Şen Tanrıkulu Ceren, Tanrikulu Yusuf, Kılınç Fahriye, Bahadır Burak, Can Murat, Köktürk Füruzan
Department of Emergency Medicine, Bülent Ecevit University Faculty of Medicine, Zonguldak-Turkey.
Ulus Travma Acil Cerrahi Derg. 2017 May;23(3):181-187. doi: 10.5505/tjtes.2016.64509.
Corrosive esophageal burns, particularly common in developing countries, lead to different problems in different age groups. The ingestion of corrosive substances can cause such problems as stricture of the esophagus, to acute perforation, and even death. Because stricture formation is related to the severity of the initial injury, the prevention of stricture constitutes a main goal of treatment. The aim of this study was to investigate the protective and anti-inflammatory effects of garlic (Allium sativum) oil in corrosive esophageal burn.
Twenty-eight rats were randomly divided into 4 equal groups: group 1 (sham), group 2 (control), group 3 (topical treatment), and group 4 (topical and systemic treatment). In groups 2, 3, and 4, corrosive esophageal burns were generated by applying sodium hydroxide to a 1.5-cm segment of the abdominal esophagus. Normal saline was applied to group 2, topical garlic oil to group 3, and topical and systemic garlic oil were used in group 4.
The level of hydroxyproline was lower in the topical treatment groups than in the control group (p=0.023). There was difference in tumor necrosis factor alpha level between the systemic treatment groups and the control group (p=0.044). Treatment with garlic oil decreased stenosis index (SI) and histopathological damage score (HDS) in corrosive esophageal burn rats. The SI in the topical treatment group was significantly lower than that of the control group (p=0.016). The HDS was significantly lower in group 4 when compared with the control group (p=0.019).
Garlic oil is an effective agent in promoting the regression of esophageal stenosis and tissue damage caused by corrosive burns. While the protective effect of garlic oil on tissue damage is more significant when applied topically, the anti-inflammatory effect is more pronounced when applied systemically. Therefore, we believe that the application of garlic oil in patients with corrosive esophageal burns can reduce complication rates.
腐蚀性食管烧伤在发展中国家尤为常见，在不同年龄组会导致不同问题。摄入腐蚀性物质可引发诸如食管狭窄、急性穿孔甚至死亡等问题。由于狭窄形成与初始损伤的严重程度相关，预防狭窄是治疗的主要目标。本研究旨在探讨大蒜油对腐蚀性食管烧伤的保护和抗炎作用。
28只大鼠随机分为4组，每组7只：第1组（假手术组）、第2组（对照组）、第3组（局部治疗组）和第4组（局部及全身治疗组）。在第2、3和4组中，通过将氢氧化钠应用于腹部食管1.5厘米段来造成腐蚀性食管烧伤。第2组给予生理盐水，第3组给予局部大蒜油，第4组给予局部及全身大蒜油。
局部治疗组的羟脯氨酸水平低于对照组（p = 0.023）。全身治疗组与对照组之间的肿瘤坏死因子α水平存在差异（p = 0.044）。大蒜油治疗可降低腐蚀性食管烧伤大鼠的狭窄指数（SI）和组织病理学损伤评分（HDS）。局部治疗组的SI显著低于对照组（p = 0.016）。与对照组相比，第4组的HDS显著更低（p = 0.019）。
大蒜油是促进腐蚀性烧伤所致食管狭窄消退和组织损伤修复的有效药物。大蒜油局部应用时对组织损伤的保护作用更显著，而全身应用时抗炎作用更明显。因此，我们认为大蒜油应用于腐蚀性食管烧伤患者可降低并发症发生率。
