Effects of moxa-moxibustion on wound healing and PI3K/Akt signaling pathway in rats with pressure ulcer

doi:10.12114/j.issn.1007-9572.2020.00.319

Abstract

Abstract: Background　In recent years，it has been found that moxa-moxibustion can promote the healing of pressure ulcer（PU），but its mechanism remains unclear.PI3K/Akt signaling pathway plays an important role in the healing process of skin injury by participating in many biological processes such as cell proliferation，differentiation and apoptosis.Objective　To observe the effect of moxa-moxibustion on wound healing and PI3K/Akt pathway in rats with PU，so as to explore the action mechanism of moxa-moxibustion on promoting PU healing.Methods　This study was conducted from March 2018 to February 2019.30 adult female SPF grade SD rats were selected，and 20 of them were modeled with PU according to the principle of ischemia-reperfusion，and were randomly divided into moxa-moxibustion group and model group according to the proportion of 1∶1 after modelling，and the other 10 were assigned to the blank group without modelling.The model group was given iodophor to clean the wound once a day，10 days as a course of treatment.In the moxa-moxibustion group，moxa-moxibustion was used to treat the wound locally，15 minutes a time，once a day，10 days as a course of treatment.On the 1st，3rd，5th，7th and 10th days of the intervention，the wound healing rate，histological state of the healing wound，the protein expression levels of phosphorylated Akts473，phosphorylated Bads136 and phosphorylated Caspase-9s196 were measured and compared.Results　On the 3rd，5th，7th and 10th days of intervention，the wound healing rate of moxa-moxibustion group was higher than that of model group（P<0.05）.Compared with the model group，HE staining tissues of moxa-moxibustion group had less inflammatory cell infiltration and more new granulation tissue and blood vessels formation.On the 1st，3rd，5th，7th and 10th days of intervention，the blank group showed lower mean expression level of phosphorylated Akts473 protein compared with other two groups（P<0.01）.The expression level of phosphorylated Akts473 protein in the moxa-moxibustion group was higher than that in the model group（P<0.05）.The blank group had lower mean expression level of phosphorylated Bads136 protein than other two groups（P<0.01）.The protein expression level of phosphorylated Bads136 in the moxa-moxibustion group was higher than that in the model group（P<0.01）.The mean expression level of phosphorylated Caspase-9s196 in the blank group was lower than that of model group and moxa-moxibustion group（P<0.01）.And it in the moxa-moxibustion group was higher than that in the model group（P<0.01）.Conclusion　Moxa-moxibustion can promote wound healing of PU rats，and its mechanism may be related to the effect of anti-apoptosis of activated PI3K/Akt signal pathway.

Key words: Pressure ulcer, Moxa stick moxibustion, Wound healing, Apoptosis, Phosphatidylinositol 3-Kinase, Protein-serine-threonine kinases

摘要： 背景　近年来研究发现，艾灸能够促进压疮（PU）愈合，但其作用机制尚未明确。磷脂酰肌醇3-激酶（PI3K）/蛋白质丝氨酸苏氨酸激酶（Akt）信号通路通过参与细胞增殖、分化和凋亡等多种生物过程，在皮肤损伤的愈合过程中发挥重要的调节作用。目的　观察艾灸对PU大鼠创面愈合及PI3K/Akt信号通路的影响，探讨艾灸在皮肤损伤与修复过程中的作用机制。方法　2018年3月—2019年2月选取SPF级成年雌性SD大鼠30只，20只大鼠参照缺血-再灌注原理进行PU造模，造模后按1∶1比例随机分为艾灸组和模型组，另外10只为空白组不予造模。模型组给予碘伏清洁创面，1次/d，10 d为1个疗程；艾灸组采用艾灸在创面局部治疗，15 min/次，1次/d，10 d为1个疗程。干预1、3、5、7、10 d观察比较创面愈合率、创面病理损伤情况、磷酸化Akts473、磷酸化Bads136、磷酸化Caspase-9s196蛋白表达水平。结果　干预3、5、7、10 d艾灸组创面愈合率均高于模型组（P<0.05）。HE染色显示，与模型组相比，艾灸组炎性细胞浸润较少，可见较多新生肉芽组织及血管。干预1、3、5、7、10 d模型组与艾灸组磷酸化Akts473蛋白表达水平高于空白组（P<0.01）；干预1、3、5、7、10 d艾灸组磷酸化Akts473蛋白表达水平高于模型组（P<0.05）。干预1、3、5、7、10 d模型组与艾灸组磷酸化Bads136蛋白表达水平高于空白组（P<0.01）；干预1、3、5、7、10 d艾灸组磷酸化Bads136蛋白表达水平高于模型组（P<0.01）。干预1、3、5、7、10 d模型组与艾灸组磷酸化Caspase-9s196蛋白表达水平高于空白组（P<0.01）；干预1、3、5、7、10 d艾灸组磷酸化Caspase-9s196蛋白表达水平高于模型组（P<0.01）。结论　艾灸能够促进PU大鼠创面皮肤愈合，其作用机制可能与激活PI3K/Akt信号通路，发挥抗凋亡作用有关。

关键词: 压力性溃疡, 艾条灸, 伤口愈合, 细胞凋亡, 磷酸肌醇3-激酶, 蛋白质丝氨酸苏氨酸激酶

HAN Chao,YIN Hongna,YANG Xirui, et al. Effects of moxa-moxibustion on wound healing and PI3K/Akt signaling pathway in rats with pressure ulcer[J]. Chinese General Practice, 2020, 23(21): 2682-2688. DOI: 10.12114/j.issn.1007-9572.2020.00.319.
韩超,尹洪娜,杨稀瑞等. 艾灸对压疮大鼠皮肤损伤修复及PI3K/Akt信号通路的影响[J]. 中国全科医学, 2020, 23(21): 2682-2688. DOI: 10.12114/j.issn.1007-9572.2020.00.319.

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