2023, Vol. 27 ›› Issue (26): 4126-4131

Mechanism of stone balm on the healing of infected refractory wounds in rats

Liu Zhilun1, Guan Zhiyu2, Jiang Taiping1, Li Chengxi1, Liu Zhaoming1   

Abstract: BACKGROUND: In clinical work, western medicine has less treatment methods for skin-infected refractory wounds, while the treatment of skin wounds with traditional Chinese medicine has attracted more and more attention.
OBJECTIVE: To investigate the effect and mechanism of stone balm on promoting the healing of skin-infected refractory wounds in rats.
METHODS: A total of 15 male Sprague-Dawley rats were selected. Of these rats, 12 rats were used to establish animal models of skin-infected refractory wounds and then randomly divided into model group (no intervention), recombinant bovine basic fibroblast growth factor (rb-bFGF) group, low- and high-dose stone balm groups, with 3 rats in each group. Administration was performed every 48 hours. The remaining three rats were not given inoculation of bacteria, serving as blank control group. After 14 days of medication, wound healing was observed and pathological changes in wound tissue were observed under microscope. The levels of superoxide dismutase and malondialdehyde in wound tissue were detected by ELISA, and the protein expressions of Nrf2 and heme oxygenase 1 in wound tissue were detected by western blot method.
RESULTS AND CONCLUSION: After 14 days of intervention, the wounds in each groups showed a healing state. Compared with the blank control group, the wound area was slightly smaller in the model group, but redness and swelling could still be seen. Compared with the model group, the wound area of were reduced in the rb-bFGF and high-dose stone balm groups, and wound redness and swelling was alleviated, while the wound area did not change significantly in the low-dose stone balm group but wound redness and swelling was also alleviated. Compared with the rb-bFGF group, the wound surface was significantly reduced in the high-dose Stone balm group, and the wound basically healed. Hematoxylin-eosin staining showed that compared with the blank control and model groups, the number of sphacelus and inflammatory substances on the wound surface was significantly reduced in the rb-bFGF, low- and high-dose Stone balm groups, and a large number of collagen fibers and granulation tissue hyperplasia were observed. Compared with the rb-bFGF group, collagen fibers and granulation tissue were denser in high-dose Stone balm group. Compared with the model group, the levels of malondialdehyde were significantly lower in the rb-bFGF, low- and high-dose stone balm groups (P < 0.05), while the levels of superoxide dismutase were significantly higher (P < 0.05). The protein expressions of Nrf2 and heme oxygenase 1 were significantly higher in the rb-bFGF group than the model group (P < 0.05), and the protein expression of heme oxygenase 1 was significantly higher in the high- and low-dose stone balm groups than the model group (P < 0.05). To conclude, regulation of the Nrf2-ARE signaling pathway induces the ARE antioxidant response element to produce heme oxygenase 1 protein and superoxide dismutase factor, while inhibiting the production of malondialdehyde and reducing cellular oxidative stress injury, which may be one of the possible mechanisms by which stone balm promotes wound healing.

Key words: infection, skin wound, refractory wound, oxidative stress injury, Nrf2-ARE signaling pathway, traditional Chinese medicine treatment