基于“护场理论”研究黄芪甲苷对糖尿病大鼠皮肤溃疡创面愈合的影响*

作者：蔡诗敏1,2，黄子歆2，邹晓玲1，胡清睿2，张玲玉2，黄雨萱2，刘向男3，郭子莘2，熊 武1，杨 楠1

单位：1.湖南中医药大学第一附属医院，湖南 长沙 410021； 2.湖南中医药大学中西医结合学院，湖南 长沙 410208； 3.湖南中医药大学针灸推拿与康复学院，湖南 长沙 410208

引用：引用：蔡诗敏，黄子歆，邹晓玲，胡清睿，张玲玉，黄雨萱，刘向男，郭子莘，熊武，杨楠.基于“护场理论”研究黄芪甲苷对糖尿病大鼠皮肤溃疡创面愈合的影响[J].中医药导报,2025,31(12):48-53.

DOI：10.13862/j.cn43-1446/r.2025.12.008

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摘要：

目的：基于“护场理论”研究黄芪甲苷（AS-Ⅳ）对糖尿病大鼠皮肤溃疡组织中氧化应激因子、促炎因子和血管生成因子表达的影响，为临床开发AS-Ⅳ用于糖尿病皮肤溃疡的治疗奠定基础。方法：复制2型糖尿病大鼠模型，在造模成功的糖尿病大鼠脊柱两侧深筋膜上切除直径2 cm的圆形全层皮肤以制成糖尿病大鼠皮肤溃疡模型（DSU），并随机分为实验组[DSU+AS-Ⅳ（50 mg/kg）]、模型组（DSU+0.9% NaCl），另设正常组（0.9% NaCl），均采用腹腔注射给药。采集第10天大鼠皮肤溃疡组织，流式细胞术测定活性氧（ROS）水平，比色法检测总抗氧化能力（T-AOC），酶联免疫吸附试验（ELISA）检测血管内皮生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）的含量。结果：与正常组比较，模型组创面愈合情况差，皮肤溃疡组织中ROS含量增多，T-AOC表达下降，促炎因子IL-1β、IL-6、TNF-α表达水平上升，血管生成因子VEGF、bFGF表达水平下降，差异均有统计学意义（P<0.01）；与模型组比较，实验组创面愈合情况优于模型组，皮肤溃疡组织中ROS含量减少，T-AOC表达上升，促炎因子IL-1β、IL-6、TNF-α表达水平下降，血管生成因子VEGF、bFGF表达水平上升，差异均有统计学意义（P<0.05）。结论：AS-Ⅳ可通过抑制创面ROS导致的氧化应激反应和炎症反应，促进创面血管新生达到“护场效应”，从而为糖尿病皮肤溃疡创面愈合创造条件。

关键词：糖尿病皮肤溃疡；护场理论；黄芪甲苷；创面愈合；氧化应激；炎症；大鼠

Abstract：

Objective: To investigate the effects of Astragaloside Ⅳ (AS-Ⅳ) on the expression of oxidative stress factor, pro-inflammatory factor and angiogenic factor in diabetic skin ulcer tissue based on the "focus field protection theory", and to lay a foundation for the clinical development of AS-Ⅳ for the treatment of diabetic skin ulcer. Methods: The type 2 diabetic rat model was replicated, and the round full-layer skin was removed with a diameter of 2 cm from the deep fascia on both sides of the spine to make the diabetic rat skin ulcer model (DSU). The DSU model rats were randomly divided into experimental group [DSU+ AS-Ⅳ(50 mg/kg)] and model group (DSU+0.9% NaCl), and a normal group (0.9% NaCl) was set. Intraperitoneal injection was used in all groups. The skin ulcer tissue was collected on the 10th day. Reactive oxygen species(ROS) levels in skin ulcer tissue were measured by flow cytometry, and total antioxidant capacity (T-AOC) in skin ulcer tissue was detected by colorimetry. Vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in skin ulcer tissue were detected by enzyme-linked immunoadsordent assay (ELISA). Results: Compared with the normal group, the model group exhibited significantly impaired wound healing, increased ROS content in the skin ulcer tissue, decreased T-AOC expression, elevated levels of the pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α), and reduced expression levels of the angiogenic factors (VEGF and bFGF), with all differences being statistically significant (P<0.01). Compared with the model group, the experimental group exhibited superior wound healing outcomes, characterized by reduced ROS content, increased T-AOC expression, decreased levels of the pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α), and elevated expression levels of the angiogenic factors (VEGF and bFGF) in the skin ulcer tissue. All these differences were statistically significant (P<0.05). Conclusion: Astragaloside Ⅳ can reduce the oxidative stress and inflammation caused by excessive ROS in wound, promote wound angiogenesis to achieve "field protection effect", then lead to create conditions for diabetic skin ulcer wound healing.

Key words：diabetic skin ulcer; focus field protection theory; Astragaloside Ⅳ; wound healing; oxidative stress; inflammation; rat

发布时间：2025-12-31

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