Different Wound Dressings in the Treatment of Diabetic Foot Ulcers
Total Page:16
File Type:pdf, Size:1020Kb
ęඈඋ1࣏ۘऺ ৰ 20 Ż ৰ 34 ƛ 20160819 ϦČ Chinese Journal of Tissue Engineering Research August 19, 2016 Vol.20, No.34 වẴ Ȑϛńசɳ҉ᱷįѥĐǧ͏ћՈۘऺ^àϬ[ ɏΜΟ1, ğË2 ǘ Œ1 2 এ,1 2(1ˍɞʖãîΆ½KˍɞʖDZƍ̣˼˵Ǔď 010059Z2ˍɞʖãî Ȱij½KˍɞʖDZƍ̣˼˵Ǔď 010059) šϬƨɏΜΟ ğË ǘŒ এ,. ]Ȑϛńசɳ҉ᱷįѥĐǧ͏ћՈۘऺ^àϬ[J].ęඈඋ1࣏ۘऺ 2016 20(34):5155-5162. DOI: 10.3969/j.issn.2095-4344.2016.34.022 ORCID: 0000-0003-2760-2653(ɏΜΟ) তȷợⓉᪿ Ɏ>τK˿K1992 ˝ÛK ]Ȑϛńசɳ҉ᱷįѥĐǧ͏ћՈàϬ ̂Zà ͟˭NK˩ȂK ˍɞʖãîÝŸœ ͅϢ༞Ȍĭ ϶̏3̏༞சǎ͢ᜑϣĭ3ồᯬ‼3൨ම ǎ͢ᜑϣĭ3 3ጥ༞ச þKƶϙÎāDŨDž Ϥ$ ச ɳ ҉ ᱷ į Ě ିǻ:R318 ѥ͔Ȍϛ A:ۅDzʃ তේǻ:2095-4344 ༞EΛ⁋3༞Ex⁋/༞ɳʻEΣ3༞(α″) Ȍt༞Ȍĭ (2016)34-05155-08 ɘ4ěY2016-05-22 L₎5 Đǧϛ ƅ࿁ȴƇīRɳʟ ẟᜐʨĿdž ࿁̻zǶϦĐǧÃ^ʐȟɬ±┨ Ưẟඈඋₑ à᪩ljĈĐǧණǕͫɏ ͣƅû ņẋ࣏ à᪩ͣƅϣĭּǭɳ ]š᰻çŁẋγz̹ѯàਘǑà ነ3û̺ňϬà᪩ǔǭ$┨໐]ỤtĐǧĐ Ñ-z,ϣඈඋϣt4 ˊ̿Ոǧϛà᪩ᰏtˈ ¿ᜥ ᖏՁ›ȵƌ ϣ⑃üƄ>ɬ3ûነϏɳ3ʻÃồɋʐƅ࿁Ư ẟႮŢՈ± ƯẟཌྷᆁඈඋՈϣʐඈඋ͔Ȍẋ࣏4Ǹ̲ Ʒà᪩ͣƅ⑃ƛɳ3άɋʌ3ሳĭťන₎ ņ4ֲQ ŻÏČඣϛՈ,Ƨϛ>ŌǕ ͢ĉŐ£Ȍ]ȐՈ༞ȌĭʐūϬŰʌάՈ༘5ͩ Νẟnj lj᪅żĄՈĐǧɳʟ4 ʼᡅ ëۘऺ>᪅ ]ȐnjϛdzƯẟசɳ҉ᱷįѥՈ͔Ȍ4ྐ Ո·එȈିƧϛՈƣˊʐàϬ Ñǎ͢Âȭசɳ҉ᱷįѥՈṉћͩ4ֲ 5ͩàϬᩥਜ਼ƶ̼௦ CNKI3PubMed3Medline3ᡃϣĭĿƚƛDzϔǒß 2005 Ⴗ 2015 ÀՈ Dz ̼௦͟⏲᪑&8சɳ҉ᱷįѥ Đǧ͔Ȍ ϛ ͏ћDiabetic foot ulcer, wound healing, dressing, treatment94 Ș^żϬՈசɳ҉Đǧ͔ȌϛĉŐωྺ3ˈωྺ3#ඹ͵̿ϛ3ᑈၠᡊ֚ିƧՈĐǧϛ 4]Ȑඈ ༞ȌĭnjᜬɴϦưĽՈĚƚ3ĭˊʐϣĭĽɳ ΞȖzͅϢ༞Ȍĭ7ZՈசɳ҉ᱷįѥ ϛ ĉŐ϶̏3̏༞சǎ͢ᜑϣĭ ጥ༞சȖzȌt༞Ȍĭ7ZՈசɳ҉ᱷįѥϛ ĉ Ő༞EΛ⁋3༞Ex⁋/༞ɳʻEΣ3༞(α″)ି ẝϛdzƯẟசɳ҉ᱷįѥՈ͔Ȍ4͢Âሳĭȭச ɳ҉ᱷįѥՈ͏ћĉŐልሳĭ͏ћ3ᯡťêÖ3ᖊᔯћͩ4 ͟⏲᪑ ϣĭnjnjּǭɳϛசɳ҉ᱷįѥĐǧ͔Ȍ͏ћවẴ 'L᪑ ϣĭϛசɳ҉ᱷįѥඈඋ1࣏ Different wound dressings in the treatment of diabetic foot ulcers Wang Bing-yang1, Niu Guang-ming2, Du Hua1, 2, Weng Li-xin1, 2 (1School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010059, Inner Mongolia Autonomous Region, China; 2Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010059, Inner Mongolia Autonomous Region, China) ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 5 1 5 5 ɏΜΟ . ]Ȑϛńசɳ҉ᱷįѥĐǧ͏ћՈۘऺ^àϬ Wang Bing-yang, Studying Abstract for master’s degree, BACKGROUND: To date, various types of dressings have been proved to promote healing of diabetic foot School of Basic Medicine, ulcers. Inner Mongolia Medical OBJECTIVE: To introduce the principle and application of various kinds of wound dressing as well as University, Hohhot 010059, other adjuvant therapies for diabetic foot ulcers. Inner Mongolia METHODS: CNKI, PubMed, Medline and Foreign Medical Journal Full-Text Service were retrieved by Autonomous Region, computer for relevant literatures published from 2005 to 2015. The search terms were “diabetic foot ulcer, China wound healing, dressing, treatment” in Chinese and English, respectively. RESULTS AND CONCLUSION: The most commonly used dressings for diabetic foot ulcers include gels, hydrogels, sponges, foam dressings, film dressings. Polymer materials with different components exhibit their unique chemical, physical and biological properties, such as natural polymer dressings (chitin, chitosan and its derivatives, fibroin, dextran), synthetic polymer dressings (polyvinyl alcohol, polyethylene glycol/polyethylene oxide, poly(α-ester)s, all of which can promote the healing of diabetic foot ulcers. Other therapies for diabetic foot ulcers include herbal therapy, becaplermin, and maggot therapy. Subject headings: Biological Dressings; Diabetic Foot; Ulcer; Tissue Engineering Cite this article: Wang BY, Niu GM, Du H, Weng LX. Different wound dressings in the treatment of diabetic foot ulcers. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(34):5155-5162. 0 šᣄ Introduction ΛȒƷ .ǂ˥D͉DȁĝΜ¦ùξĕƁƤǂ˥D˵ Ƕ┨ʃβƗȧΡ~ ʩEƷšƷÛȁĝ°Þ2011˝ÝÿHNjɞˍKʑα 1.3 ϑYɪ) ɻˬϗƔ˼ͲBˌĝģ u3.66!ĝf˝N͉uǂ˥DK§!2ʌKŃļdz hɻˬĝDh́üKϟLsƤɤüĝƁ͇Kɻˬĝ Ė2030˝ °ÞĖ5.52![1]9ŪĆǂ˥Dɩƶϙ Dh́üGģȔŀǝʐΉÌʐcƷ2˝õ¬ æ§ǕĝEƷšK¿u85%ǂ˥D͉ŀĝ9ŪĆnȀ ļ(Ήļ)ϢȢġlͲʼnͯφĝɻˬǜɺƤ. bĞςDΟĝ[2]`ʭuţ2ʌKuŌƋ͇ĝȼ§ ɻ æèKΛÎƗãǒɻĝ̱ŨæϠºŪǠƍæKĄ ΨRYĚ͇ȴ[3] 2ȘResults Ɓ>ǂ˥D9ŪĝŊƽN÷Ý˗KĄ2̀ǂ˥ 2.1 ͞|ġì˼ċĿġ ȴ͇ǂ˥DÒlD)ş D͉ŀNļÝʦ̜ˋν°ÞȀbD)űɒĝ ,ɡƲðͿe͇ĝÒlȆŮƍ¬KĆǂ˥Dƕ@ ƷDȁ˼ŝɏȁKĆǂ˥D͉ŀƾ½ȋ@Ϧĝ°9 ϦĝEƷšKǓļĆŖΊƛɞÒlKĕƁƛɞÒlě ǂ˥DȀbĞς͉ŀĝƔÛ͉DǼ˪J15%25% ƍKƯϟͻǐƘĦ ŭϏ[4]K˝ƷDȁ¿ɡ2%[5]ɩǂ˥D͉ŀ̓˗Ū ǂ˥DÒlD)˼ƛɞ͇ͻʭΝDȁ@Ć 9ŪĝǼ˪ʑαĆɩɐuǂ˥D͉ŀĝ23_[6]Ń ǂ˥DȀĞςĝƶϙ9ŵ[7]KŃƖɩ9ŵæˏþŷͿ ̜ȴ͇˄¬÷ɫ͉ŀóįƥĝƟǦhKϡ˩ B˾ΓƘǰjəͻʭΝDÛʦſ3@Køʩ; ƷÚǢǂ˥D͉ŀĝÛͻƉƘ ǂͻ͇ě˳KùξƋɃAĝɃ͇̜Ρ~Qəŷ Kǂ˥DȀĞςƍƟ˵ʩĝĢ˄îƗĆnˎſ 1ᰈʐ5ͩData and methods ˼sĝͻ͇Qijĉ"ɍ˼/ͿnĦŋͬĝQijĉ 1.1 »Ϙ́ Khαƀ·ϗƔCNKIPubMed "ɍƅά[8] MedlineʮɻÛʦΉÌɻˬļÿ2005ƀ2015 ÆȻK4ͻ˼ͻʭΝDȁ@ͮĦƟˏſKΓ ˝ĝɻˬKϗƔʩϧÅɡ ǂ˥DȀĞςK¬÷˾K °9ĆnφΧ˼¬÷OωɺKϠºKŃ̜ʁǝ ȈƨKƍƟZDiabetic foot ulcer, wound healing, ƶϙĆněƍͻʭÛfĝÛA9ǰĝ2êKΟͻʭ dressing, treatment ˍ͓ÛA9ǰ˼ͻ̔0·͇ÛA9ǰ[9]ϡæˏĆ 1.2 Ί2̶ΤÞf φ̼ă3@K°ĉ"ΊŖKfˠɣˍF˼(ƉˍF ൷͑ʃβɬɻǝ˼ċϙY̓KǙƗȧ ĝε ˼ùŲ3@KΛŖΊĝˍFȻΆƉȆΛΓ ĝɻˬZȁˎɻˬjŸ˼ǏŸ̢ĜĖǂ˥DȀĞς ƗʊΆƉQijĉ"ɍġ°9ĕƁĊͻ̔04 ĖR ˼¬÷Ȉƨ˵ʩĝǸĵśɻˬDŸQəƲΡ~ ǭĝ°ðK˾ΡƃŻΟÇû[8]9ɡͻ̔0ΚK 5156 P.O. Box 10002, Shenyang 110180 ɏΜΟ . ]Ȑϛńசɳ҉ᱷįѥĐǧ͏ћՈۘऺ^àϬ ˰ͻ9ǰTČǚKĕƁÝƍ¬bɲĝˠɣĉ"˰Ć^ Ćŋ˼φΧĝ6ȑʗ>ƯKŋǠȈƨĝKhÝό Ίˠɣĉ"˰ĆȔɡɩƲðŔKEÉƂɡƃ̢ ƫĝɃA¬÷ŰTƉKæˏn4φ˼ˎſNé ĝ˾8ƅ ĝ̈́rKæξό͂ŝȆŮĝDZʉǫCK9Æͮݬ÷ ǂ˥DĆƕũƗƕBķȆŮ3@uʩĝΝ ¡ùξɃAĝǼ˪˰ȁ@Kh́fâż˼°͓ DKŃ̜3@^Ŷǂ˥D͉ŀ¬÷˾K`ʭuȀ ́fĝ¬÷K9ÆƘɜϡæh͂¬÷KŶÔY ʌ˼ĉĊĝʭŨKǂ˥DȀĞς¯ɻ͆Ć˾͇ȴͿ ¬÷ ¯Ń̜ƨæͬ¸LsÝǂ˥DȀĞς¬÷ ʕƽ˾ Iˎ1ƛ[12-13] 2.2 ŧϐϘϘ$ƙ͞|ġì˼ċȿŤ jΜ͇¬÷ ˈωྺYŃśȈƨƶϙĆhɣ̱ɒſNéĝ¬ ϊKùόǂ˥DȀĞς˾ĝˎil ŻK¬÷ ÷̈́rKþͿ˾ŋ˾˾ʦ(j˰ĝ́ü)ÝL ȈƨKȶͲôĉĊĝÛʦƨKǕŸɃAKÔY ǍŋǒɻǜÞ20%jˌŋ˛Ƙɒ95%KŃ̜ƨ ˾(ǜɺɩŨ̀ĝév̈́rK:ƹ¬÷ʩ)KÝƍ ȁ@ŷşɡɒʳŋ͇Ķūŋ˰æʃφͿǜʃφ ƟˎiƏKϘhțƨæǜɺsͫ˼u̚ĝÛʦͻ͇ʦ ƃKõƅ^Ɔ̓Įĝˏſ˼ɣ̱Γʊ̈BʊKƯ ƉČǚKǕŸΓݬ÷˾ˎiƏΉŶȤ̼ǂ˥D ϟƘɜæˏæ˙Ĥî(Ϳƒ̔)Ýŋ̈́rƏǓşĝ ȀĞςÝ°æƗƕǒüǫśKĄƖuĝǫśų pHŴ˼ŦǰόſŴŋ˰ˏʌÔY ¯ĝ͂ŝȆ ĞςÏſ˼ĆȆáÝʘƅΨͿ͂ɡ/Ǚ ŮDZ_Kɯu̚ıȼò¬÷K̋ºuÙ[12-13]Ń 2.2.1 ¬÷ȈƨĝƕśΛƶϙǓļ DZ>͓ȉTR ś¬÷ȈƨĝîjļĆKƘɜȁ@æ0˲ıKh ɡĆɃɕĝ¬÷ȈƨK9ÆŨ̀ĝ¬÷ȈƨKȶēǢ ˼KɐuΖîȼH¬÷>Ưŋ˰ȈƨĝK ȧƅƙĝij͇Îŵö°ÑK¬÷ȈƨȋTRɡÝ hiͥݬ÷ǫɯʦˎƗðKͮĕƁ¬÷_Dz˼ʕƽ ˾ˎiƏźĆΟƕTŦḺȔh>ƯK]Σí ˾ʁǝ ˝įƷ˫évȈƨæÔY¬÷ɯĉı˾ÆȻK #ඹ͵̿ϛYÆśȈƨKhÝɹ˼Ϳɒ̐˳ĝ Néĝ¬÷̈́rϡĆɩzĕfˠɣˍF˼(Ɖˍ ¬÷KƘɜ.İøhǓşĝ˾ʦƨ˼̮ʠ FùŲ˼ε Λùό°ĉ"˾fĝƗϙ9ŵKϠº ̠ſįʳĔ¬÷ǠŃ̜ȈƨĆɒſʳĔάKu ͷ̊́f ͇ḺȔhKȐ˾ÎǠ͓ȉ2ɻÆȻKƘɜ̋` ƤLţȋμĝŋǫƋ¬÷̈́rKʲν¬÷Ȉ TǺKæĉKƖ͛¬÷ĝî̔[14]9ΓʳĔ͇˼ ƨϡKȶY uˏſǜɺév̈́rKY̓ΧǠ͈K Ǖ̱ǓļK̮ʠüȈƨæǍݬ÷Aê7 d9ÆK ˏʌ:ƹ̖¬÷Ù˼ː KÔYȆŮƗ ˎ ̮ʠTǜȔɡǂ˥DȀĞςƍƟĝξÝ̡ͲȈ iZ!KȶuÛʦ˵`͇K^DΟQ˽ˎʉͿɷ& ƨ[15] KëljKZ"KȶḺ¬÷ηƷɃAKuÖ¹Ö ᑈၠᡊ֚ିƧՈĐǧϛYŃśȈƨȁ@Ćȑʌ ΨȔhZ#Kȶ̋`Ư^ïf¬÷¯¬KŶ ĝKˀhK`ȔKφɤ(KæɺîƙøhZȑ ̵ÛȆŮÛfĄn¬÷ĝ^ȅś̀˼¬÷˾ φ˼ŋŕΧK@@^ȑŋ˼ˍ¹KˏʌǕŸˍ¹ʒAZ 8ƅĝ^ȅKʲνW>ɐuƕȈƨæu̚KhƖ ij̚άJʗȈƨĝƶϙ4ļĆKƘɜKȶźh u¬÷ɡƤȱȀîƗļ¬÷˾ĝ͛˼˾ĝ^ ̋ºuǫɯʦĝ¬÷Kȁ@æsͫKhšʜǧ ȅ8ƅKlÇƷƤ^ȅĝ¬÷Ȉƨĉh^ȅ¬÷ nJʗȈƨæɯ˲ı͑ȧ¬÷KEuȷ§ǐ ś̀[10] ǠͰİĝij͇K9ÆJʗȈƨϡŰÝÇƷ˼Kh ɬƙɜĝƶϙś̀˼ǓļKȋ@hĝǂ˥D¬ ǂ˥DȀĞςƍƟ[1] ÷˾Ȉƨƨæǫśj˗Y ^ȅĝÛʦ˾f˵`͇ƨ˼ǧ>ɒǫǰ̼˾ ωྺYŃśĆNé·ƅĝ¬÷ȈƨKȁ@Gģ ʦKΛƙɜĝ˾ʦͿȆ˾˼^ȅĝ¡ŨǒƽK ɩŦsƨ(j6ȑJʗ̮ʠͿĉˠɣʕǙ_)˼ TǜE!şǠȻ˼Ǡˍ¬÷ȈƨĝKhŃ̜Ȉƨ "Ϥŋ/ǠżǰKæˏ˛uÛʦ˵`͇ĝ˰ĝ ƨhKEÝƲ°øhɡ\˼ξό. ĉ"Ɖ(j°ʌ)ͿƗǂ(jˠɣŵΛΓέÛ ¬÷ȈƨɷˏKÇƷƤΣƕ^ȅĝȋKjÇΛĝÛ ʦ)[11]Ċ4 ¬÷ÙʦðKŃ̜ƨ ʳĔ¬÷ ʦͻ͇̼˾ʦ(jÛA9ǰŤ˾fϘʦ˼/ͿDZ> ǠK9Ææ¯ ɩNéĝ̈́rÆȻKƙɜϡ Ά̼˾ʦ/ǜ$)ĝϘhțƨ ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 5157 ɏΜΟ . ]Ȑϛńசɳ҉ᱷįѥĐǧ͏ћՈۘऺ^àϬ 2.2.2 ^ȅ˾ƨƋǂ˥DȀĞςĝƍƟ ¬÷ _Ə[24]äǂϡæ_xu·žKóȭŀ˸ĝ ˾̚ȁ$µΣɩ9ŵKj¬÷ś̀˼8ƅƍ¬ ǫǰ˵̲ȔhKŃæˏuƹΓ¡Ũ˼Y`Ŝ˾f iſ͉ŀēȆŮ ΛͲôĝȈƨKÚ˾ âżʗˠɣͿ˒ɵÆij͇øäǂΛΓέÛ ĝùόά˼ƍƟ͇ʦƉ(jˌøh)Ϙʦ˼/ͿΓƘƍ ʦ(þŷͿΓƘ˾ʦƨ˵B˾ĝ/ʃÒ˾ʦ ƟùόάæTʼn¬÷Ȉƨ˾ʦŔƶϙhį ƨ)TʴǏΡ~EȔɡȩŔĝ̜ϘʦKh[24-25] ȷ§˼ξŶ˾ Ýž͇ǰ˗KäǂóŞŀ˸K9Æƙɯ`á ^ȅȆǫ˾ʦƨ2˫ŷǓĝ̼ʦŨ˼ Ý͓ȉĝóȭŀ˸ǫǰKjĉ"Ɖ<ŦǰƗǂ˼ ÛʦǓ͇KɡƤǜɺ^ȅĝɷˏ͇ƉKæÉα^ȅ| ˺ž˵̲ȔhÆȻKäǂɡΆĝƨȁ@2 â˼́Ǒh¬÷ȈƨƅaˊȌKɩȋϝþĝǒƽ ˫Şŀ˸(Ľ̀ĝ¬÷pHŴ)͇ƉKfʗˏſKɹ˼ įǫƘɜĝį·Yɒǫǰƨĝ˾fͿDZ>Ά ĝ˰Ǔ͇˼όîĝ¬÷ȆŮĝĔ4͇ˏKäǂΛ ˾ʦ˼ʃʦKȷ͇ɒǫǰƨ(ȁˎDZ>ĝ̼ȷ ΓέÛʦˏʌξόͻ˰ʝ˼ξŶ¬÷˾Ǔ5Ć ͇˾ʦ)Ϳ˾ʦ/^ȅĝ˾ʦ˼ʃʦĝȆ˾ϡ ĦȪćſĝäǂʗTţʌ͑Ŝ2ɻ¬÷Ću æÙǾʲνƋǂ˥DȀĞςĝƍƟţʌɪƕɒ ̚ĝΓƘǧƨϡ2ʌŃ̜ƨæùόƏ͇"ˍF ǫǰƨæǜɒƍƟK̜h[16] ĈˍF˼Ə͇żˍFĝΨšȔhKÔYeΐȆŮu ȖzͅϢ༞Ȍĭ7ZՈசɳ҉ᱷįѥϛǧ> ɩĉĊĝΨšljK[26-27] ˾ʦæį·əÛʦŦʦͿűʦKȁ@uĉ"Ɖ ÆȻKäǂæÇΏfˠɣˍFͻʭÛfK˾ ͿƗǂĝ͇Ɖnƙɜį·ŦʦͿűʦȆŮKî f˼şΉ^Ί°ˠɣKÔYȆŮùŲ Ƙĝ3Ɖ͇˼͋Éĝ)̼ƶϙ˳ƅƤƙɜKhΓƘ (2)ȑʌƉžYȑʌƉžĆƕǧ>ƗǂKΟǜNj ʁǝGģKnĆȻ·Ϳ3ƕΟ·ĝ°ûƨKŃ̜ ž̼ǂǂKĆʦ̜[lŦʦjpʘBķȆŮˍF ƨĝf˵Ƌ0ɒ(Οĉ"Ɖƨ)˼u¦AD˵ʩ ȻΆƉĝƶϙfǫKjάFƀǠΙó˼̹ʗ[28-30] ĝǼ˪ÆȻKɿş͇-Kſ͇ˏϡæˏ˳ƅΓʴ ÝŻƶǠˍKȑʌƉžuǜˎʉ͇˼Ûʦ˵`͇ ǏKh>ƯKɡƤèȓŃ̜4ļKɪƕɪϊĝ̼ ÆȻKȑʌƉž͆uBʊ˼òϏǩ͇ˏKv̹ȔhK ˾f˼/ͿƅȔǒüĝ͑ȷų̓KͿ Ń̜ƨΓ ΛƋȆŮ˼ˍFȻΆƉĝŋʳȰ˼Lsˏſʲ Ƙɒǫǰƨ(Gģ˾f˾ʦ)˾Ćdžɩæ̓ĝ νKÝ̮ʠ̀˼ŋ˰̀¬÷ȈƨƏKhȑʌƉ Ͳô[17-18] ž[31-32] (1)ςäŵäǂΛΓέÛʦYςäŵĆDZ>H (3)ˠɣŵΛΓέÛʦYˠɣŵĆűʦˍFĝƶ Ə˛ƗǂȋƗĝÛʦŭ[19-21] KáÝ̜pǠŦ ϙfǫKĆı°ȋǶȮĝu·ɒǫǰƨ9ÆK ʦ˼ςäŦʦʘǠΛŇ¹ˍFƏ@Ϧĝςäŵį ƙ Ć ƕ æ Ü Û ĝ Û ʦ ƨ K f Ħ K ` ; ·ˏ̪Kæ0Ħĝf;ĜKŃøςäŵÝɪƕ Ĝ[33-34]ÆȻKƙϡæ̋`ıLJ͈fΣɩuξÝ ϤÛʦƨKhƏűόĝʳDſ[21-22]ςäŵÝ jąĝέÛʦ ŋ_Ə^_CKƙȁ@ĆLJ̼ɡäǂĝȪć ˠɣŵΛΓέÛʦÝòΧŋ˼ȚCƏųu̜ ſKÝKϙ͇_ƏáÝ9ÆKäǂĆƕ˴͇ ˍ¹˼Ň¹CKĕƁΓ·̨όſ˗Kŋ_͇ǜ ʃʦD`Ά;njǂ˼NćD`Ά;njǂä ɒ[35-36]ÆȻKnˠɣŵæϠºƋ3ʦĝΨšljKK ǂĝ̼ʦŨ˼ÛʦǓ͇ΓȪćſ˼Γǫǰ 9 Æ ˠ ɣ ŵ ɡ Ά ĝ ƨ T R ɡ Ć Û ʦ ˵ ` ƘŰ4˵ʩäǂuæÛʦC͇Ûʦ˵`͇ ͇[37-38]ˠɣŵɦέÛʦKjςΆˠɣŵÍ@Άˠ ʕÖ°͇ʕŵÛʦ̚Ȱ͇ÖəÛʦÛʦͻ͇ ɣŵÍΆˠɣŵÍΆςΆˠɣŵÍ@Άς ΛŸͻȔh[23]ƙϡ̋`ȁˎ̼ŋCKΛnʦ Άˠɣŵ˼ÎςΆˠɣŵuşKŋ_͇KΓƘǓ ̜ɍΟ_¹ɍC ͇Kju·_άƏĝ_C͇KŹ͇̓ɡΛÛʦͻ ÆȻKäǂ`Ά˼ÍΆΆȞæ̋`ıljKƯ ͇[39-41]ˠɣŵĉέÛʦKjÒžˠɣŵÒžˠɣ ƷÛ̼)͇KøΓuɒ̼ȁh͇h`Άĝ ŵˠɣŵNjžĉKϡĆˠɣʗ́fƨÆȻKƙ ̼͑čͮÚȪćſK9ÆȋƔƖĜĖĝƨó ɜĝǫǰƘæĆƗƕƗϊĝK9Æƙɜĝŋ_̚ſ uυŦǰ͇Ɖäǂ`_CÝ˵Ƌ0ĦĝpHŴ ˼˰Ǔ͇æTŐŜŃ̜ǓļøΓKhÝΣƕϘʦ 5158 P.O. Box 10002, Shenyang 110180 ɏΜΟ . ]Ȑϛńசɳ҉ᱷįѥĐǧ͏ћՈۘऺ^àϬ ƅά˼ɪƕÛʦƏ[40-42] æÔY͓ȉˍFùŲKùό°ĉ"^Ί˼Ϡºͷ (4)ŜŵYŜŵĉ"æÎνƏǫŦĜĖnΓ ̊́fKTţʌuŶǂ˥D¬÷˾[58-61] ƕ˲ĝÛʦ˵`͇ͻ˵`͇C͇ȴKȑΧ͇ (3)³αĉ´YlžnÝϘʦČǚ˼ȆŮɵ ˼Ùȑ͇KÝÛʦƏaěʩƿŜˠɣĆnˠ iˊȌƏu˵Ƌ0ɒĝόſ˼ĉĊĝCȁKĆɩ ɣĉ"(ŵ)̱˼ĉ"(Ŝ)ɞIƯf[43-46]Ɓ> ȋǐ̓ĝūǓȂĉŭāô°Klžuƕ˲ Ŝĉ"^ÔYɷ&ljKKĄŜĉ"æˏͮ9Û˵lj ĝ·̨Ǔ͇Cæõ͇˼ƕ˲ĝÛʦ˵`͇[51K62]K ĝ̚ˌÆȻKŜŵĉ"ˏʌŦs2͓ˍF˼fˠɣ >ƯΓόîĝħŋ͇˳ƅƤΓξÝĝKh·ž ˍFȰǢĤ˼ùŲKÔY¯ɻ˾[45-47] Ćdžɩ(αĉ)KΓϤŋ͇˼CŶſÝŋ_Ə (5);ǂY;ǂĆϤŋ͇ĝKŋ_͇ɒKÝÛ ͿÝǠˍ˵Ƌlž0ĉ[63]lžÍΆžu ʦˊȌƏɡƟ͇KæȁˎÍΆljKƷÛʪˏ̼[48]; ̋όĝÛʦ˵`͇KæõĝÛʦC͇KÆȻKƙæ ǂΛΓέÛʦuÛʦC͇KÛʦ˵`͇KÖĉ ξɵf͠Ɨ^ȅĝ́üKjǰʜâżˠɣġKʼ "ʳȰKEϟ^ÚˍFͻſ9ÆKƙĆɩƕ˲ ɬżǰlžÍΆžərhEGFTţʌǜɒfˠ ĝ˾ʦKhƟKhKjʘŇ͓˼͓˗˾˼ ɣˍFĝÛAȁ[58K61] Ϙʦ¦ĶƙuŶΨšˍF_vKÔYͻʭÛfˍ ΥˍĉĆdžɩuÛʦ˵`͇˼æÛʦ Fε Ė¬÷ǂā;ǂ˾ʦTKhǂ CĝĉKnƙæÔY¬÷ɯĉ˾EϠºΨšlj ˥D͉ŀbĞςͿ¬÷ɃAƏ[49] KKThȆŮÜÛ˼¬÷˾ǒɻĝΡ~Υ ȖzȌt༞Ȍĭ7ZՈசɳ҉ᱷįѥϛ* ˍĉCŶȁ0lž ·ž˼lžÍΆ (1)ʾ·Yʾ·ĆuϤŋ͇ʕŵʕ žʌ˩͇ȴ[58-59] ƁXKl·CŋC`CĜĖĝÒžʾĉÛʦ˵ 2.3 =Ǫ [͞|ġì˼ċŪȽą ˫8ƅKŌƋǂ `͇ĝ˾ʦ[50-53] ʾ·TʴǏhȆŮɵ ˥DȀĞςĝƍƟǒƽuÖ¹ϘʦÛA9ǰ¦Ȍ i˼ϘʦģŪKƤƙĝɒϤŋ͇˼ʳŋˏſKƙ͆ ϘʦțƹƟƽΛ¯÷ȈƨĝKhġǂ˥DȀAΉ æTƅȔfâżˠɣǙŮͦ˒ɵġ́üÆ Ğς˼ΠƗɃAĆĕƁ͂9ŪĝƗϙ°99ÆK ȻKƙuƕ˲ĝ̼˼ɍ͇ˏKΛƕ˲ĝ̚Ȱ͇ ¬÷̱ŨÖÛŵøhƋ¬÷˾˼ȆŮ͑ȧϡΖɡ ˏ˼φÙȑ>ƯKʾ·2˫̜^Ŷĝ·̨ ƗϙKÖ¹άĝͲô̋îiſ°$µəÛʦĝļ ͇ˏ(jόſ˼Ĉ͇)Λ˵Ƌ0-ĝKɿş͇ʾ Ʋͯʑ˼ɃAΠƗiſ ·̋`_CK9Æ^æˏĆɩAΉͿe͇Ȉ uãνΡ~2ʌKį·¦ȌϘĝǧ>˾f ƨʾ·ΛΓέÛʦThȔ@ʷ¬÷ȈƨKE 9ʦijΡLˊȌűʦƏáÝĝɪƕÛʑɣs Ƌǂ˥D¯ɻƍƟY̓Ƥ!ē[54]ÆŭȻK fǫKæhʦ̜ɃA͇ΝD˼ȴ͇¬÷ĝƍƟ ʾ·ɡΆĝȈƨ͆TξÛuÛʦͻ͇ĝ̼˾ʦK ampucareĆƏϘfǫKΓͻ͇fǫƶϙĆF˼ jîɎŵ˼̈́@̺Ö¹Ϙʦĝu̚ČǚKæˏu ͓KijƕrΆϘʦKhbƍƟ¶¬¯ɻ ƹȷ§AΉ˄˾ĝEƷš ¯ɻġKuÖΨ˼Ö¹͇ˏKȅðϡǜɒƤ¯ɻͻ (2)Ƶ·«̈́φɂYƵ·Ćƕɦ ǐƘKuƃǢȆŮÜÛΟĖɷ&Ő;Ȕhĝɷˏ] ϡTcɡ̈́φɂͿφ̼ʾKŃ$µƙĝǫ Å΄ŐʌĆƕhbƍƟǂ˥D˗ŪĞς(& ǰƉƘƙuϤŋ͇Ûʦ˵`͇Ĉ͇ʕŵ͇ &Ļ˼ȡ)ϘʦKijͻ̔0·͇ÛA9ǰśϘʦK ˼ǜɷ&°͇ĝʦƉKÖĉ"ʳȰKEϟæȁˎ<Ŧ æÔYˍFĝǫƪ˼̵ĝ͓ȉĝ́fȁˎîIJǂ˥ ǰͿυŦǰ˾ljK˾f̈́φɂ[55]Ƶ·͆æ Dʖ̀ēκ2ʌKampucareƍƟȆ0]Å΄Őʌƍ ΓƘ˾ʦʃKjäǂlž·ž˼ ƟȆÝÝǂ˥Dʖ̀îIJĝ¬÷˾Əĝɷ̚ɯ ȮȤžKǜɒΓʝuĝ_CſϣóK͇ˏ ˲[20] ſ͇ˏΛBfſ˼̚ſΆƵ·σƅʃʦ Ɨ̃Ρ~QęæøhțƹƟƽȷ§ǂ˥DȀ ĝ́fϡĆɩæ̓ĝͲô Ğς¬÷ɃA˾ēŃ̜țƹæèGģȭΊ¬ ΆƵ·ĝŋ˰Th͠ƗÛʦ ÷ƍƟ[7]ƗȆżˍFΚțÇΏ9ǰˊȌ͇ɒΊφƟ ƏKGģ¬÷Ȉƨ[56-57]ÆȻK9ɡŃƕś̀ĝŋ˰ ƽ|()Ɵƽ˼ǹɰĝøh[30K33] ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 5159 ɏΜΟ .