结直肠肛门外科 (Apr 2022)
The efficacy of modified Bixie Shenshi Decoction combined with Traditional Chinese Medicine fumigation for treating postoperative wounds of simple low anal fistula with dampness-heat diffusing downward pattern and its effects on serum levels of high-sensitivity C-reaction protein, serum amyloid A, and procalcitonin
Abstract
[Objectives] To investigate the efficacy of modified Bixie Shenshi Decoction combined with Traditional Chinese Medicine fumigation for treating postoperative wounds of simple low anal fistula with dampness-heat diffusing downward pattern and its effects on serum levels of high-sensitivity C-reaction protein (hs-CRP), serum amyloid A (SAA), and procalcitonin (PCT). [Methods] Seventy-eight patients with simple low anal fistula with dampness-heat diffusing downward pattern were recruited at the Second Affiliated Hospital of Hebei College of Chinese Medicine between January 2018 and January 2021. Patients were divided into the control group (n=39, patients receiving routine postoperative antibiotics and application of Vaseline) and the treatment group (n=39, in addition to routine postoperative antibiotics and external application of Vaseline, patients receiving modified Bixie Shenshi Decoction combined with Traditional Chinese Medicine fumigation) using the random number table. The followings were compared between the two groups: wound healing rate (at 3, 7, and 14 days postoperative), serum levels of hs-CRP, SAA, and PCT on the day of surgery and at 2, 7, and 14 days postoperative, and adverse events during the treatment. [Results] The overall effectiveness rate was 100% in the treatment group and 92.3% in the control group, with no between-group differences(P>0.05). In both groups, wound healing rates at the 7 and 14 days postoperative were significantly higher than that at 3 days postoperative. At the respective time points, wound healing rates were significantly higher in the treatment group than in the control group (P0.05); the levels of these biomarkers at 2 days postoperative were significantly higher than those on the day of surgery; subsequently, their levels gradually decreased at 7 and 14 days postoperative with significantly lower levels in the treatment group than in the control group (P<0.05). No obvious adverse events occurred in the study, and there were no reports of abnormalities of routine blood work, routine urinalysis, and liver/renal function tests. [Conclusion] The modified Bixie Shenshi Decoction combined with Traditional Chinese Medicine fumigation is effective for treating postoperative wounds of simple low anal fistula with dampness-heat diffusing downward pattern. It can promote wound healing. Its effects can be associated with lowering the serum levels of hs-CRP, SAA, and PCT, hence, alleviating inflammation.
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