ObjectiveThe aim of this study was to assess the clinical efficacy of Radix Arnebiae oil (RAO) in patients undergoing incision and drainage of perianal abscess and to investigate its effects on pyroptosis-related factors, thereby providing evidence to support its clinical application and offering insights into its potential mechanism of action.MethodsNinety patients were randomly assigned to three groups (n = 30 per group) using a random number table: the RAO group, the Moist Exposed Burn Ointment (MEBO) group, and the petrolatum group. Beginning on postoperative day (POD) 1, the assigned topical agent was applied to the wound in each group and continued until complete wound healing. Pain and wound exudate scores were assessed on PODs 3, 7, and 14. In addition, wound healing rates and healing duration were recorded. Protein expression levels of caspase-1, interleukin (IL)-1β, and IL-18 were assessed using enzyme-linked immunosorbent assay (ELISA) and immunohistochemical (IHC) staining.ResultsTreatment with RAO significantly alleviated postoperative pain and reduced wound exudation following incision and drainage of perianal abscess. On POD 14, the corresponding scores in the RAO group were significantly lower than those in the MEBO and petrolatum groups (p < 0.05). The RAO group demonstrated a higher wound healing rate and a significantly shorter healing duration than the MEBO and petrolatum groups (both p < 0.05). The overall clinical efficacy was significantly greater in the RAO group than in the other two treatment groups (p < 0.05). ELISA findings on POD 14 showed significantly lower protein expression levels of caspase-1, IL-1β, and IL-18 in the RAO group than in the petrolatum and MEBO groups, with statistically significant differences (all p < 0.05). Consistent with these findings, IHC staining demonstrated reduced expression of these proteins in the RAO group compared with the MEBO and petrolatum groups.ConclusionRAO alleviates postoperative pain, reduces wound exudation, and promotes wound healing in patients undergoing incision and drainage of perianal abscess. Its mechanism of action may be associated with the regulation of pyroptosis-related mediators, including caspase-1, IL-1β, and IL-18.

Ulcerative colitis (UC) is a persistent inflammatory condition affecting the bowels. Gegen Qinlian decoction (GQD) has been widely used in the therapy of gastrointestinal diseases. We investigated the protective impacts and mechanism of GQD against UC. To establish the UC model, dextran sulfate sodium (DSS) was utilized. The disease activity index (DAI), colon length and colonic pathology were assessed to examine the impacts of GQD on UC. The level of pan-lysine lactylation (Pan kla) and specific sites were detected using western blot. Then, the inflammatory factors and the oxidative stress parameters were measured via the corresponding kits, respectively. Our findings demonstrated that GQD suppressed the lactate generation and LDH activity. The western blot revealed that GQD inhibited the expression of Pan kla and specific sites of H3K18la, H3K23la, H4K8la, and H4K12la. Furthermore, the suppressive effects on inflammation and oxidative stress caused by GQD were counteracted upon the exogenous lactate. GQD suppressed the phenotypic differentiation of M1 macrophages by reducing the expression of M1 markers, which was also reversed by exogenous lactate. In conclusion, GQD effectively suppressed UC progression through histone lactylation. Our results broadened the theoretical basis for the clinical use of GQD.

The purpose of this study was to explore the mechanism of "simmer pus and grow meat" method based on bFGF regulating WNT / β-Catenin signaling pathway. Of 100 SPF rats, 25 were randomly selected as blank group, and 75 rats were established chronic infectious wound model and divided into blank group, model group (normal saline treatment, n = 25), experimental group (purple and white ointment treatment, n = 25), and wet burn ointment group (wet burn treatment, n = 25). The wound healing rate of rats was compared. The protein expressions of PCAN, VEGF, bFGF, β-Catenin, GSK-3β and C-Myc in granulation tissues were detected. On the 7th day, the wound healing rate of the model group was lower than that of the other 3 groups (P<0.05), and the wound healing rate of the positive control group was higher than that of the experimental group and the control group (P<0.05). The expressions of bFGF, GSK-3β and C-MyC in model group were higher than those in control group (P<0.05). The β-catenin protein expression in the model group was lower than that in the control group (P<0.05), and the β-catenin protein expression in the experimental group and the positive control group was higher than that in the model group (P<0.05). The expressions of PCAN and VEGF in model group were lower than those in model group (P<0.05). We found that Zibai ointment promotes chronic wound healing by modulating the bFGF/Wnt/β-Catenin signaling pathway.

OBJECTIVE:In this study, we investigated the impact of Zibai ointment on wound healing by analyzing the expression levels of two key apoptosis-related factors-B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated X protein (Bax), in patients following surgery for anal fistula. METHODS:We included 90 patients with anal fistulas who were treated in the People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine. Patients were randomly assigned to receive treatment with Zibai ointment (n = 45) or petroleum jelly (n = 45). The levels of apoptosis-related factors Bcl-2 and Bax were evaluated using enzyme-linked immunosorbent assay (ELISA), while cell apoptosis was assessed using Terminal deoxynucleotidyl transferase (TdT) dUTP Nick-End Labeling (TUNEL) assay. RESULTS:The results of ELISA showed that on Day 21 after the surgery, the levels of Bcl-2 and Bax in the Zibai ointment group were significantly different compared to the petroleum jelly group, with values of (60.11 ± 1.31) ng/mL and (7.05 ± 0.01) versus (83.79 ± 1.74) ng/mL and (6.00 ± 0.05) ng/mL, respectively (p < .05). Furthermore, light microscopy revealed a large number of apoptotic cells within the field of vision 14 days postsurgery in the Zibai ointment group, and the healing time in the Zibai ointment group was significantly different from that in the petroleum jelly group (p < .05). CONCLUSION:We found that Zibai ointment effectively promoted wound healing in patients following anal fistula surgery, possibly by regulating Bcl-2 and Bax apoptosis-related factors.

术后换药是肛肠疾病手术治疗疾病的重要过程,而"煨脓长肉"法作为中医外科学特色换药理念之一,在术后应用得当,可取得满意的临床疗效.文中列举紫白膏换药验案1则,探讨"煨脓长肉"法在痔术后换药中的具体应用,探析其医理,以期为广大临床工作者提供参考.

目的 观察黄白胶囊用于治疗湿热下注型痔病患者的疗效.方法 选取2019年11月—2020年11月在福建中医药大学附属人民医院肛肠二科就诊的98例湿热下注型痔病患者,随机分为试验组(52例)和对照组(46例).试验组采取口服黄白胶囊进行治疗,对照组采用口服肾上腺色腙片进行治疗.观察2组患者的治疗效果,采用临床症状体征积分进行比较.结果 试验组与对照组治疗前的临床症状体征评分差异无统计学意义(P>0.05);治疗后,试验组评分优于对照组,差异有统计学意义(P<0.05).结论 黄白胶囊能有效改善湿热下注型痔病患者的便血和脱出症状,改善痔核黏膜形态,显著降低临床症状体征评分,值得在临床推广.

在我国中医药领域,"国医大师"是最高荣誉,是对获得者医德、医术及对中医药事业发展贡献的充分肯定.自2009年始,该荣誉每5年授予一次,每届评选30人.作为第四届"国医大师"荣誉获得者,福建中医药大学附属人民医院教授、主任医师陈民藩,深耕肛肠学科医教研工作近七十年,构建"湿热论治、以通为用、内外并治、存体寡损、形神兼顾"的学术思想,始终引领学科跨越性发展.

"煨脓长肉"法是中医外科学特色换药法之一,在促进创面愈合过程中起着重要作用.陈民藩教授重视肛肠疾病术后创面换药的重要性,认为术后换药亦是手术成功的重要组成部分.其中煨脓长肉换药法是陈教授推崇的理念之一,认为其应用得当,可缩短创面愈合时间,同时可使创面修复更加良好.笔者总结其经验,以期肛肠同仁临床应用有所启发.

目的:研究并分析溃疡性结肠炎患者应用葛根芩连汤加减方疗效.方法:将溃疡性结肠炎患者62例随机分成对照组和研究组,分别纳入患者31例,所选患者均2020年5月-2021年7月于福建中医药大学附属人民医院进行治疗,对照组应用单纯西药,研究组在此基础上应用葛根芩连汤加减方.比较两组治疗后临床症状缓解情况、中医症候积分及肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)指标变化及并发症.结果:两组临床疗效对比,研究组高于对照组,差异有统计学意义(P<0.05).两组中医症候积分治疗后对比,研究组显著低于对照组,组间差异有统计学意义(P<0.05).治疗后两组TNF-α及CRP水平均低于治疗前,组内差异有统计学意义(P<0.05).治疗后,研究组TNF-α及CRP指标水平均低于对照组,组间差异有统计学意义(P<0.05).研究组并发症总发生率低于对照组,组间差异有统计学意义(P<0.05).结论:溃疡性结肠炎患者应用葛根芩连汤加减方可进一步提高疗效,能够有效促进临床症状缓解并可有效降低炎症因子水平及并发症发生率,病情控制和改善效果均较为理想.

便秘是临床较为常见的病症,张仲景对其病因病机及理法方药有非常全面系统的剖析.笔者结合学习《伤寒论》中经方所得体会,选取几组具有代表性的便秘治疗方,包括三大承气汤、麻子仁丸、大小柴胡汤、蜜煎导方、猪胆汁方、大陷胸汤、抵当汤、桂枝汤及真武汤,对诸方进行简要论述,以期对临床合理使用经方以及提高辨治便秘具有一定借鉴意义.

Vascular endothelial growth factor (VEGF) and its receptor (VEGFR2) are important for wound repair. The aim of this study was to investigate the effect of Zibai ointment on the expression of these factors in wound models. In order to establish wound models, a total of 120 rats were used, which were assigned to vaseline group, Zibai ointment group and erythromycin group. The granulation tissues in each group were obtained on the 3rd, 7th, 14th or 21st day after the establishment of the model. The methods such as immunohistochemistry, RT-PCR, and western blot were used to detect the expression of VEGF and VEGFR2. Comparing to the erythromycin group or vaseline group, the expression of VEGF and VEGFR2 in Zibai ointment group on the 21st day was much higher (P < 0 05). The results of scanning electron microscopy (SEM) showed that with time in the Zibai ointment group, the granulation tissue gradually formed dense reticular layers of loose, curly fibers, and presented with more collagen deposition. In conclusion, Zibai ointment could effectively improve the expression of VEGF and VEGFR2 in granulation tissues of wounds and promote wound healing.

痔是肛肠科的最常见的疾病,以出血、脱垂、疼痛不适为主要临床特征,男女老幼皆可发病,且呈日益严重化、年轻化的疾病走势.依据其发病部位的不同,可分为内痔、外痔及混合痔.关于内痔的治疗,中医学历来有从脾立论治疗脾虚气陷型内痔的运用,疗效可观,其中的作用机制值得我们进一步研讨.中医学"脾主肌肉"理论,无形中提示着内痔脱出与肌肉的天然联系.现代医学"肛垫下移学说"的提出,有力地支撑了中医益气升提法治疗脾虚气陷型内痔的临床疗效.本文基于脾主肌肉理论及肛垫下移学说理论,从中西医角度探索总结从脾论治脾虚气陷型内痔的相关性,建立"脾-肛垫-提肛"轴.

目的 探讨紫草油(本院制剂)外用治疗小儿肛门湿疹的临床疗效. 方法 选择2018年1月～2019年1月我科门诊诊治的肛门湿疹患儿40例,随机分为治疗组和对照组各20例,治疗组给予本院协定方紫草油外涂,对照组给予氧化锌软膏外涂,治疗2周后观察两组患儿的瘙痒程度、皮损变化,并评估临床疗效. 结果 治疗组痊愈15例,好转5例,总有效率100％;对照组痊愈13例,好转1例,无效6例,总有效率70％;两组总有效率比较,治疗组明显优于对照组(P＜0.05).两组瘙痒程度评分比较,治疗前差异无统计学意义(P＞0.05),治疗后治疗组的瘙痒评分明显低于对照组(P＜0.05).两组患儿的皮损改善方面比较,治疗组患儿的皮损均有改善,对照组仍有5例皮损无改善,组间差异有统计学意义(P＜0.05). 结论 紫草油治疗小儿肛门湿疹的疗效确切,能有效缓解肛门瘙痒,促进皮损恢复,且无不良反应,值得进一步研究运用.