BACKGROUND: This study aimed to explore the therapeutic effect of external application of ligustrazine combined with holistic nursing on pressure sores, as well as the underlying mechanism.

MATERIAL AND METHODS: From February 2014 to March 2015, a total of 32 patients with Phase II and Phase III pressure sores were enrolled and randomly assigned to an experimental group or a control group. The clinical data were comparable between the 2 groups. In addition to holistic nursing, the patients in the experimental group received 4 weeks of continuous external application of ligustrazine, whereas patients in the control group received compound clotrimazole cream. Therapeutic effect and healing time were recorded. HaCaT cells were used as an in vitro model for mechanism analysis of the effect of ligustrazine in treating pressure sores. After culturing with different concentrations of ligustrazine or the inhibitor of AKT (LY294002) for 72 h, cell viability, clone formation numbers, and levels of phosphatidyl inositol 3-kinase (PI3K), p-AKT, and p-mammalian target of rapamycin (mTOR) were determined.

RESULTS: Compared to the control group, the total effective rate in the experimental group was significantly higher, and the healing time was significantly reduced. Cell viability and clone formation numbers were significantly upregulated by ligustrazine in a dose-dependent manner. Both the cell viability and clone formation numbers were significantly inhibited by application of LY294002.

CONCLUSIONS: Our results suggest that ligustrazine combined with holistic nursing is an effective treatment of pressure sores. The protective effect may be associated with the promotion of cell growth by activation of the PI3K/AKT pathway.

Keywords: Aged, 80 and over, Case-Control Studies, Cell Cycle - drug effects, Cell Proliferation - drug effects, Cell Survival - drug effects, Clotrimazole - administration & dosage, Holistic Nursing - methods, Phosphatidylinositol 3-Kinases - metabolism, Pressure Ulcer - therapy, Proto-Oncogene Proteins c-akt - metabolism, Pyrazines - administration & dosage, Signal Transduction - drug effects, TOR Serine-Threonine Kinases - metabolism