The Effects of Gyejibokryeong-hwan(桂枝茯?丸)
for Wound Healing after Skin Suture

Hoon Jung
Dept. of Korean Medicine
Graduate school, Daejeon University
(Directed by Prof. Min-Seok Oh, D.K.M., Ph.D.)

Objectives :
There is few Korean medicinal studies about post-operation wound healing despite much effort for minimizing wound or post-op scar. The aim of this study is to evaluate the wound healing effect of Geijibokryunghwan(GBH) after skin suture.

Methods :
<In vitro>
We observed anti-oxidative and anti-inflammatory effect by using lipopolysaccharide(LPS)-treated RAW 264.7 cells. For anti-oxidation, we mesured the total amount of polyphenol, flavonoid, DPPH scavenging ability, ABTS scavenging ability and the value of ROS production, and for anti-inflammation, we mesured the amount of NO and pro-inflammatory cytokines(TNF-α, IL-1β, IL-6).



<In vivo>
Thirty SD rats were divided into five equal groups(n=6, one normal, two controls and two experimentals). All groups except normal group were made a scar(around 1x4 ㎠) in the back by the depth of the fascia and then sutured by a thread and needle. Normal group rats received no treatment at all. Control group rats were fed distilled water, and positive control group rats were percutaneously applied terramycin once in 2 days. GBH 200 group rats were orally medicated GBH 200 ㎎/㎏, and GBH 400 group rats were orally medicated GBH 400 ㎎/㎏ per day for two weeks. We analyzed the blood samples(WBC, neutrophil, lymphocyte, monocyte, eosinophil), and the serums(TIMP-1, MMP-2, MMP-2. PGE2, TGF-β, VEGF), and examined the wounded skin tissue histopathologically.

Results :
<in vitro>
1. DPPH and ABTS scavenging activity was increased concentration-dependantly, and ROS production was significantly increased in GBH treated cells(100 ㎍/㎖). Therefore in this study, Gyejibokryeong-hwan appears to have the anti-oxidative.
2. NO production was significantly reduced in GBH treated cells(100 ㎍/㎖), and IL-1β production was significantly reduced in GBH treated cells(1 ㎍/㎖). But, TNF-α and IL-6 did not show uneffective action. Therefore in this study, Gyejibokryeong-hwan did not show any significant effect on anti-inflammatory process.


<in vivo>
1. Monocyte and neutrophil was significantly increased in GBH(200, 400) groups. WBC, lymphocyte and eosinophil did not show significant change.
2. TIMP-1, MMP-2, VEGF were significantly increased in GBH 400 group, PGE2 was significantly reduced in GBH 400 group. TGF-β was significantly increased in GBH(200, 400) groups, and MMP-9 was increased concentration-dependantly in GBH groups, but there was no significance.
3. In histopathological examinations, collagen was significantly increased and keratin was significantly decreased in GBH(200, 400) groups.

Conclusions :
According to in vitro experiment, Gyejibokryeong-hwan appears to have the anti-oxidative effect and in vivo experiment, Gyejibokryeong-hwan stimulate the wound healing process hematologically and histopathologically. In conclusion, the results suggest that Gyejibokryeong-hwan promotes wound healing after skin suture.