Department of Proctology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, No. 164 Lanxi Road, Shanghai 200333, China.
Comput Math Methods Med. 2022 Apr 19;2022:9397478. doi: 10.1155/2022/9397478. eCollection 2022.
Anal fistula is a common anorectal disease. At present, most scholars believe that its pathogenesis is related to anal gland infection. Anal fistula cannot heal on its own after the onset and must be treated surgically. The wound of anal fistula surgery is open and polluted, and it belongs to three types of three-stage healing; it is the most difficult to heal among all surgical incisions, with a long course of disease, a lot of exudation, and pain for the patient; traditional Chinese medicine has rich experience in the treatment of postoperative wound healing of anal fistula. The study aimed to evaluate the mechanism of Qingre Huayu (QRHY) Recipe on wound healing after fistulotomy on SD rats. SD rats ( = 72) were randomized into three groups post-anorectal surgery. The rats in the positive control group were given potassium permanganate (PP), treatment group were given QRHY, and trauma model group were given 0.9% normal salinity. The changes in wound secretion, granulated tissue, and epithelium tissue were observed, and wound healing rates were evaluated by the discrepancies in wound area. HE and Masson's staining as well as transmission electron microscopy were also performed. The localization as well as the measurement of Ang1, Src, and VE cadherin expression in each group adopted real-time PCR, western blot, and immunohistochemistry (IHC) assays. Statistically higher wound healing rates were observed in QRHY group on days 3, 7, and 14 compared with other groups. Histological analyses showed highly significant increase in collagen and fibroblasts, less inflammatory cells, and vascular endothelial permeability in QRHY rats. The transmission electron microscopy revealed that the intact structure of tight junctions in endothelial cells and well-organized collagen and VE-cadherin, Ang1, and Tie-2 were upregulated by QRHY, while Src was inhibited. This study showed that QRHY can promote wound healing after anal fistulas.
肛门瘘是一种常见的肛肠疾病。目前，大多数学者认为其发病机制与肛腺感染有关。肛门瘘发病后不能自行愈合，必须手术治疗。肛门瘘手术的伤口是开放性的，污染严重，属于三级三期愈合；是所有手术切口愈合中最难的，病程长，渗出多，患者疼痛大；中医在治疗肛门瘘术后伤口愈合方面有丰富的经验。本研究旨在评价清热化瘀方（QRHY）对 SD 大鼠肛瘘切开术后伤口愈合的作用机制。SD 大鼠（n = 72）于肛肠手术后随机分为三组。阳性对照组大鼠给予高锰酸钾（PP），治疗组给予 QRHY，创伤模型组给予 0.9%生理盐水。观察伤口分泌物、肉芽组织和上皮组织的变化，通过伤口面积的差异评估伤口愈合率。还进行了 HE 和 Masson 染色以及透射电镜检查。采用实时 PCR、western blot 和免疫组化（IHC）检测各组中 Ang1、Src 和 VE 钙粘蛋白的定位和表达量。与其他组相比，QRHY 组在第 3、7 和 14 天的伤口愈合率显著更高。组织学分析显示，QRHY 组胶原纤维和纤维母细胞显著增加，炎症细胞明显减少，血管内皮通透性降低。透射电镜显示，QRHY 可上调内皮细胞紧密连接的完整结构以及组织良好的胶原和 VE-cadherin、Ang1 和 Tie-2，同时抑制 Src。本研究表明 QRHY 可促进肛门瘘术后伤口愈合。
