ABSTRACT
ObjectiveTo observe the clinical efficacy of compound Huangbai liquid fomentation on diabetic foot ulcer of Wagner grade 1-2. MethodPatients were classified into the observation group and control group， with 41 cases in either group. The observation group received routine therapy and compound Huangbai liquid fomentation， while the control group was treated by routine therapy and medical silver nanoparticles-containing dressing. Ulcer area， ulcer depth， traditional Chinese medicine （TCM） syndrome score， ankle-brachial index， transcutaneous oxygen pressure， vascular endothelial growth factor， epidermal growth factor， advanced glycation end product， high-sensitivity C-reactive protein， interleukin-6， erythrocyte sedimentation rate， and adverse events were observed before and after treatment in two groups. ResultAfter treatment， the ulcer area， ulcer depth， TCM syndrome score， vascular endothelial growth factor， epidermal growth factor， advanced glycation end product， high-sensitivity C-reactive protein， interleukin-6（IL-6）， and erythrocyte sedimentation rate were lower than those before treatment in two groups （P<0.05）， and ankle-brachial index， transcutaneous oxygen pressure， vascular endothelial growth factor， and epidermal growth factor were higher than those before treatment in two groups （P<0.05）. After treatment， the ulcer area， ulcer depth， TCM syndrome score， advanced glycation end product， high-sensitivity C-reactive protein， IL-6， and erythrocyte sedimentation rate were lower in the observation group than in the control group （P<0.05）， and ankle-brachial index， transcutaneous oxygen pressure， vascular endothelial growth factor， and epidermal growth factor were higher in the observation group than in the control group （P<0.05）. The clinical efficacy of observation group was better than that of the control group （P<0.05）. There was no significant difference in the incidence of adverse events and endpoint events between two groups. ConclusionCompound Huangbai liquid fomentation is effective for diabetic foot ulcer of Wagner grade 1-2， as it is beneficial to the healing of the ulcer. This study provides clinical evidence for the further promotion of Chinese medicine fomentation.
ABSTRACT
Objective:To explore the effects of Compound Huangbai Liquid coating combined with Xiaochuang Mixture on wound healing, clinical symptoms and inflammatory response in patients with perianal abscess surgery; To evaluate the clinical efficacy.Methods:Randomized controlled trial. 120 patients after perianal abscess surgery in the hospital from August 2021 to August 2022 were selected as the observation subjects, and they were divided into three groups by the random number table method, with 40 cases in each group. On the basis of routine anti-infection therapy, external TCM application group was given Compound Huangbai Liquid coating, oral TCM administration group was given oral Xiaochuang Mixture, and combined treatment group was treated with Compound Huangbai Liquid coating + Xiaochuang Mixture. The three groups were continuously treated for 15 days. TCM symptoms scores and VAS score were performed on the 2nd day, 7th day and 15th day after surgery, and the levels of IL-6 and TNF-α were detected by ELISA. The wound healing time and carrion shedding time of patients were observed and recorded, and the clinical efficacy was evaluated.Results:The scores of perianal secretions, granulation morphology and surrounding tissue edema and score of VAS decreased in the three groups at 7 days and 15 days after surgery compared with those at 2 days after surgery ( P<0.01), and with the extension of time, the scores of perianal secretions, granulation morphology and surrounding tissue edema and VAS score from the aspects of time-point effect ( F=21.69, 134.65, 19.27, 73.15) and between-group effect ( F=7.99, 98.79, 8.68, 10.71) were declined ( P<0.01), and there was an interaction effect between the decline degree and the treatment method ( F=9.78, 59.52, 11.29, 22.48, P<0.01). The carrion shedding time [(4.63±1.31) d vs. (6.22±2.14) d, (6.17±2.09) d, F=9.16] and healing time [(27.76±3.46) d vs. (30.27±4.11) d, (31.48±4.23) d, F=9.24] were earlier in combined treatment group than those in the external TCM application group and oral TCM administration group ( P<0.01). Serum levels of IL-6 and TNF-α in the three groups at 7 and 15 days after surgery were reduced compared with those at 2 days after surgery ( P<0.01), and with the extension of time, the levels of serum IL-6 and TNF-α in the three groups decreased from the aspects of time-point effect ( F=69.36, 38.76) and between-group effect ( F=21.81, 13.50) ( P<0.01), and there was an interaction effect between the decrease degree and treatment method ( F=28.46, 23.34, P<0.01). The total effective rate was 100.0% (40/40) in combined treatment group, 80.0% (32/40) in external TCM application group and 87.2% (34/39) in oral TCM administration group ( H=8.44, P=0.015). Conclusion:The combination of Compound Huangbai Liquid coating and Xiaochuang Mixture can reduce perianal secretions, improve granulation morphology, alleviate surrounding tissue edema and wound pain, promote wound healing, and reduce inflammatory response of patients with perianal abscess surgery.
ABSTRACT
Objective:To explore the influence and possible mechanism of compound Huangbai liquid on wound healing in rats with skin ulcer.Methods:A rat model of skin ulcer was constructed and randomly separated into model group,compound Huang-bai liquid low-dose,medium-dose and high-dose groups(compound Huangbai liquid L,M,H groups)and erythromycin ointment group,10 rats/group;another 10 rats were randomly collected as the normal group.Compound Huangbai liquid L,M,H groups were given 2.5 ml,5 ml and 10 ml of compound Huangbai liquid,respectively;the erythromycin ointment group was given erythromycin ointment to spread evenly on the wound surface using cotton swabs;the model group and normal group were not given drug treatment.At 0 d,3 d,7 d and 14 d of administration,the wound healing of the rats were recorded by taking pictures,and the wound healing rate were calculated.On the 14th day of administration,the pathological changes and collagen deposition in the wounds of rats were determined by HE and Masson staining methods;the levels of IL-1β,TNF-α,nitric oxide(NO),transforming growth factor-β(TGF-β)and hydroxyproline in wound tissue were determined by kits;and the expressions of Notch1 and Twist1 proteins in wound tissue were determined by Western blot.Results:On the 7th and 14th day of administration,compared with model group,the wound healing rate of the rats in the compound Huangbai liquid L,M,H groups and the erythromycin ointment group were significantly improved(P<0.05),and the inflammatory cell infiltration and other phenomena in rats were significantly improved on 14 days of administration,and the deposition of collagen in the wound surface of rats was also significantly increased.On the 14th day of administration,com-pared with the normal group,the levels of IL-1β,TNF-α,NO,hydroxyproline and TGF-β in the wound tissues of the model group were significantly increased(P<0.05),the protein expressions of Notch1 and Twist1 were significantly decreased(P<0.05);com-pared with model group,the levels of IL-1β,TNF-α and NO in the compound Huangbai liquid L,M,H groups and erythromycin oint-ment group were significantly decreased(P<0.05),the levels of hydroxyproline and TGF-β and the protein expressions of Notch1 and Twist1 were significantly increased(P<0.05).Conclusion:Compound Huangbai liquid can promote wound healing in rats with skin ulcers by activating the Notch1/Twist1 axis.