@article{oai:kanazawa-u.repo.nii.ac.jp:00043780,
 author = {ハリアント and 大貝, 和裕 and 仲上, 豪二朗 and 大江 , 真琴 and 中谷, 壽男 and 大桑, 真由美 and 真田, 弘美 and 須釜, 淳子 and Haryanto and Ogai, Kazuhiro and Suriadi and Nakagami, Gojiro and Oe, Makoto and Nakatani, Toshio and Okuwa, Mayumi and Sanada, Hiromi and Sugama, Junko},
 issue = {2},
 journal = {Journal of wellness and health care, Journal of wellness and health care},
 month = {Jan},
 note = {Background                                                                                                                                           In vitro and in vivo studies have indicated that the sea cucumber has biological and pharmacological activities, including antiinflammatory, antimicrobial, antibacterial, antibiofilm, and wound healing activities. However, there have been no studies to evaluate the effects of sea cucumber on wound healing in clinical settings.
Objective
This study was performed to evaluate wound healing of diabetic foot ulcers （DFUs） using sea cucumber and to evaluate the effects of sea cucumber on biofilm, tumor necrosis factor alpha （TNF-α）, matrix metalloproteinase （MMP-2）, and matrix metalloproteinase （MMP-9）.
Subjects and Methods
This study had a prospective cohort design. The study population consisted of 42 DFU patients with new ulcers; 21 each were treated using sea cucumber and honey. This study was conducted at two sites: Kitamura Wound Care Clinic and the Outpatient Wound Care Clinic at Soedarso General Hospital, Pontianak, West Kalimantan, Indonesia, from March 2016 to February 2017. The participants were followed up for 12 weeks.
Results
There were significant differences in the TNF-αlevel between weeks 0 vs. 8, 0 vs. 10, and 0 vs. 12 in the sea cucumber group （p = 0.005, p = 0.006, and p = 0.010, respectively; Steel post hoc test）. There was no significant difference in the change in pattern of biofilm-like staining from positive to negative between the groups （p = 0.55, Fisherʼs exact test）. There was no significant difference in wound healing between the sea cucumber and honey groups （p = 0.66; Kaplan-Meier analysis, log rank test）.
Conclusion
These results indicated that sea cucumber could be used as an alternative wound dressing for DFUs in a clinical setting., 【背景】海鼠の抗炎症作用、抗菌作用、創傷治癒効果については生物学的、薬理学的にある
いは実験動物にて報告されている。しかし臨床においての創傷治癒効果については報告されていない。【目的】本研究の目的は海鼠の糖尿病足潰瘍（DFU）における創傷治癒効果をバイオフィルム、腫瘍壊死因子（TNF-α）、マトリックス分解酵素（MMP）-2、9 を指標として評価することである。【対象・方法】研究デザインは前向き観察研究である。42 名の糖尿病患者に新規に発生した DFU に、海鼠あるいは蜂蜜が創部に使用された（各群 21 名）。調査場所は、インドネシア西カリマンタン・ポンティアナックにある創傷専門クリニックまたは創傷外来であった。調査期間は 2016 年 3 月から 2017 年 2 月であった。創傷は 12 週間観察された。【結果】海鼠使用群では、調査開始時と比べ 8 週、10 週、12 週の TNF- αが有意に低下した（p=.005, 006, 010）。両群のバイオフィルム陽性→陰性変化割合に有意差はなかった（ｐ =.55、Fisher exact test）。さらに群間の創傷治癒に有意差はなかった（p=.66, Kaplan-Meier 解析、log rank test）。【結論】海鼠は DFU の創傷局所療法として使用可能であると示唆された。},
 pages = {41--56},
 title = {A prospective observational study using sea cucumber and honey as topical therapy for diabetic foot ulcers in Indonesia},
 volume = {41},
 year = {2018}
}