黄芪提取物联合表皮生长因子治疗大鼠皮肤烫伤的实验研究

目的：探讨黄芪提取物联合表皮生长因子对皮肤烫伤愈合的疗效。方法：Wistar大鼠80只,每只背部造成2处直径2.8cm深Ⅱ度烫伤创面。将大鼠随机分为黄芪提取物联合表皮生长因子治疗组（联合组）、表皮生长因子治疗组（EGF组）、黄芪提取物治疗组（黄芪组）和生理盐水对照组（对照组）,每组20只,观察伤后愈合情况。烫伤后第2、5、7、10、14、18、21天计算创面愈合率;第7、14、18天取大鼠创面皮肤采用羟脯氨酸测试盒测定烫伤创面羟脯氨酸含量;第7、14、21天取大鼠创面皮肤采用Ⅷ因子免疫组织化学染色计算微血管密度;第14、21天取大鼠创面皮肤做病理学分析。结果：联合组愈合时间显著小于其它组（P〈0.05,P〈0.01）,EGF组和黄芪组愈合时间显著小于对照组（P〈0.05）;联合组于烫伤后10、14、18、21d和7、14d创面愈合率、创面微血管密度明显大于其它组（P〈0.05,P〈0.01）,EGF组和黄芪组创面愈合率以及创面微血管密度显著大于对照组（P〈0.05）;联合组创面组织羟脯氨酸水平在伤后第7、14天均显著高于其他组（P〈0.05,P〈0.01）,EGF组和黄芪组创面组织羟脯氨酸水平显著高于对照组（P〈0.05）。结论：黄芪提取物联合表皮生长因子能显著促进皮肤烫伤的愈合,缩短愈合时间。     

封闭负压引流联合局部氧疗对糖尿病大鼠烫伤创面愈合的影响

目的 观察封闭负压引流(negative pressure wound therapy,NPWT)联合局部氧疗对糖尿病大鼠烫伤创面愈合的影响.方法 以腹腔注射链脲佐菌素诱导糖尿病SD大鼠模型,并在其背部用蒸汽喷头制作皮肤烫伤模型.将90只糖尿病背部烫伤SD大鼠随机分为糖尿病烫伤对照组(A组)、NPWT治疗组(B组)和NPWT联合局部氧疗组(C组),每组30只,并给予相应处理.伤后7d、14d和21d测量创面愈合率并留取标本进行常规病理检查,并以Western blotting实验检测创面组织中血管内皮细胞生长因子(VEGF)的表达情况.结果 B组和C组在伤后7d、14d和21 d时创面愈合率及VEGF蛋白表达量均高于A组(P＜0.01) C组伤后7d和14d时创面愈合率及VEGF蛋白表达量高于B组(P＜0.01).病理检查提示C组大鼠创面炎性反应较轻,肉芽组织和上皮细胞生长速度较快.结论 与单纯NPWT治疗相比,NPWT联合局部氧疗能促进创面组织内新生血管的生长,提高创面愈合效率,使创面愈合时间明显缩短.     

苗药挖腐生肌膏对实验性体表溃疡模型大鼠创面愈合的实验研究

目的:观察苗药挖腐生肌膏在大鼠体表创面愈合过程中对大鼠皮肤创面ECG基因表达新生肉芽组织成纤维细胞及新生毛细血管的影响.方法:60只8W龄SD大鼠,建立大鼠背部感染溃疡创面模型后分为3组:凡士林组、对照组(湿润烧伤膏组)和观察组(苗药挖腐生肌膏组),每组20只.分别于用药后d3、d5、d7、d14取创面肉芽组织,用原位杂交法测定EGF,以光密度值反映其含量变化,采用PCNA免疫组织化学染色法检测创面新生肉芽组织成纤维细胞数量,采用CD34免疫组织化学法测定创面新生肉芽组织毛细血管数量,并记录创面愈合时间.结果:换药后d3、d5、d7,对照组和观察组肉芽组织EGF、创面新生肉芽组织成纤维细胞数量和新生肉芽组织毛细血管数量均高于凡士林组(P＜0.01).d14时两组上述指标减少,各时间点对照组和观察组组间比较无显著差异(P＞0.05).对照组和观察组创面完全愈合所需时间明显短于凡士林组,有显著差异(P＜0.01).结论:苗药挖腐生肌膏能够促进大鼠皮肤切口感染性创面的愈合.其机制可能与增加早、中期大鼠创面肉芽组织细胞中EGF的含量和创面新生肉芽组织成纤维细胞数量和新生肉芽组织毛细血管数量,从而加快创面愈合.     

五谷虫提取物凝胶对大鼠深Ⅱ度烫伤创面愈合的影响

目的：探讨五谷虫提取物凝胶对大鼠深Ⅱ度烫伤创面愈合作用的影响。方法：取雄性SD大鼠75只,建立大鼠深Ⅱ度烫伤模型,随机分为A组（给予五谷虫提取物凝胶）,B组（给予京万红软膏）,C组（给予凝胶基质）;每组25只,连续给药14 d。每组随机取5只,观察烫伤后创面形态变化,记录愈合时间。烫伤后第4,7,10,14天每组各取5只大鼠,计算创面愈合率后,取各时间节点大鼠创面并分为双份,一份用于测定创面组织中羟脯氨酸含量,一份用于组织病理学检查,观察成纤维细胞、毛细血管、胶原等指标,并采用免疫组化的方法对创面中表皮细胞生长因子（EGF）和碱性成纤维细胞生长因子（bFGF）的表达进行定量分析。结果：五谷虫提取物凝胶可提高创面愈合率,缩短愈合时间,增加创面羟脯氨酸含量,促进创面成纤维细胞迁移、增殖,毛细血管新生、胶原蛋白表达增加,并提高EGF和bFGF的表达。结论：五谷虫提取物凝胶具有促进烫伤创面愈合的作用。     

复方足疡平促进糖尿病大鼠皮肤溃疡创面愈合及对RAGE/NF-κBp65/VEGF表达的影响

目的：探讨复方足疡平对糖尿病大鼠皮肤溃疡创面愈合的作用及其作用机制。方法：将50只SPF级SD大鼠分成正常对照组、皮肤溃疡模型组、凡士林组、足疡平组、rhEGF（重组人表皮生长因子外用溶液）组,每组10只。大鼠糖尿病模型通过高脂高糖饮食结合腹腔注射链脲佐菌素诱导。50只大鼠背部制造皮肤溃疡创面,各组给与相应药物外敷创面。观察创面愈合情况计算创面愈合率;分别在治疗第7,14天时采集创面肉芽组织制作HE染色切片,进行组织病理学观察;Western blot检测创面肉芽组织中晚期糖基化终末产物受体（RAGE）、核转录因子-κB p65（NF-κB p65）、血管内皮生长因子（VEGF）表达水平。结果：干预治疗第7,14天时,与皮肤溃疡模型组比较,足疡平组和rhEGF组能明显提高创面愈合率（P<0.01）,而凡士林组大鼠创面愈合率与皮肤溃疡模型组无显著性差异（P>0.05）;足疡平组和rhEGF组大鼠创面组织胶原纤维沉积、毛细血管、肉芽组织生长均明显增加;足疡平组能显著降低RAGE、NF-κB p65蛋白表达,升高VEGF蛋白表达（P<0.01）,rhEGF组在第7天时NF-κB p65蛋白表达与皮肤溃疡模型组比较差异无显著性（P>0.05）,其余指标均有显著性差异（P<0.01）。结论：复方足疡平可有效促进糖尿病大鼠皮肤溃疡创面愈合,其作用机制与抑制糖尿病大鼠皮肤溃疡创面中RAGE、NF-ΚB p65表达,促进VEGF的表达相关。     

胶原海绵促进肉芽生长与创面愈合实验研究

目的评价含胶原纤维不同的胶原海绵促进创面肉芽生长与愈合的疗效比较。方法将含胶原纤维较多的可即邦胶原海绵与较少的艾微停微纤维止血胶原海绵分别作为治疗组1与治疗组2,与对照组凡士林纱布比较,外用于兔背部机械性创面,于用药后3、7、14d分别测定创面面积愈合率、肉芽毛细血管密度、肉芽内血红蛋白含量及羟脯氨酸含量,并记录各组疮面愈合时间。结果创面愈合率及愈合时间,治疗组明显优于对照组,差异有统计学意义（P〈0.01）,其中第7天时创面愈合率及创面愈合时间,治疗组1优于治疗组2;创面肉芽毛细血管密度与血红蛋白含量,治疗组优于对照组（P〈0.01）,第7天时,治疗组1优于治疗组2,与创面愈合率一致;创面肉芽羟脯氨酸含量结果与创面愈合率一致,不同的是第14天时,治疗组1优于治疗组2。结论胶原海绵对创面具有促进愈合的疗效,作用机制之一是促进血管新生与胶原合成。含胶原纤维较高的可即邦胶原海绵更有利于创面愈合。     

紫檀芪对糖尿病性皮肤溃疡模型大鼠创面愈合的影响及机制

目的 探究紫檀芪（PTE）对糖尿病性皮肤溃疡模型大鼠创面愈合的影响及机制。方法 取10只SD大鼠为对照组,其余大鼠以饲喂高脂高糖饲料+腹腔注射链脲佐菌素+剪去背部标记区域皮肤及皮下组织建立糖尿病性皮肤溃疡模型后,随机分为模型组、PTE低剂量组（40 mg/kg）、PTE高剂量组（80 mg/kg）和PTE高剂量+PP2组（80 mg/kg的PTE+2 mg/kg的SRC抑制剂PP2）,每组10只。于建模后第2天,各药物组大鼠腹腔注射相应药液,对照组和模型组大鼠腹腔注射生理盐水,每天1次,连续14 d。测算各组大鼠给药第7、14天的创面愈合率,检测血清中白细胞介素1β(IL-1β)、IL-6、肿瘤坏死因子α(TNF-α)、血管内皮生长因子（VEGF）含量,观察创面肉芽组织的病理变化并检测创面肉芽组织中SRC/促分裂原活化的蛋白激酶激酶（MEK）/胞外信号调节激酶（ERK）信号通路相关蛋白的表达。结果 与对照组比较,模型组大鼠的创面愈合率、血清中VEGF含量和创面肉芽组织中SRC、MEK1/2、ERK1/2的磷酸化水平均显著降低（P<0.05）,血清中IL-1β、IL-6、TNF-α...     

京万红软膏上调PDGF mRNA表达改善大鼠缺血合并外伤型糖尿病足的研究

目的考察京万红软膏对大鼠缺血合并外伤型糖尿病足的疗效及作用机制。方法建立糖尿病大鼠模型,在此基础上建立大鼠缺血合并外伤型糖尿病足模型。实验设置4组,每组大鼠15只,分别为假手术组、模型组、京万红软膏组、重组人表皮生长因子外用溶液(rhEGF)组。给药14 d,记录给药前后大鼠体质量、血糖、足部形态及溃疡面积的变化情况。并于给药后取足部溃疡部位组织行HE染色,采用RT-PCR法检测京万红软膏对血小板源性生长因子(PDGF)、血管内皮生长因子(VEGF)及其受体FLT-1 mRNA表达的影响。结果京万红软膏对大鼠缺血合并外伤型糖尿病足具有消肿生肌,促进创面愈合的功效。与模型组相比,京万红软膏组给药14 d后可极显著减少大鼠足部外伤部位的溃疡面积(P0.01);可极显著上调PDGF mRNA的表达(P0.01)。结论京万红软膏对大鼠缺血合并外伤型糖尿病足具有促进伤口愈合的功效,可能与上调PDGF mRNA的表达相关,但对VEGF及其受体Flt-1 mRNA的表达没有影响。     

独一味胶囊对大鼠机械性皮肤损伤的促愈合作用

目的研究独一味胶囊对大鼠机械性皮肤损伤的促愈合作用及其可能机制。方法在SD大鼠背部皮肤造成机械性损伤模型,将损伤模型大鼠分为独一味(生药)4、2、1 g.kg-1组、模型组、阳性对照组,给予大鼠ig独一味胶囊药液或阳性药,连续16 d,观察各创面的愈合情况,计算各创面的愈合率,并于造模后第4、7、10、14、17天分别处死大鼠,取创面标本,分别进行病理组织学检查、毛细血管计数和血管内皮生长因子(VEGF)、表皮生长因子(EGF)的免疫组化测定。结果大鼠灌服独一味胶囊后可明显缩短伤口的愈合时间。造模后第4~14天,生药4.0 g.kg-1组大鼠的创口愈合率、创面组织EGF、VEGF的表达明显高于模型组(P<0.05);造模后第4~7天,生药4.0 g.kg-1组大鼠新生毛细血管计数明显多于模型组(P<0.01)。组织形态学评价结果表明:造模后第4~14天,生药4.0 g.kg-1组大鼠的创口修复情况明显优于模型组,在创口修复早期,能加速成纤维细胞的增生,促进新生毛细血管的生成,减少炎症反应。结论独一味胶囊能促进机械性皮肤损伤的愈合,其作用机制可能与促进新生毛细血管生成,促进组织中内源性EGF、VEGF等相关因子的表达有关。     

rhGM-CSF对糖尿病大鼠深Ⅱ度烫伤创面微循环形成的作用

目的 探讨重组人粒细胞巨噬细胞刺激因子(rhGM-CSF)对糖尿病大鼠深Ⅱ度烫伤创面微循环形成的作用.方法 42只雄性SD清洁级大鼠用链脲佐菌素(STZ)诱导建立糖尿病模型,造模成功后稳定2个月,随机分为实验组36只和对照组6只,实验组大鼠背部造成4个直径3 cm深Ⅱ度烫伤创面,分别给予rhGM-CSF凝胶、SD-Ag冷霜、空白凝胶、生理盐水(对照用药),每日换药1次,实验组大鼠根据伤后1、3、7、10、14、21 d随机分成6组,每组6只,对照组为非烫伤糖尿病大鼠.测量和计算各时相点创面愈合率.采用ELISA法检测创面组织成纤维细胞生长因子-2(FGF-2);采用免疫组化染色法检测Ⅷ因子,评价微血管密度(MVD).结果 rhGM-CSF凝胶组(A组)与SD-Ag冷霜组、空白凝胶组和生理盐水组(B组)相比,烫伤后第10、14、21 d,创面愈合率显著提高(P＜0.05);烫伤后第3、7、10、14、21 d,创面组织FGF-2含量显著增加(P＜0.05);烫伤后第10、14、21 d,创面微血管密度显著增大(P＜0.05).SD-Ag冷霜组、空白凝胶组和生理盐水组间比较,差异无统计学意义.结论 rhGM-CSF凝胶能通过增加糖尿病大鼠深Ⅱ度烫伤创面组织FGF-2含量,增加创面微血管形成,促进创面愈合.     

冰黄凝胶烫伤膏对大鼠深Ⅱ度烫伤创面愈合的实验研究

目的：观察冰黄凝胶烫伤膏对大鼠深Ⅱ度烫伤创面愈合影响。方法：采用大鼠深Ⅱ度烫伤模型,实验组创面外用冰黄凝胶烫伤膏,通过伤后不同时间点创面取材,检测创面组织新生毛细血管数目,创面组织含水量,创面愈合率及组织病理学变化,以湿润烫伤膏做阳性对照,基质乳膏做阴性对照。结果：烫伤创面外用冰黄凝胶烫伤膏后创面新生毛细血管数目和创面愈合率均高于烫伤对照组,而创面组织含水量低于烫伤对照组。结论：冰黄凝胶烫伤膏可减轻烫伤创面早期水肿,促进烫伤创面愈合。并且对于创面修复过程肉芽组织中新生毛细血管数量与形态具有良好的调节作用。     

积雪苷在妇科腹腔镜术后患者促进伤口愈合应用中的效果观察

目的观察积雪苷霜软膏促进妇科腹腔镜手术后患者伤口愈合,减少瘢痕形成,提高患者形象自我满意度的效果。方法随机选取妇科腹腔镜手术后100例患者分成两组,实验组患者给予指导应用积雪苷霜软膏,对照组患者未予应用积雪苷软膏,伤口自然愈合。观察患者术后4周伤口愈合时间,创面色素沉着及患者对创面外观自身感受主观评价的差别。结果应用积雪苷霜软膏患者伤口愈合时间短,色素沉着发生率小,患者对创面外观自我满意度高。结论积雪苷霜软膏可以有效促进伤口愈合,减少瘢痕形成及色素沉着,能够满足女性患者对腹部创面外观的要求,有效减轻对术后自我形象的心理顾虑。     

Bilirubin modulated cytokines,growth factors and angiogenesis to improve cutaneous wound healing process in diabetic rats

Bilirubin has shown cutaneous wound healing potential in some preliminary studies. Here we hypothesize that bilirubin facilitates wound healing in diabetic rats by modulating important healing factors/candidates and antioxidant parameters in a time-dependent manner. Diabetes was induced in male Wistar rats by streptozotocin. In all diabetic rats wounds were created under pentobarbitone anesthesia. All the rats were divided into two groups, of which one (control) was treated with ointment base and other with bilirubin ointment (0.3%). Wound closer measurement and tissue collection were done on days 3, 7, 14 and 19 post-wounding. The relative expressions of hypoxia inducible factor-1 alpha (HIF-1α), vascular endothelial growth factor (VEGF), stromal cell-derived factor-1 alpha (SDF-1α), transforming growth factor- beta₁ (TGF-β₁⁾, tumor necrosis factor-α (TNF-α) and interlukin-10 (IL-10) mRNA and proteins and the mRNA of interlukin-1 beta (IL-1β) and matrix metalloprteinase-9 (MMP-9) were determined in the wound tissues. CD-31 staining and collagen content were evaluated by immunohistochemistry and picrosirius red staining, respectively. Histopathological changes were assessed by H&E staining. The per cent wound closer was significantly higher from day 7 onwards in bilirubin-treated rats. HIF-1α, VEGF, SDF-1α, TGF-β₁, IL-10 mRNA and protein levels were significantly higher on days 3, 7 and 14 in bilirubin-treated rats. The mRNA expression and protein level of TNF-α and the mRNA of IL-1β and MMP-9 were progressively and markedly reduced in bilirubin-treated rats. The collagen deposition and formation of blood vessels were greater in bilirubin-treated rats. Bilirubin markedly facilitated cutaneous wound healing in diabetic rats by modulating growth factors, cytokines, neovasculogenesis and collagen contents to the wound site. Topical application of bilirubin ointment might be of great use in cutaneous wound healing in diabetic patients.     

Embelin accelerates cutaneous wound healing in diabetic rats

This study reports the effect of embelin (1) on cutaneous wound in streptozotocin (STZ)-induced diabetic rats. The effect was studied using excision, incision, and dead space models. In diabetic rats, topical application of embelin 5% (w/w) ointment showed a significant increase in wound contraction and better epithelialization, thereby facilitating the healing. Embelin was also active by the oral route (25 and 50 mg/kg) in the incision and dead space wound models. In incision wound model, wound granulation tissues were removed on 8th post-wounding day, and the hydroxyproline, hexosamine, total protein, and DNA contents were determined. In STZ diabetic rats, topical and oral applications of embelin showed an increase in hydroxyproline, hexosamine, total protein, and DNA contents. It also showed a significant increase in wound breaking strength. Embelin significantly increased granuloma tissue weight and breaking strength in dead space model. These results indicated that embelin accelerated wound healing in diabetic rat.     

Improvement in Wound Healing by Epidermal Growth Factor (EGF) Ointment. I. Effect of Nafamostat,Gabexate, or Gelatin on Stabilization and Efficacy of EGF

The healing effect of human epidermal growth factor (hEGF) on open wounds was studied in rats. No improvement in wound healing was found by topical application of EGF alone to open wound sites. We found an ointment containing EGF and a protease inhibitor, nafamostat mesilate or gabexate mesilate, or gelatin accelerated the healing rate of open wounds. Significant increases in the dry weight of the wound site granulation tissue, uronic acid (as an index of acid mucopolysaccharide) and hydroxyproline (as an index of collagen) were observed by treatment with EGF ointment containing nafamostat compared with the controls. The effects of the protease inhibitor on wound healing were dose dependent. Nafamostat was more efficient than gabexate or gelatin on wound healing. The degradation of ¹²⁵I-EGF in wound tissue homogenate was significantly decreased in the presence of a protease inhibitor, such as nafamostat or gabexate, or gelatin. These findings indicate that the stabilization of EGF at the wound site is an important factor in permitting the expression of its healing effects and suggest that the ointment containing EGF and a stabilizing agent would be a suitable dosage form for acceleration of wound repair.     

生肌玉红膏对深Ⅱ度烧伤大鼠创面修复的影响

目的 从组织病理学方面动态观察生肌玉红膏对深Ⅱ度烧伤大鼠创面修复的影响,初步探讨生肌玉红膏促进皮肤烧伤创面愈合的作用及可能机理。方法 将深Ⅱ度烧伤大鼠模型按体质量随机分为模型组、生肌玉红膏组和湿润烧伤膏组,每组24只。烧伤创面涂以相应药物,每天1次,连续给药直至创面愈合。观察各组动物创面愈合时间、创面愈合率,并于烧伤后第7,14,21天对各组动物创面组织进行取材,分别进行HE常规染色、Masson皮肤胶原染色。光镜下观察各组创面组织形态学变化,成纤维细胞形态及数量变化,并对创面中成纤维细胞进行计数,用图像分析软件分析各组创面胶原纤维面积。结果 与模型组相比,生肌玉红膏组创面愈合时间缩短,创面愈合率提高（P〈0.05）;烧伤后第7,14天,生肌玉红膏组创面成纤维细胞数量多于模型组（P〈0.05）;烧伤后第14,21天,生肌玉红膏组创面中心胶原纤维面积大于模型组（P＜0.05）。结论 生肌玉红膏可促进深Ⅱ度烧伤大鼠创面愈合,可能与其促进创面成纤维细胞增生和胶原纤维分泌有关。     

重组人表皮生长因子促进面颈部斑痣激光治疗创面的愈合作用

目的：观察重组人表皮生长因子（rhEGF）对面颈部斑痣激光治疗创面愈合效果的影响。方法：120例面颈部斑痣患者经激光治疗后随机分为两组,实验组创面局部喷涂重组人表皮生长因（rhEGF）,外涂红霉素软膏,对照组创面涂红霉素软膏,观察创面愈合情况。结果：rhEGF治疗激光术后创面,实验组比对照组相比：愈合时间提前2-4d,实验组痊愈率和总有效率分别为20%和76.67%。对照组痊愈率和总有效率分别为6.67%和41.67%,实验组愈合后的创面不存在凹陷,愈合效果好。未见明显的不良反应。结论：rhEGF对激光治疗面颈部斑痣的创面具有明显的促进愈合的作用。     

Wound healing properties of Indian propolis studied on excision wound-induced rats

Context: In traditional medicine propolis is widely used for the treatment of various ailments including ulcer and wound healing. The phytochemical screening of Indian propolis indicates the presence of biologically active ingredients in appreciable amounts. In the absence of systematic evaluation of wound healing properties of Indian propolis in the literature, the present study was undertaken.

Objective: The aim of this study was to evaluate the wound healing potential of Indian propolis on excision wounds induced in experimental rats.

Materials and methods: Excision wounds were created in male Wistar rats and were treated with Indian propolis ointment (nitrofurazone was used as a reference drug - widely used for wound healing) for a period of 14 days. Control rats were treated with petroleum jelly. The parameters analyzed include wound contraction, hydroxyproline, hexosamine, uronic acid, total protein, DNA, and RNA.

Results: Topical application of propolis ointment for 14 days significantly improved the wound contraction when compared to the control group of rats. The determination of hydroxyproline, hexosamine, uronic acid, DNA, RNA and protein levels in the wound matrix revealed the pro-healing effects of propolis. The results obtained were comparable with nitrofurazone.

Discussion and conclusion: It appears that the ethanol extract of Indian propolis possesses significant pro-healing activity by accelerating the healing process at various phases of tissue repair. The presence of biologically active ingredients such as flavonoids, phenolic acids, terpenes, benzoic acids, amino acids and vitamins, etc. in Indian propolis may readily account for the observed prophylactic action of propolis in wound healing.     

重组人表皮生长因子联合磺胺嘧啶银霜治疗糖尿病足溃疡的疗效观察

目的观察重组人表皮生长因子与磺胺嘧啶银霜局部联合应用治疗糖尿病足溃疡的疗效。方法18例2型糖尿病足溃疡合并感染患者,按Wagner分级,在常规治疗基础上,局部采用重组人表皮生长因子与磺胺嘧啶银霜联合应用,观察溃疡愈合情况。结果18例患者中有2例因经济等原因自动出院,有12例住院期间足溃疡愈合,治愈率达75％,愈合时间10～47d,另有4例出院时足溃疡愈合面积超过原溃疡面的1／2,出院后仍然采用重组人表皮生长因子及磺胺嘧啶银霜局部联合应用,有2例随访1个月愈合良好。结论糖尿病足溃疡病变程度在Wagner4级及以下的病例通过使用包括重组人表皮生长因子及磺胺嘧啶银霜局部应用在内的综合治疗,可使一部分患者避免外科手术甚至截肢之苦。