Research progress in the application of traditional Chinese medicine fumigation and washing therapy after anorectal disease surgery﹟
Wang Yanhua1 Chen Yugen2 ﹡
(1 Nanjing University of Traditional Chinese Medicine, Nanjing, 210046; 2 Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, 210029)
[Keywords] traditional Chinese medicine; fumigation and washing therapy; postoperative anorectal diseases
Chinese medicine fumigation is a unique treatment method in Chinese medicine. The effect of fumigation and washing with traditional Chinese medicine for anorectal diseases is significant, and there are many reports. The author summarizes and analyzes the relevant reports in recent years. The summary is as follows.
1. Progress in clinical application
Traditional Chinese medicine fumigation after anorectal disease has become a routine treatment. Huang inherited  used hemorrhoid fistula fumigation lotion to treat postoperative patients with anorectal diseases, and potassium permanganate was used as the control group. Results: In the treatment group, 53 cases were markedly effective, 8 cases were effective, and 1 case was ineffective. The total effective rate was 98.4%; in the potassium permanganate solution group, 19 cases were markedly effective, 22 cases were effective, and 17 cases were ineffective. The total effective rate was 70.7%. Liu Hua et al.  used Fumigation and Washing No. 1 Recipe to treat complications after anorectal surgery, and compared the effects with PP powder and Jieeryin. Result: Compared with PP powder, Fumigation and Washing No.1 prescription can significantly improve wound pain, swelling and itching symptoms, reduce wound secretions, accelerate epithelial crawling and wound healing, and have better wound healing rate and healing time than Jieeryin . Liu Jingjing  applied Jinxuan Zhike Fumigation Powder to postoperative anorectal diseases, and used potassium permanganate as a control. The results show that Jinxuan Zhike Fumigation Powder also has a good preventive and therapeutic effect on the treatment and prevention of perianal eczema, and its effect on edema and pain is more significant, and it is significantly better than the control group; the traditional Chinese medicine fumigation and washing therapy can reduce swelling and relieve pain , Anti-inflammatory, and promote wound healing. The author searched the literature of traditional Chinese medicine fumigation and washing in medical Chinese core journals from 2004 to 2010, and found that the total effective rate of traditional Chinese medicine fumigation and washing in the postoperative treatment of anorectal diseases was 96.6%-100%, and the effective rate was statistically higher than that of the control group. Significant difference, showing the curative advantage of Chinese medicine sitz bath.
2. Basic research progress
New progress has been made in the pharmacodynamic research of traditional Chinese medicine fumigation therapy after anorectal disease. Research shows that traditional Chinese medicine fumigation can significantly relieve pain, anti-inflammatory and swelling, and promote wound healing.
1. Pharmacodynamic research:
(1) Anti-inflammatory and analgesic effects. Li Guodong et al.  reported that Jinxuan hemorrhoids fumigation lotion has a significant inhibitory effect on rat foot plantar swelling caused by carrageenan and mouse ear swelling caused by xylene; it has a significant inhibitory effect on heat stimulation. Mouse pain has obvious analgesic effect, which can significantly increase the pain threshold. Chen Huihua  reported that the compound hemorrhoids fumigation powder has a significant inhibitory effect on croton oil-induced ear swelling in mice. The pharmacological effect of the high-dose group is similar to that of the aspirin group, indicating that the drug has obvious anti-inflammatory effects; ——The pain response caused by the hot plate method has a good inhibitory effect, and the pharmacological effect of the high-dose group is equivalent to that of morphine hydrochloride, indicating that the drug has a strong analgesic effect.
(2) Promote wound healing. Huang Jian et al.  The speed of healing of ulcer wounds in rats in the Zhifu Fumigation and Washing Granules group was significantly accelerated, and the area of anal ulcers in rats in the medium and high-dose groups was significantly smaller than that of the vehicle control group on the 8th day after administration. The healing days were also shortened, which was significantly different from the vehicle control group (P<0.05 or P<0.01). Liu Hua et al.  reported that fumigation and washing No. 1 prescription can promote the appearance of epithelial crawling, the tensile strength of the wound was significantly improved on the 7th and 14th days after the operation, the wound healing rate was improved on the 9th and 13th days after the operation, and the average healing days were earlier.
2. Pharmacological research: The author counts the literature on traditional Chinese medicine sitz in core journals from 2004 to 2010. Among them, the most used Chinese medicines are Phellodendron chinense and Sophora flavescens, with a usage rate of 61.1%; followed by Glauber's salt with a usage rate of 44.4%; It is Galla Chinensis and Rhubarb, the utilization rates are 38.9% and 33.3% respectively. Modern research shows that Phellodendron has antibacterial, anti-inflammatory, antipyretic, anti-ulcer, and antibacterial effects ; Sophora flavescens contains a large number of alkaloids and flavonoids, and has anti-oxidant, anti-viral, anti-allergic, and anti-inflammatory effects. Activity and pharmacological effects ; Glauber's salt can clear away heat and reduce swelling, and has a certain inhibitory effect on mouse ear swelling caused by xylene ; the main active ingredient in gall is tannin, which has hemostasis, membrane protection and reduction Secretion and exudation and prevention of bacterial erosion. It has a significant antibacterial effect on Staphylococcus aureus and Pseudomonas aeruginosa ; Rhubarb has antibacterial and hemostatic effects, and its effective ingredients such as rhein and emodin have broad-spectrum antibacterial effects. Chrysophanol can shorten the clotting time, promote the adhesion and accumulation of platelets, reduce the permeability of capillaries, improve the fragility of blood vessels, increase fibrin, increase the contractile activity of blood vessels, and increase the number of platelets and the fibrinogen content Increase and promote blood coagulation .
Three, thinking and prospects
Looking at the application and research of fumigation therapy in anorectal diseases in recent years, the following points need to be considered and discussed: (1) Prescription optimization. Although all prescriptions are empirical drugs, and their efficacy has obvious advantages over the control group, most of them have not been used and verified on a large scale. This question not only reflects the controversy of Chinese medicine, but also requires us to explore the best prescription design. (2) Dosage form problem. At present, there are mainly liquids and powders. In the process of using liquids, we found that the effect of liquids is not long enough, the products are roughly extracted, the technology is relatively backward, and it is inconvenient to use and carry. (3) Further standardize the research issues. Most of the current research is not standardized and does not meet the requirements of evidence-based medicine. Rather than research, it may be called "reporting" more accurately. For example, in the selection of the control group, many researchers use potassium permanganate solution as a control, which is less comparable; research designs generally have fewer samples and insufficient objective indicators, and the comparison is not scientific. (4) Deepen basic research issues. According to statistics from related reports in recent years, there are many reports on the clinical application of traditional Chinese medicine fumigation lotion, and relatively few basic researches. At the same time, the depth of research is not enough, the ingredients of various prescriptions are also more complicated, the mechanism of treatment is vague, and there is often a lack of clear pharmacodynamic basis.
In summary, we believe that the traditional Chinese medicine fumigation and washing therapy, as a commonly used traditional special treatment after anorectal disease, needs to combine the basic theories of traditional Chinese medicine, carefully summarize the existing clinical and experimental results, and focus on the pathological characteristics of the anorectal disease. Research, especially in the optimization of prescription composition, improvement of preparation technology, and more standardized clinical research can make a difference. Through more standardized basic and clinical research, the development of new dosage forms with clear mechanisms, better efficacy, and easy use should be the direction of in-depth research in the future.
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