Intervention Effect and Mechanism of Fufang Huangbaiye Tuji on Skin with Deep Ⅱ Degree Burn Wound / 中国实验方剂学杂志

Objective:To study the intervention effect and underlying mechanism of Fufang Huangbaiye Tuji （FFHBY） on skin with deep Ⅱ degree burn wound. Method:Patients with deep Ⅱ degree burn of fire-toxin injuring fluid syndrome diagnosed in the Affiliated Hospital of Chengde Medical University from June 2019 to June 2020 were randomly divided into a control group （iodophor solution， 35 mL per 1% body surface area）， a low-dose treatment group （FFHBY， 17.5 mL per 1% body surface area）， and a high-dose treatment group （FFHBY， 35 mL per 1% body surface area）， 40 cases in each group. The patients in each group were treated correspondingly with dressing chance once per day. The pathological changes of the wound were observed on the 14th day after treatment. Wound symptoms and signs in each group before treatment and on the 7th， 14th， and 21st days after treatment were quantified， and the clinical efficacy on the 21st day after treatment was evaluated. Wound healing rates in each group were calculated on the 7th， 14th， and 21st days after treatment. The levels of vascular endothelial growth factor （VEGF）， fibroblast growth factor （FGF）-2， FGF-7， epidermal growth factor （EGF）， interleukin （IL）-10， tumor necrosis factor （TNF）-<italic>α</italic>， and Caspase-3 in wound tissues were measured with enzyme-linked immunosorbent assay （ELISA）. Nuclear factor kappa-B （NF-<italic>κ</italic>B） p65 expression in wound surface was detected by immunohistochemistry. The apoptosis rate in wound tissues was determined by the TdT-mediated dUTP-biotin nick end labeding assay （TUNEL） method. Result:There was no significant difference in scores of symptoms and signs among groups before treatment. Compared with the control group， the treatment groups showed no significant difference in wound healing rates on the 7th day after treatment and increased healing rates on the 14th and 21st day after treatment（<italic>P</italic><0.05）. The clinical efficacy in the treatment groups was superior to that in the control group on the 21st day after treatment. Additionally， the treatment groups also showed decreased scores of local symptoms and signs， increased levels of VEGF， FGF-2， FGF-7， EGF， and IL-10， and dwindled apoptosis rate and levels of Caspase-3， TNF-α， and NF-<italic>κ</italic>B p65 expression in wound tissues on the 7th，14th and 21st day after treatment （<italic>P</italic><0.05）. The high-dose treatment group was superior to the low-dose treatment group in the above indicators （<italic>P</italic><0.05）. Histopathological examination showed that inflammatory cell infiltration was relieved in the treatment groups as compared with that in the control group， and the high-dose treatment group exhibited superior efficacy. Conclusion:FFHBY had an obvious therapeutic effect on deep Ⅱ degree burn. It could promote wound healing by up-regulating the level of growth factors， improving inflammatory response， and inhibiting cell apoptosis in a dose-dependent manner.

Efficacy of Fufang Huangbaiye Tuji on Inflammation on Skin with Deep Ⅱ Degree Burn and Its Dose-effect Relationship / 中国实验方剂学杂志

Objective:To observe the effect of different doses of Fufang Huangbaiye Tuji asin the treatment onof the inflammatory response in healing process for of skin with deep Ⅱ degree burn. Methods in healing process. Methods:The 120 cses patients with deep Ⅱ degree burn of fire-toxin injuring fluid syndrome diagnosed in the affiliated hospital of Chengde Medical University between June 2019 and March 2020 were randomly divided into control group，low -dose treatment group and high -dose treatment group，with 40 cases in each group and once. They got a dressing change perevery day. Control group was locally administered with lodophor solution 35 mL per 1% on the body surface area. Low-dose treatment group was locally administered with compound cortex phellodendri fluid 17.5 mL per 1% on the body surface area，while high-dose treatment group was locally administered with compound cortex phellodendri fluid 35 mL per 1% on the body surface area. Observe theThe inflammatory reaction of wound surface in each group onwas observed at admission and after treatment. The pathological changes of each groupsgroup were observed， and determination of nuclear factor kappa-B（NF-<italic>κ</italic>B） p65 expression inon the wound surface was determined by immunohistochemistry on the 4th day after the treatment. The levels of interleukin（IL）-2，IL-8 and tumor necrosis factor（TNF）-α in wound tissue were measured with ELISA and Bacterial culture and count were performed in each group on the 4^th，10^th and 21^st daydays after treatment. The levels of IL-2，IL-8 and TNF-α in wound tissue were measured with ELISA. Results:There was no significant difference in the degree of wound inflammation in each group at admission，and the degree of relief after treatment was positively correlated with the treatment time. At the simultaneous phase point，the inflammatory reaction was severest in control group，which was followed by low-dose treatment group and high-dose treatment group. Bacterial growth were observed on the 4^th day in control group，which was found in low-dose and high-dose treatment groups on the 10^th day，the detection rates of Staphylococcus aureus and Pseudomonas aeruginosa were the highest. Compared with control group，the mean integrated optical density of NF-<italic>κ</italic>B p65 in wound tissue decreased markedly in low-dose and high-dose treatment groups on the 4th day after treatment（<italic>P</italic><0.05），the bacterial count decreased significantly in low-dose and high-dose treatment groups on the 10^th and 21^st days after treatment（<italic>P</italic><0.05），and the levels of IL-2，IL-8 and TNF-<italic>α</italic> in wound tissue decreased markedly in low-dose and high-dose treatment groups on the 4^th，10^th and 21^st days after treatment（<italic>P</italic><0.05），with statistically significant differences between low-dose and high-dose treatment groups（<italic>P</italic><0.05）. Histopathological examination showed that inflammatory granulocytes and edema were improved in low-dose and high-dose treatment groups compared with control group，with a more significant performance in high-dose treatment group. Conclusion:The external application of compound cortex phellodendri fluid can reduce thebacterial growth of bacteria in on the wound surface，which may reduce the inflammatory reaction by inhibiting the production and release of inflammatory mediators，with a certain dose-effcteffect relationship，and is worth clinical promotion.