| Objective:Comparison of different concentrations of Ma-sang-gou-bang oil scraping(containing oil scraping scraping medium)and simple scraping(general vegetable oil medium)for the treatment of chronic soft tissue injury,objective evaluation of Ma-sang-gou-bang oil scraping treatment,and to observe the changes of chronic soft tissue injury model in rats and pathological changes of skin,muscle,serum inflammatory factors levels indicating its therapeutic mechanism.Method:1、clinical trial120 cases were included,according to randomized,single blind,parallel control principle,divided into simple scraping group,low concentration of Ma-sang-gou-bang oil scraping group,low concentration of Ma-sang-gou-bang oil scraping group and high concentration of Ma-sang-gou-bang oil scraping group,30 cases in each group,every 4 days and curettage 1 times.Continuous scaling 7 times.Before treatment,after each treatment and first,third month follow-up visit 10 period were observed in the two groups of VAS score,TCM clinical signs(tenderness,dysfunction)integral change,in the end before and after treatment and first,third month follow-up visit 4 period were observed in the two groups of SF-36 scale score changes,statistics of the four groups the onset and recovery of the required number of curettage,recorded the occurrence of adverse reactions.2、Animal experiments55 rats were randomly divided into 5 groups:normal group,control group,oil scraping group,Ma-sang-gou-bang oil scraping group,Ma-sang-gou-bang oil inunction group,animal model formation method of chronic soft tissue injury in addition to the normal group were treated with mechanical shock contusion.The normal group and the control group was not treated,the oil scraping group and Ma-sang-gou-bang oil scraping group local scrape,Ma-sang-gou-bang oil inunction group local rubs.Every 1 days,4 times.48 hours after the last treatment,the rats were killed in each group.The local skin and muscle tissue of the scraping were taken with HE staining.The aseptic inflammation and related pathological manifestations of the local tissue were observed under the optical microscope.The levels of TNF-a、IL-1β、IL-6、iNOSandp-EP were detected in the skin,muscle and serum.Result:1、clinical trialBecause of the testing process of shedding of 7 cases(5.8%),according to the analysis of the whole scheme set(FAS)principle,related to missing data from the nearly 1 observations carried forward,eventually in 120 cases(simple data scraping group 30 cases,low concentration of Ma-sang-gou-bang oil scraping group 30 cases,medium thick the degree of Ma-sang-gou-bang oil scraping group 30 cases,high concentration of Ma-sang-gou-bang oil scraping group 30 cases analysis).1.1 baseline comparisonThe baseline data of four groups(gender,age,course of disease,pain,tenderness,dysfunction,VAS and SF-36 scale),in addition to the SF-36 scale in general health(GH),social function(SF)compared with statistical significance(P<0.05),the difference was not statistically significant(P>0.05)group.Comparable between.1.2 internal comparison of groupsThe four groups were statistically significant(P<0.01/P<0.001)on VAS,pressure pain,dysfunction and SF-3 6 scale before and after treatment.1.3 comparison between the groupsThere were statistical significance(P<0.05)on the dimensions of PF,RP,BP,VT,RE and MH in the VAS,pressure pain and SF-36 scales after treatment and follow-up.After the treatment and follow-up period in VAS,tenderness,different concentrations of Ma-sang-gou-bang oil scraping group than the simple scraping group was more significant(P<0.05/P<0.01/P<0.001),high concentration of Ma-sang-gou-bang oil scraping effect is better compared to dogs in low concentration group(P<0.05);in RP,BP,MH,and low concentration of Ma-sang-gou-bang oil scraping group and simple scraping group efficacy(P>0.05).The curative effect of high concentration of Ma-sang-gou-bang oil scraping group was better than that of the other three groups(P<0.05/P<0.01/P<0.001).The efficacy of medium concentration of Ma-sang-gou-bang oil scraping group was better than that of low concentration of Ma-sang-gou-bang oil scraping group and pure scraping group(P<0.05).On PF,low concentration of Ma-sang-gou-bang oil scraping group,moderate concentration of Ma-sang-gou-bang oil scraping group and pure scraping treatment had the same effect(P>0.05).The curative effect of high concentration of Ma-sang-gou-bang oil scraping group was better than that of the other three groups(P<0.05).On VT and RE,the median concentration of Ma-sang-gou-bang oil scraping group and high concentration of Ma-sang-gou-bang oil scraping group had the same curative effect(P>0.05).The curative effect of moderate concentration of Ma-sang-gou-bang oil scraping and the high concentration of Ma-sang-gou-bang oil scraping group was better than that of the other two groups(P<0.05/P<0.01).Low concentration of Ma-sang-gou-bang oil scraping group was superior than that of the scraping group(P<0.05);compared four groups of onset and recovery required curettage times were statistically significant(P<0.05)between the four groups;the cure rate,effective rate,low concentration of Ma-sang-gou-bang oil scraping group and simple scraping group efficacy(P>0.05).The curative effect of high concentration of Ma-sang-gou-bang oil scraping group was better than that of the other three groups(P<0.05).The curative effect of medium concentration of Ma-sang-gou-bang oil scraping group was better than that of low concentration of mulberry dog oil scraping group and pure scraping group(P<0.05),and there was no significant difference in the treatment of shoulder back and waist in further group(P>0.05).During the experiment,no adverse effects were found on the normal physiological indexes of the subjects,such as syncope,exacerbation,skin damage and so on.2.Animal experimentsDue to sample contamination in the course of the experiment in 5 cases(9.1%of the total),the final case was 50 cases(10 cases in the normal group,9 cases in the control group,10 cases in the tea oil scraping group,11 cases in the Ma-sang-gou-bang oil scraping group,and Ma-sang-gou-bang oil rubbing group 9 cases)were analyzed.After the model was made,the injured muscle tissue was taken to make sections.After observing the histomorphological changes under the light microscope,significant muscle fiber necrosis,degeneration,muscle fiber discoloration,foam body dissolution were observed,and mechanized scar tissue and necrotic muscle cells were observed.Increased,the success rate of modeling is 100%.2.1 changes in rat tissue and serum cytokine levels2.1.1 changes in serum cytokine levels in ratsThe results showed that the Ma-sang-gou-bang oil has good analgesic effect,can increase the serum β-EP content,and relieve the pain caused by scraping.Under the joint action of the Ma-sang-gou-bang oil and scraping,it exerted a better curative effect than the simple scraping and the rubbing of the Ma-sang-gou-bang oil,and achieved a better anti-inflammatory effect.2.1.2 Changes in cytokine content in rat skinAfter the model was established,the levels of TNF-a in the skin of the model group were higher than those in the normal group.The changes of IL-1β,IL-6,iNOS,and β-EP were not obvious,and there was no obvious inflammatory reaction and pain in the skin.There was no significant change in the factors of the skin of the tea-scraping group compared with the model group.The levels of TNF-α and IL-6 in the skin were significantly lower in the Ma-sang-gou-bang oil scraping Group and the Ma-sang-gou-bang oil rubbing Group than in the model group,and the iNOS content was decreased.,Reducing skin tissue inflammatory response.The content of TNF-a,IL-1β,IL-6,and iNOS in the skin of the Ma-sang-gou-bang oil scraping group was higher than that of the Ma-sang-gou-bang oil rubbing group and the tea-scraping group,and the β-EP content was increased.The Marsannes help scratch the skin better than the simple scraping and rubbing of the Ma-sang-gou-bang oil to help the oil reduce inflammation and relieve pain.The mating of Ma-sang-gou-bang oil and scraping contributes to synergy.2.1.3 Changes of cytokine content in rat muscleCompared with the normal group,the levels of TNF-a,IL-1β,IL-6 and iNOS in the model group were significantly higher than those in the normal group,and theβ-EP content was significantly decreased.This proved that the model group had significant inflammatory reaction and pain.The content of TNF-α,IL-1β,IL-6,and iNOS in skin of Ma-sang-gou-bang oil scraping group was significantly lower than that of the model group.The content of β-EP was significantly increased,which proved that Ma-sang-gou-bang oil scraping can effectively reduce inflammation and improve Muscle tissue damage,relieve pain.There were no significant differences in the levels of TNF-α,IL-1β,IL-6,iNOS and β-EP in the muscles of the Ma-sang-gou-bang oil rubbing group,the tea-scraping group and the model group.There was a decreasing trend of muscle TNF-α,IL-1β,and iNOS levels in the Ma-sang-gou-bang oil rubbing group compared with the model group.Compared with the model group,the TNF-α,IL-1β,IL-6 and iNOS of the tea oil scraping group had a decreasing trend.It was proved that the Ma-sang-gou-bang oil scraping group,the Ma-sang-gou-bang oil rubbing group,and the Tea Scraping Group all reduced the inflammatory reaction to a certain extent,and the effect of the Ma-sang-gou-bang oil rubbing group was significantly better than that of theMa-sang-gou-bang oil rubbing group.Tea oil scraping group,at the same time,the Ma-sang-gou-bang oil scraping has a good analgesic effect.2.2 Local histopathological changes in rats2.2.1 Local skin pathological changes in ratsIn the normal group and the model group,the stratum corneum was evenly distributed.and closely arranged.No horny layer was detached or free,and the keratinocyte(KC)was tightly arranged.The horny layer of the Ma-sang-gou-bang oil rubbing group was relatively complete and arranged closely.In some regions,the outer keratin was banded and distributed free.A few cuticles fell off and the KCs were closely arranged.The squeezing group of the tea oil scraping group and the Ma-sang-gou-bang oil scraping group were loosely arranged.The distance between the epidermis and the outer layer of the stratum corneum was significantly increased,and the shedding phenomenon was obvious.In most areas,the outer layer of keratin was banded and separated from the epidermis,and the inner layer appeared to be separated.More vacuoles;other areas of the stratum corneum are looser,separated from the active epidermis layered,KC gap becomes larger.2.2.1 Pathological changes of local muscle tissue in ratsIn the normal group,the cell structure was intact,well organized,and no morphological changes were observed.Tea-scraping group,Ma-sang-gou-bang oil rubbing group,Ma-sang-gou-bang oil scraping group,and model group damaged local muscle morphological changes.There were obvious muscle fiber necrosis,degeneration,muscle fiber discoloration,foam body dissolving,and observation was observed.Scar tissue increased necrotic muscle cells.A large number of connective tissue hyperplasia,residual broken muscle fibers are absorbed or mechanized,extensive tissue degeneration,cell arrangement is less regular.Ma-sang-gou-bang oil scraping group were lighter than those in the Tea oi scraping group,the Ma-sang-gou-bang oil rubbing group,and the model group.Conclusion:1.Concentration is one of the influencing factors of curative effect of drug-containing and scraping medium.Different concentrations of Ma-sang-gou-bang oil scraping have better curative effects than painlessness,quality of life,clinical cure rate,and dominance rate.Faster,shorter treatment time,and positively related to the concentration of tannins in Ma-sang-gou-bang oil within a certain range;2.Scraping and lipid media can enhance skin permeability,and the combination of scraping and drug-containing scraping media can speed up drug-containing scraping media.The percutaneous absorption of active ingredients produces a synergistic effect,which is more effective in reducing inflammation and relieving pain than rubbing with a simple scraping and rubbing with a drug-containing scraping medium.3.Ma-sang-gou-bang oil scraping can reduce the levels of IL-6 and TNF-α in skin by reducing the levels of IL-1β,IL-6,TNF-α and iNOS in muscles and increase the level of β-EP;-6 level,increase the level of β-EP to reduce inflammation,relieve pain,while reducing muscle tissue muscle fiber necrosis,degeneration,connective tissue hyperplasia,scar tissue formation,play a therapeutic role. |
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