ABSTRACT
A chronic refractory wound is caused by continuous skin damage. At the same time， it may be formed due to repeated infection， vascular insufficiency， diabetes， tumors， chronic osteomyelitis， and other reasons， resulting in wound repair interruption and recovery delay. Chronic refractory wound seriously affects the quality of life of patients and consumes a lot of medical resources. Polysaccharides in traditional Chinese medicine （TCM） are the effective components of most TCM. Modern pharmacological studies have found that polysaccharides contained in TCM have anti-inflammatory， antioxidant， anti-radiation， hypoglycemic， antiviral， anti-tumor， hypolipidemic， and immunomodulatory effects. Through the summary and analysis of the literature， it was found that the mechanism of polysaccharides in TCM to promote chonic refractory wound repair was mainly realized from the following aspects： firstly， regulating inflammatory cytokines like interleukin-4 （IL-4）， interleukin-10 （IL-10）， interleukin-8 （IL-8）， and tumor necrosis factor-α （TNF-α） or regulating macrophage-related inflammatory proteins and chemotactic proteins like MIP-2， MCP-1， to shorten the inflammatory period. Secondly， activating growth factors like platelet-derived growth fator （PDGF）， basic fibroblast growth factor （bFGF）， TGF-α， and vascular endothelial growth factor （VEGF） to recruit endothelial cells and fibroblasts into tissue proliferation. Thirdly， activationg VEGF and its downstream receptor vascular endothelial growth factor receptor-1 （VEGFR-1） and vascular endothelial growth factor receptor-2 （VEGFR-2）-mediatated protein kinase C/extracellular regulated kinases （PKC/ERK） signaling pathway or promoting angiogenesie and improving wound blood flow through angiotensin （ANG）. Fourthly， promoting the ablility of collagen synthesis by enhancing the secretion of hydroxyproline and hyaluronic acid （HA） from fibroblasts （FB） and regulating relevant matrix metalloenzymes and their enzyme inhibitor to regulate the extracellular matrix. Fifthly， eliminating free radiccals to reduce the damage caused by oxidative stress to tissue. Sixthly， enhancing the phagocytic ability of macrophages， the activity of natural killer cells， and the proliferation of T cells to improve the defense ability of tissue. Polysaccharides in TCM can repair wounds in many ways at the same time. Its advantage lies in the multiple targets and multiple pathways. It is expected that the research will pay more attention to the mechanism of wound repair by polysaccharide components in TCM when improving the treatment of chronic refractory wounds.
ABSTRACT
Objective To explore the intervention mechanism of Yiqi Huoxue Fang on deep venous thrombosis ( DVT) of rabbit model,by observing its effects on serum t-PA and PAI-1,D-D,NO,CRP,PT,blood rheology and vascular pathology. Methods Fifty New Zealand rabbits were randomly selected.Ten rabbits were served as blank control group.DVT animal models were established in the remaining 40 rabbits, which were randomly divided into model control group, Yiqi Fang group, Huoxue Fang group and Yiqi Huoxue Fang group (n=10 each group).The changes of serum t-PA,PAI-1,D-D,NO,CRP,PT and pathological changes of blood vessel were observed after 7-days treatment. Results As compared with the blank control group, the serum t-PA,PAI-1,D-D,CRP and PT were significantly increased in the model control group,Yiqi Fang group,Huoxue Fang group and Yiqi Huoxue Fang group (all P0.05 in Yiqi Huoxue Fang group vs.the blank control group).As compared with model control group,the serum t-PA,NO,D-D increased,PAI-1 and CRP value reduced in Yiqi Huoxue Fang group and Huoxue fang group (P<0.01 or P<0.05).As compared with Yiqi Huoxue Fang group,serum t-PA in both Yiqi Fang group and Huoxue Fang group was significantly lower (P<0.01 and P<0.05) ,other indexes were significantly higher than that in Yiqi Huoxue Fang group (serum PAI-1,P<0.01 in Yiqi Fang group;NO and D-D,P<0.01 or P<0.05 in Yiqi Fang group;CRP value,P<0.01).Vascular pathology showed that blood vessels,especially vascular endothelia,of Yiqi Huoxue Fang group were most slightly injured,with slightest infiltration of inflammatory cells. Conclusion Yiqi Huoxue Fang can prevent DVT through regulating t-PA and PAI-1,keeping the fibrinolytic system function at a relatively high level,protecting vascular intima and relieving the inflammation in venous thrombosis.