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Journal of Thai Traditional & Alternative Medicine Vol. 9 No. 2 September-December 2011 85

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¡“π·º≈ ‚¥¬∑“∫√‘‡«≥∑’ˇªìπ·º≈«—π≈– 1-3 §√—Èß “√ °—¥∫—«∫° ·≈– “√‡Õ‡™’¬μ‘‚§‰´¥å¬—ß¡’
¬“√—∫ª√–∑“π „π√Ÿª¢Õ߬“·§ª´Ÿ≈ (§√—Èß≈– 400 ª√–‚¬™πå„π°“√√—°…“·º≈‡ªìπ·≈–·º≈‡ªìππŸπ (keloid) ‚¥¬
¡‘≈≈‘°√—¡ «—π≈– 3 §√—Èß) À√◊Õ¬“™ß (™ßπÈ”§√—Èß≈– 2-4 °√—¡ «—π≈– æ∫«à“‡Õ‡™’¬μ‘‚§‰´¥å “¡“√∂≈¥¿“«–‡°‘¥æ—ߺ◊¥ (fibrosis)
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3 §√—Èß) „™â·°â‰¢â ·°â√âÕπ„π ·°â™È”„π ¢Õß·º≈ ®÷ߙ૬ªÑÕß°—π°“√‡°‘¥·º≈‡ªìπ‰¥â ‚¥¬¡’°≈‰°°“√
ÕÕ°ƒ∑∏‘ϧ◊Õ ‡æ‘Ë¡°“√ √â“ߧÕ≈≈“‡®π·≈– acidic muco-
ß“π«‘®—¬ √√æ§ÿ≥·≈–§«“¡ª≈Õ¥¿—¬
polysaccharides ·≈–¬—∫¬—Èß°√–∫«π°“√Õ—°‡ ∫¢Õß·º≈
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1. ƒ∑∏‘Ï∑“߇¿ —™«‘∑¬“„πÀ≈Õ¥∑¥≈Õß·≈– —μ«å∑¥≈Õß ‡ªìπ∑’Ë¢¬“¬μ—«‡°‘π (hypertrophic scars) ·≈–·º≈‡ªìππŸπ
À≈—°∞“π∑“߇¿ —™«‘∑¬“∑’Ë ”§—≠∑’Ë π—∫ πÿπ √√æ§ÿ≥ ‡¡◊ËÕ„Àâ “√¡“‡¥·§ ‚´‰´¥å·°àÀπŸ∂’∫®—°√∑“ߪ“°
„π°“√√—°…“·º≈¢Õß∫—«∫°μ“¡¢âÕ∫àß„™â¢â“ßμâπ ‰¥â·°à ƒ∑∏‘χ√àß ®–· ¥ßƒ∑∏‘Ï„π°“√√—°…“·º≈‰À¡â °√–μÿâπ„Àâ·º≈ªî¥‡√Á« ‚¥¬

°“√À“¬¢Õß·º≈ ·≈–ƒ∑∏‘Ïμâ“πÕ—°‡ ∫ ¡’°≈‰°°“√ÕÕ°ƒ∑∏‘ÏÀ≈“¬Õ¬à“ß ‰¥â·°à ƒ∑∏‘Ïμâ“πÕÕ°´‘‡¥™—π
1.1 ƒ∑∏‘Ï„π°“√√—°…“·º≈ ‡√àß°“√ √â“ߧÕ≈≈“‡®π ‡√àß°“√·∫àßμ—«¢Õ߇´≈≈å √â“߇ âπ„¬
ƒ∑∏‘Ï„π°“√√—°…“·º≈¢Õß∫—«∫°¡“®“°ƒ∑∏‘Ï ·≈–‡π◊ÈÕ‡¬◊ËÕ·°√πŸ‡≈™—π °√–μÿâπ°“√ √â“߇ âπ‡≈◊Õ¥„À¡à ·≈–

¢Õß “√°≈ÿࡉ∑√‡∑Õ√åæ’π∑—ÈßÀ≈“¬ ‰¥â·°à °√¥‡Õ‡™’¬μ‘° °√¥ ≈¥°“√·∑√°´÷¡¢Õ߇´≈≈å°àÕ°“√Õ—°‡ ∫ (inflammatory
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¡“‡¥·§ ‘° ‡Õ‡™’¬μ‘‚§‰´¥å ·≈–¡“‡¥·§ ‚´‰´¥å ‚¥¬ “√ cells)

‡À≈à“π’È°√–μÿâπ°“√ √â“ߧÕ≈≈“‡®π (collagen) ´÷Ë߇ªìπ‚ª√μ’π ®“°°“√»÷°…“¥â«¬«‘∏’ gene microarrays ·≈–
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∑’ˇ°’ˬ«¢âÕß°—∫°“√À“¬¢Õß·º≈ ·≈–°“√»÷°…“„π‰ø real-time RT-PCR „π‡´≈≈å √â“߇ âπ„¬‡æ“–‡≈’ȬߢÕß¡πÿ…¬å
‚∫√∫≈“ μå (fibroblast) ´÷Ë߇ªìπ‡´≈≈å∑’Ë √â“߇¡∑√‘°´åπÕ°‡´≈≈å (cultured human fibroblast) æ∫«à“ “√ °—¥∫—«∫°·≈–

(extracellular matrix) ·≈–§Õ≈≈“‡®π ·≈–¡’∫∑∫“∑ ”§—≠ “√‰∑√‡∑Õ√åæ’πÕ¬¥å∑—Èß ’Ë™π‘¥¢Õß∫—«∫° ‡æ‘Ë¡°“√· ¥ßÕÕ°
μàÕ°“√À“¬¢Õß·º≈ (wound healing) æ∫«à“ “√ °—¥∫—«∫° ¢Õ߬’π (gene expression) ∑’ˇ°’ˬ«¢âÕß°—∫°“√ √â“߇ âπ
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°√–μÿâπ°“√ √â“ߧÕ≈≈“‡®π¢Õ߇´≈≈å √â“߇ âπ„¬ (fibroblast) ‡≈◊Õ¥„À¡à (angiogenesis) ·≈–°“√ √â“߇¡∑√‘°´åπÕ°
πÕ°®“°π’È æ∫«à“ “√‡Õ‡™’¬μ‘‚§‰´¥å‡√àß°“√À“¬¢Õß·º≈À≈—ß ‡´≈≈å¢÷Èπ„À¡à (remodeling of extracellular matrix)
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ºà“μ—¥ ‚¥¬‡√àß°√–∫«π°“√ √â“߇π◊ÈÕ‡¬◊ËÕ„À¡à ‡¡◊ËÕ∑“‡Õ‡™’¬μ‘- √«¡∑—È߬’π¢Õß growth factor À≈“¬™π‘¥
‚§‰´¥å ≈ß∫πº‘«Àπ—ߢÕßÀπŸ∑’ˇªìπ·º≈ ®–‡√àß°“√À“¬¢Õß à«πÕ’°√“¬ß“πÀπ÷Ëß°≈à“««à“‡¡◊ËÕ»÷°…“¥â«¬

·º≈·≈–‡æ‘Ë¡§«“¡∑π·√ߥ÷ß (tensile strength) ¢Õߺ‘«Àπ—ß cDNA microarray technology æ∫«à“‡Õ‡™’¬μ‘‚§‰´¥å¡’º≈
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∑’Ë √â“ß„À¡à ‡æ‘Ë¡°“√ √â“ß mRNA ®“°¬’π¢Õ߇´≈≈å √â“߇ âπ„¬®“°Àπ—ß
“√ °—¥∫—«∫°¥â«¬·Õ≈°ÕŒÕ≈å ‡¡◊ËÕ„Àâ∑“ߪ“° ·∑â¢Õߧπ (human dermal fibroblast) 54 ¬’π ∑’Ë∑”Àπâ“∑’Ë
À√◊Õ‚¥¬°“√∑“ ™à«¬‡√àß°“√À“¬¢Õߺ‘«Àπ—ßÀπŸ¢“« ‚¥¬‡æ‘Ë¡ §«∫§ÿ¡°“√‡æ‘Ë¡®”π«π¢Õ߇´≈≈å (cell proliferation), °“√
°“√·∫àßμ—«¢Õ߇´≈≈å·≈–°“√ √â“ߧÕ≈≈“‡®π ¥’‡ÕÁπ‡Õ ·≈– °â“«Àπâ“¢Õß«—Ø®—°√‡´≈≈å (cell cycle progression) ·≈–°“√

‚ª√μ’π„π‡π◊ÈÕ‡¬◊ËÕ·°√πŸ‡≈™—π (granulation tissue) ¡’º≈‡√àß √â“߇¡∑√‘°´åπÕ°‡´≈≈å∑’ˇ«≈“μà“ß Ê °—π ·≈–√–¥—∫¢Õß mRNA
°√–∫«π°“√ √â“߇´≈≈凬◊ËÕ∫ÿº‘« (epithelialization), °“√ ·≈–°“√ √â“ß‚ª√μ’π¢Õ߬’π∫“߬’π∑’ˇ°’ˬ«¢âÕß°—∫°“√ √â“߇¡∑
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‡®√‘≠‡μÁ¡∑’Ë (maturation) ·≈–°“√‡°‘¥ crosslinking √‘°´åπÕ°‡´≈≈å°Á‡æ‘Ë¡¢÷Èπ‡™àπ‡¥’¬«°—π
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¢ÕߧÕ≈≈“‡®π 1.2 ƒ∑∏‘Ï≈¥°“√Õ—°‡ ∫
‡¡◊ËÕ∑“‡Õ‡™’¬μ‘‚§‰´¥å 0.2% ∫πº‘«ÀπŸ¢“«∑’Ë ‡¡◊ËÕ»÷°…“ƒ∑∏‘Ï≈¥°“√Õ—°‡ ∫¢ÕßÕÿâ߇∑â“ÀπŸ·√μ

‡ªìπ·º≈ æ∫«à“¡’º≈∑”„Àâ√–¥—∫¢Õß “√μâ“πÕÕ°´‘‡¥™—π (anti- ∑’Ë∂Ÿ°°√–μÿâπ¥â«¬°“√©’¥ “√§“√“®’·ππ æ∫«à“ “√ °—¥πÈ”·≈–
oxidants) ‰¥â·°à superoxide dismutase, catalase, glu- “√ °—¥‡Õ∑“πÕ≈®“°∫—«∫°¢π“¥ 100 ¡°./°°. ‡¡◊ËÕ„Àâ∑“ß
tathione peroxidase, «‘μ“¡‘πÕ’ ·≈–«‘μ“¡‘π´’‡æ‘Ë¡¢÷Èπ„𠪓°¡’ª√– ‘∑∏‘º≈μâ“πÕ—°‡ ∫‡∑’¬∫‡∑à“°—∫‰Õ∫‘«‚æ√‡øπ
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‡π◊ÈÕ‡¬◊ËÕ∑’Ë √â“ß„À¡à (ibuprofen) ¢π“¥ 100 ¡°./°°. à«πÕ’°°“√»÷°…“Àπ÷Ëßæ∫