The Clinical Research Of External Application With Pulse-Recuperatihg Paste In The Prevention And Treatment Of Chemotherapeutic Phlebitis And The Empirical Study On The Relationship Of Pulse-Recuperating Paste With VEGF&EGFR

Object:To observe the preventive and therapeutic effect of chemotherapeutic phlebitis caused by vinorelbine by external application with Pulse-Recuperating paste; To explore the safety of Pulse-Recuperating paste for enepidermic use; And to develop a normal animal model of Vinorelbine-induced skin wound and explore the therapeutic effect and mechanism of Pulse-Recuperating paste and50%magnesium sulfate.Methods:40cases of patients treated by chemotherapy of NP program via peripheral vein were randomly divided into two groups, with20patients in each group; we apply Pulse-Recuperating paste in the observation group and wet compress with50%MgSO4in the control group; The occurrence rate and the main clinical symptom points of phlebitis between the two groups were compared.80cases of patients with phlebitis induced by chemotherapy of NP program via peripheral vein were randomly divided into the treatment group and the control group, each including40cases; Applying Pulse-Recuperating paste on afflicted part in the treatment group, and in the control group, applying wet compress with50%magnesium sulfate everyday; After5days, Compared prior treatment with post-treatment, we estimate the clinical effect and the improvement of the main clinical symptom points of phlebitis of the two groups. Observed the situation caused by applying Pulse-Recuperating paste on animals’skin. In stage1, Intradermal Vinorelbine was injected on the right side and subpannicular Vinorelbine on the left.18animals are divided into6groups, intradermal and subpannicular injections were made for three SD rats per group, using the different concentrations but the same volume of Vinorelbine. In stage2,42animals are divided into2groups, Pulse-Recuperating paste and50%magnesium sulfate,21in each. Pulse-Recuperating paste and50%magnesium sulfate were applied on the left side,0.9%physiological saline was applied on the right side as a control. At the end of the different days after Vinorelbine injection, the area of the skin wounds on the five rats picked at random were calculated and a biopsy on the three rats picked at random, including all damaged tissue and surrounding healthy tissue, was obtained after injection and histopathologic examination was performed for all specimens. At the same time, the distribution and expression of VEGF&EGFR in all specimens were detectd by immunohistochemisty and compared.Result:Pulse-Recuperating paste displays more effective in preventing and treating chemotherapeutic phlebitis and releasing the main cilnical symptoms than50%magnesium sulfate(P<0.05). Pulse-Recuperating paste has no irritation and hypersusceptibility occurred on animals’skin. The concentration of intradermal Vinorelbine(1.O) injected can form a homogeneous skin wound. At each designated time point, the measured areas of injured tissue from Pulse-Recuperating were smaller than from50%magnesium sulfate and0.9%physiological saline, the statistical difference was very notable (P<0.01). The histopathologic evaluation of injured tissue from Pulse-Recuperating paste showed milder Inflammatory reaction and skin destruction than from50%magnesium sulfate and0.9%physiological saline in its early stage, no hemorrhage and thrombosis in its all stage; and newly formed sufficient granulation tissue and reepithelization in its late stage. At each designated time point, VEGF expression (IOD) of injured tissue from Pulse-Recuperating paste was higher than from50%magnesium sulfate and0.9%physiological saline, the statistical difference was very notable (P<0.01), but the statistical difference of EGFR expression (IOD) was unnotable (P>0.05).Conclusion:Pulse-Recuperating paste for enepidermic use is safe, it is a valid prevention and treatment method of chemotherapeutic phlebitis. The research shows that Pulse-Recuperating paste has the effect of anti-infection、anti-thrombus and improving microcirculation, it also can accelerate wound healing by promoting expression of VEGF、EGFR.