
单位：1.西安市中医医院，陕西 西安 710016； 2.南京中医药大学附属医院，江苏 南京 210023
引用：引用：张永丽，钱海华，孙林梅，张欣颖，宫丹丹，胡建生.黄芪当归汤联合中医序贯疗法促进SD大鼠肛周脓肿术后创面愈合[J].中医药导报,2025,31(9):32-37,54.
DOI：10.13862/j.cn43-1446/r.2025.09.005
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摘要：
目的：探讨黄芪当归汤联合序贯换药法对肛周脓肿术后创面愈合的促进作用。方法：取24只SD大鼠建立肛周脓肿术后模型，分为模型组、黄芪当归汤组、中医序贯换药组和黄芪当归汤联合中医序贯换药组，另取6只健康SD大鼠不作任何处理，作为正常组。除正常组外各组给药处理均1次/d，共干预21 d。观察创面愈合情况，测量治疗第7、14、21天的创面愈合率；苏木精-伊红染色（HE）观察创面组织病变；酶联免疫吸附测定（ELISA）检测创面组织中肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-6、IL-10水平；免疫组织化学检测创面组织中血管内皮生长因子（VEGF）和血管内皮细胞特异性标记物（CD31）表达水平；流式细胞术检测创面组织中的CD86+巨噬细胞和CD206+巨噬细胞数量；蛋白质印迹法（Western blotting）检测创面组织中Janus激酶2（JAK2）、p-JAK2、信号传导及转录激活因子3（STAT3）、p-STAT3蛋白表达水平。结果：模型组大鼠创面组织在21 d内均未完全愈合，其余用药组大部分创面组织完全愈合。与正常组比较，模型组创面组织结构破坏严重，组织中TNF-α浓度、IL-6浓度、VEGF、CD31蛋白表达升高（P<0.05），CD86+巨噬细胞数量增加（P<0.05），IL-10浓度及JAK2、p-JAK2、STAT3、p-STAT3蛋白表达降低（P<0.01），CD206+巨噬细胞数量减少（P<0.05）。与模型组比较，黄芪当归汤组、中医序贯换药组和黄芪当归汤联合中医序贯换药组均有明显改善（P<0.05），其中黄芪当归汤联合中医序贯换药组效果最佳（P<0.01）。结论：内服黄芪当归汤联合外用中医序贯换药可以促进大鼠肛周脓肿术后创面血管新生与创面愈合。
关键词：肛周脓肿；创面愈合；黄芪当归汤；中医序贯疗法；血管新生；大鼠
Abstract：
Objective: To determine whether Huangqi
Danggui decoction combined with sequential dressing change can promote wound
healing after perianal abscess surgery. Methods: Totally 24 SD rats were used
to establish a postoperative model of perianal abscess and the rats were
divided into model group, Huangqi Danggui decoction group, Traditional Chinese
Medicine (TCM) sequential dressing change group (sequential group), and Huangqi
Danggui decoction combined with TCM sequential dressing change group
(combination group). Another 6 healthy SD rats were taken without any treatment
as the normal group. Except for the normal group, the treatments were given
once a day for a total of 21 days. The wound healing rates were measured at 7th
day, 14th day, and 21st day. HE staining was used to observe the wound tissue
lesions. Enzyme-linked immunosorbent assay (ELISA) was used to detect the
concentrations of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and
andinterleukin-10 (IL-10) in wound tissue. The expression levels of vascular
endothelial growth factor (VEGF) and vascular endothelial cell specific marker
(CD31) in wound tissue were detected by immunohistochemistry. The number of
CD86+ macrophages and CD206+ macrophages in wound tissue was detected by flow
cytometry. Western blotting was used to detect the protein expressions of Janus
kinase 2 (JAK2), phosphorylase Janus kinase 2 (p-JAK2), signal transducer and
activator of transcription 3 (STAT3), and phosphorylase signal transducer and
activator of transcription 3 (p-STAT3) in wound tissue. Results: The wound
tissue of the model group was not completely healed within 21 days, and most of
the wound tissue of the other medication groups were completely healed.
Compared with the normal group, the wound tissue structure of the model group
was severely damaged, and the TNF-α, IL-6 , VEGF and CD31 protein expressions
were increased (P<0.05). The number of CD86+ macrophages were increased
(P<0.05), and the IL-10, JAK2, p-JAK2, STAT3 and p-STAT3 protein expressions
were decreased in model group (P<0.01). The number of CD206+ macrophages was
reduced in model group (P<0.05). Compared with the model group, the Huangqi
Danggui decoction group, sequential group and combination group showed
significant improvement (P<0.05), and the combination group showed the best
effect (P<0.01). Conclusions: The method of oral administration of Huangqi
Danggui decoction and external application of TCM sequential dressing change,
can promote wound angiogenesis and wound healing.
Key words：perianal abscess; wound healing; Huangqi Danggui decoction; traditional Chinese medicine sequential therapy; angiogenesis; rats
发布时间：2026-01-08
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