To investigate the efficacy of Longxuejie（Resina Draconis）combined with fluorouracil injection in patients with keloid scarswith different transforming growth factor-β（TGF-β）single nucleotide polymorphisms.

A total of 240 cases of keloid patients admitted to the hospital from July 2019 to January 2022 were included，which were categorized into wild group（wild-type TGF-β）and mutant group（mutant TGF-β）based on TGF-β single nucleotide polymorphisms，and themutant group was divided into rs747857 group（rs747857-type TGF-β），rs1800469 group（rs1800469 type TGF-β）and rs2241716 group（rs2241716 type TGF-β）. Five groups were treated with fluorouracil injection monotherapy or Longxuejie（Resina Draconis）combined with fluorouracil injection. The patients in the five groupswere scored by the Vancouver Scar Scale（VSS），the Patient and Observer Scar Assessment Scale（POSAS）and the Dermatologic Quality of Life Index（DLQI）scale before treatment and 12 months after the first treatment.

Compared with those of the wild group，the expression levels of TGF-β mRNA in themutation group，rs747857 group，rs1800469 group and rs2241716 group increased（P<0.05）. Compared with the wild group，the patients in the mutation group，rs1800469 group and rs2241716 group under monotherapy showed a significant increase in the total VSSscore and the total POSAS score after treatment（P<0.05）；whereas，compared with monotherapy，the patients in the mutation group，rs1800469 group and rs2241716 group under the combination therapy showed a significant decrease in the total VSS score and the total POSAS scores were significantly decreased（P<0.05）. Compared with thewild group，the patients in the rs2241716 group all showed a significant increase in DLQI scale scores after treatment（P<0.05）；whereas，compared with monotherapy，the patients in the rs2241716 group under combination therapy all showed a significant decrease in DLQI scale scores after treatment（P<0.05）. Compared with the wild group，the patients in the rs1800469 and rs2241716 groups showed a significant decrease in the effective rate after treatment（P<0.05）；while compared with mono therapy，the patients in the rs1800469 and rs2241716 groups under combination therapy showed a significant increase in the effective rate after treatment（P<0.05）. Compared with the wild group，the patients in the mutation group，rs1800469 group and rs2241716 group had delayed the first apparent effect and the number of fluorouracil times to reach the first apparent effect（P<0.05）；while compared with the monotherapy，the patients in the mutation group，rs1800469 group and rs2241716 group under the combination therapy had advanced the first apparent effect and the number of fluorouracil times to reach the first apparent effect（P<0.05）. Fewer total adverse reactions were observed in the wild，mutant，rs747857，rs1800469 and rs2241716 groups under combination therapy compared with monotherapy（P<0.05）.

Longxuejie（Resina Draconis）combined with fluorouracil injection has better efficacy and fewer adverse effects in patients with keloids with different TGF-β single nucleotide polymorphisms.