Traditional Chinese herbal medicine retention enema combined with perineal massage (THREM): a promising therapeutic strategy for refractory chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a debilitating condition characterized by lower urinary tract symptoms and persistent pelvic pain or discomfort lasting for more than three months. Currently available oral drug therapies exhibit limited efficacy in the treatment of CP/CPPS. Therefore, personalized and combination therapies are recommended by Chinese CP/CPPS guidelines, which primarily include traditional Chinese medicine, radiofrequency therapy, urethral lavage, transrectal prostate massage, extracorporeal shock wave therapy. However, a significant number of patients do not respond well to all types of these therapeutic methods. Among those who have sequentially or simultaneously undergone at least three different treatment modalities, in addition to oral medications, for more than 1 year, they are defined as patients with refractory CP/CPPS. This retrospective study aims to evaluate the clinical effect of traditional Chinese herbal medicine retention enema combined with perineal massage (THREM) in managing refractory CP/CPPS. Methods: A total of 20 patients with refractory CP/CPPS, who did not show significant improvement despite receiving multiple conventional treatments, including oral medications, were included in this study. Following THREM therapy, the International Prostate Symptom Score (IPSS), visual analogue scale (VAS), and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) quality of life (QoL) score were used to assess treatment efficacy. Results: Six months after THREM therapy, a significant decrease in IPSS, VAS, and QoL scores was observed (P<0.01). Importantly, 85% of the patients experienced a reduction in symptoms of ≥60%, with an average degree of alleviation reaching 70.25%±24.20%. Conclusions: THREM treatment demonstrated excellent efficacy in managing refractory CP/CPPS at least for 6 months. It has promising clinical application prospects. Further research is warranted to validate these results and explore the underlying mechanisms of THREM therapy.

Administration of modified Gegen Qinlian decoction for hemorrhagic chronic radiation proctitis: A case report and review of literature.

BACKGROUND: Hemorrhagic chronic radiation proctitis (CRP) is a common late complication of irradiation of the pelvis and seriously impairs life quality. There is no standard treatment for hemorrhagic CRP. Medical treatment, interventional treatment, and surgery are available, but they are limited in their applications due to nondefinite efficacy or side effects. Chinese herbal medicine (CHM), as a complementary or alternative therapy, may provide another option for hemorrhagic CRP treatment. CASE SUMMARY: A 51-year-old woman with cervical cancer received intensity-modulated radiation therapy and brachytherapy with a total dose of 93 Gy fifteen days after hysterectomy and bilateral adnexectomy. She received six additional cycles of chemotherapy with carboplatin and paclitaxel. Nine months after radiotherapy treatment, she mainly complained of 5-6 times diarrhea daily and bloody purulent stools for over 10 d. After colonoscopy examinations, she was diagnosed with hemorrhagic CRP with a giant ulcer. After assessment, she received CHM treatment. The specific regimen was 150 mL of modified Gegen Qinlian decoction (GQD) used as a retention enema for 1 mo, followed by replacement with oral administration of 150 mL of modified GQD three times per day for 5 mo. After the whole treatment, her diarrhea reduced to 1-2 times a day. Her rectal tenesmus and mild pain in lower abdomen disappeared. Both colonoscopy and magnetic resonance imaging confirmed its significant improvement. During treatment, there were no side effects, such as liver and renal function damage. CONCLUSION: Modified GQD may be another effective and safe option for hemorrhagic CRP patients with giant ulcers.

Exploring the clinical efficacy and mechanism of high-position colon dialysis combined with Traditional Chinese Medicine retention enema in real-world patients with stage 3-5 chronic kidney disease (non-dialysis) based on the theory of the Gut-Kidney axis.

Background: With societal and economic development, the annual incidence of chronic kidney disease (CKD) is increasing. Current treatments for CKD are limited, and once patients progress to the uraemic stage, it places a significant economic burden on families and society. Based on the "gut-kidney axis" theory and real-world research, this study aims to evaluate the clinical efficacy, safety, and potential mechanism of high-position colon dialysis combined with traditional Chinese medicine (TCM) retention enema in treating stage 3-5 chronic kidney disease (non-dialysis). Additionally, it seeks to identify new therapeutic targets and approaches for CKD treatment. Methods: The TCM decoction was analyzed using Ultra-Performance Liquid Chromatography-Quadrupole-Orbitrap-High Resolution Mass Spectrometry (UPLC-Q-Orbitrap-HRMS). Participants meeting the inclusion criteria were divided into a control group (n = 153) and a treatment group (n = 159) based on their preferences and physicians' recommendations. Both groups adhered to a high-quality low-protein, low-salt, low-phosphorus, and low-fat diet supplemented with essential amino acids, and were monitored for blood pressure, blood glucose, and blood lipids. The treatment group received high-position colon dialysis combined with TCM retention enemas (administered at least 12 times every other day). Results: Thirteen compounds were identified from the herbs by UPLC-Q-Orbitrap-HRMS. The CKD3-5 treatment group exhibited improvements in blood biochemistry and other laboratory indices, with significant enhancements in renal function-related indices for CKD4 and CKD5 stages (p < 0.05). Following treatment, indoxyl sulfate (IS), endotoxin, and D-lactic acid levels decreased to a certain extent in both groups, with a statistically significant difference observed within the treatment group (p < 0.05). The treatment group displayed a significant reduction in aerobic bacterial colonies, an increase in anaerobic bacterial colonies, a decrease in Escherichia coli colonies, and an increase in Bifidobacterium and Lactobacillus colonies (p < 0.05). No significant changes in colony numbers were observed in the control group. Conclusion: High-position colon dialysis combined with TCM retention enema may serve as an adjuvant treatment for CKD4-5 (non-dialysis), and its mechanism may be related to the reduction of uraemic toxins, improvement of intestinal mucosal barrier function, and regulation of intestinal microecology. Clinical Trial Registration: https://www.chictr.org.cn/, identifier ChiCTR2200062852.

Clinical outcomes after faecal microbiota transplant by retention enema in both immunocompetent and immunocompromised patients with recurrent Clostridioides difficile infections at an academic medical centre.

BACKGROUND: Recurrent Clostridioides difficile infection (CDI) is one of the most common and challenging infections to treat in healthcare facilities. Faecal microbiota transplantation (FMT) is recommended as a definitive treatment option. METHODS: We performed a retrospective review of 50 patients from January 2015 to December 2019 who underwent FMT for recurrent CDI. Primary outcome was recurrence of CDI within 12-weeks of FMT and secondary outcomes were the need for repeat FMT, serious adverse outcomes related to FMT and all-cause mortality. RESULTS: Fifty charts were reviewed, of which 47 cases comprising 17 immunocompromised patients treated with FMT via retention enema were included in the study. The majority of the patients had ≥3 recurrent CDIs (62%). Nine (19%) patients failed to respond to the first FMT and five underwent repeat FMT within four to 12 weeks. The cure rate was 81% after the first FMT (38/47) and 91% after the second FMT treatment (43/47). Serious adverse events occurred in 2% and all-cause mortality was 2% at 90-day follow up. CONCLUSION: Our study demonstrated the safety and efficacy of FMT administered via retention enema, a simple bedside procedure, for the treatment and prevention of recurrent non-severe and severe CDI with an overall cure rate of 91%.

[Meta-analysis of therapeutic effect of retention enema with traditional Chinese medicine on ulcerative colitis].

To evaluate the therapeutic effect of traditional Chinese medicine( TCM) retention enema in treating ulcerative colitis( UC) by Meta-analysis method. Randomized controlled trials( RCTs) of TCM retention enema in treatment of UC were retrieved from databases as CNKI,Wan Fang,CBM,VIP and PubMed from inception to June 2019. The quality of RCTs was assessed by using the Cochrane collaboration's tool for assessing risk of bias,Meta-analysis were performed with Rev Man 5. 3 software and publication bias was tested by using Stata 15. 1 software. There were twenty-eight articles enrolled,and 2 477 patients were included. The result of Meta-analysis showed that retention enema with TCM had significantly better effectiveness in overall curative effect( RRSASP= 1. 18,95%CI[1. 13,1. 22],Z = 8. 32,P < 0. 01; RR5-ASA= 1. 13,95% CI[1. 03,1. 21],Z = 2. 61,P < 0. 01) symptom curative effect( RR =1. 44,95%CI[1. 22,1. 71],Z = 4. 25,P<0. 01) than those of the control group,and the treatment group was lower than the control group in terms of recurrence( RR = 0. 31,95% CI[0. 17,0. 56],Z = 3. 88,P< 0. 01) and adverse events( RR = 0. 38,95% CI[0. 18,0. 78],Z = 2. 64,P<0. 01),with statistically significant differences. However,there was no significant difference in Meta-analysis result of colonoscopic mucosal change between the two groups. TCM enema is an effective method to treat ulcerative colitis.

Vancomycin Enema in the Treatment of Clostridium difficile Infection.

Background: Current guidelines for the treatment of Clostridium difficile infections (CDIs) recommend vancomycin enemas for patients with adynamic ileus. There is significant variability in guideline recommendations for vancomycin dose and enema volume and whether a retention enema should be used. The most recent (2017) guidelines from the Infectious Diseases Society of America/Society for Healthcare Epidemiology of America recommend rectal instillation of 500 mg of vancomycin in 100 mL of physiologic saline every 6 hours as a retention enema. Methods: Published studies regarding vancomycin enema use in CDI (1990-present) were reviewed to compare drug dose, volume, and whether a retention enema was used in order to determine the efficacy and make recommendations for optimal dosing. Results: Case series with higher vancomycin dose, higher enema volume, and use of retention enema demonstrated greater efficacy. Use of smaller volumes and lower doses (100 mL; 125-250 mg q 6 hours) demonstrated no efficacy of intracolonic vancomycin. Conclusion: We recommend revision of the current CDI guideline recommendations for patients with adynamic ileus to the following: Vancomycin per rectum (500 mg in a volume of 500 mL q 6 hours) by retention enema (18F Foley catheter with 30-cc balloon inserted into the rectum, balloon inflated, solution instilled, and catheter clamped for 60 minutes) for optimal efficacy.

Meta-analysis of therapeutic effect of retention enema with traditional Chinese medicine on ulcerative colitis / 中国中药杂志

To evaluate the therapeutic effect of traditional Chinese medicine( TCM) retention enema in treating ulcerative colitis( UC) by Meta-analysis method. Randomized controlled trials( RCTs) of TCM retention enema in treatment of UC were retrieved from databases as CNKI,Wan Fang,CBM,VIP and PubMed from inception to June 2019. The quality of RCTs was assessed by using the Cochrane collaboration's tool for assessing risk of bias,Meta-analysis were performed with Rev Man 5. 3 software and publication bias was tested by using Stata 15. 1 software. There were twenty-eight articles enrolled,and 2 477 patients were included. The result of Meta-analysis showed that retention enema with TCM had significantly better effectiveness in overall curative effect( RRSASP= 1. 18,95%CI[1. 13,1. 22],Z = 8. 32,P < 0. 01; RR5-ASA= 1. 13,95% CI[1. 03,1. 21],Z = 2. 61,P < 0. 01) symptom curative effect( RR =1. 44,95%CI[1. 22,1. 71],Z = 4. 25,P<0. 01) than those of the control group,and the treatment group was lower than the control group in terms of recurrence( RR = 0. 31,95% CI[0. 17,0. 56],Z = 3. 88,P< 0. 01) and adverse events( RR = 0. 38,95% CI[0. 18,0. 78],Z = 2. 64,P<0. 01),with statistically significant differences. However,there was no significant difference in Meta-analysis result of colonoscopic mucosal change between the two groups. TCM enema is an effective method to treat ulcerative colitis.

Design and application of retention enema device / 中华危重病急救医学

Drug retention enema is a common therapy for various illnesses. However, it is impossible to keep the drug in the colon for a long time, due to the limitation of the current equipment, and it is unable to achieve the purpose of retention enema. A retention enema device was designed by the department of intensive care unit (ICU) of Dongfeng Hospital Affiliated to Hubei University of Medicine. The retention enema device adds a spindle shaped inflatable air bag on the basis of the traditional enema device, which not only fix on the anus, but also prevent the leakage of enema fluid. It can achieve retention enema, play the enema drug effect fully, and significantly reduce the nursing workload, in addition, the silica gel material of the retention enema device ensures the comfort of the patients, the decompression air bag also avoids the damage of the high pressure of the spindle fixed air bag for the patients, which is worthy of clinical use.

Effect of Jiawei Changfengyin with Retention Enema Therapy on Th1/Th2 in Patients with Acute Radiation Proctitis / 中国实验方剂学杂志

Objective: To discuss the efficacy of Jiawei Changfengyin with retention enema therapy for acute radiation proctitis and investigate its influence on regulating levels of helper T cell(Th)1/Th2. Method: One hundred and twenty-eight patients were randomly divided into control group and observation group by random number table. Patients in control group (64 cases) got montmorillonite powder (3.0 g), dexamethasone (10 mg) and normal saline (100 mL), with retention enema therapy. Patients in observation group (64 cases) got Jiawei Changfengyin(Changfengyin+Xileisan+pearl powder), with retention enema therapy. Both groups of patients received enema once every night, and the treatment course was 4 weeks in both groups. Before and after treatment, scores of main symptoms, proctoscopy, routine examination of stool+occult blood, and KPS scores of quality of life were graded. Levels of Th1 cell factors[interleukin(IL)-1β, IL-8 and interferon-γ(IFN-γ)], Th2 cell factors (IL-4 and IL-10) were detected. Result: The total effective rate for comprehensive clinical efficacy was 95.31% in observation group, higher than 82.81% in control group (χ2=5.132, PPZ=2.764, PPPβ, IL-8 and IFN-γ in observation group were lower than those in control group, while levels of IL-4 and IL-10 were higher than those in control group (PConclusion: Jiawei Changfengyin can relieve symptoms of acute radiation proctitis, promote healing of rectal mucosa, improve quality of life, and regulate Th1/Th2 cytokines, with good repairing effect for intestinal mucosa.

Design and application of retention enema device / 中华危重病急救医学

Drug retention enema is a common therapy for various illnesses. However, it is impossible to keep the drug in the colon for a long time, due to the limitation of the current equipment, and it is unable to achieve the purpose of retention enema. A retention enema device was designed by the department of intensive care unit (ICU) of Dongfeng Hospital Affiliated to Hubei University of Medicine. The retention enema device adds a spindle shaped inflatable air bag on the basis of the traditional enema device, which not only fix on the anus, but also prevent the leakage of enema fluid. It can achieve retention enema, play the enema drug effect fully, and significantly reduce the nursing workload, in addition, the silica gel material of the retention enema device ensures the comfort of the patients, the decompression air bag also avoids the damage of the high pressure of the spindle fixed air bag for the patients, which is worthy of clinical use.

An analysis on curative effect of Biafine combined with routine drugs in retention enema treatment for radiation proctitis of cervical cancer / 中国医学装备

Objective: To observe and analyze the clinical efficacy of Biafine combined with routine drugs in retention enema treatment for radiation proctitis of cervical cancer. Methods: 80 patients with cervical cancer who have complications of acute radiation proctitis after radiotherapy were divided into observation group(Biafine combined with routine drugs in retention enema treatment, 40 cases)and control group(routine drugs in retention enema treatment, 40 cases). The curative effects of two methods for radiation proctitis of cervical cancer were compared and researched. Results: The effective rate of observation group for curing radiation proctitis was 95% , and it was 75% in control group. The difference of effective rate between the two groups was significant(x2=7.333, P<0.05). Conclusion: It is significant that Biafine is applied to combine with routine drugs in retention enema treatment for radiation proctitis.

Clinical study of Wuwei-Xiaodu decoction lavage assisted vacuum sealing drainage (VSD)in the treatment of perianal abscess pus period / 国际中医中药杂志

Objective To evaluate the clinical effect of Wuwei-Xiaodu decoction lavage assisted VSD in the treatment of perianal abscess pus period. Methods Ninety patients with perianal abscess who met the inclusion criteria were divided into 2 groups by random number table, 45 in each group. The control group was treated with 0.9％ sodium chloride injection assisted VSD. The treatment group was treated with Wuwei-Xiaodu decoction lavage assisted VSD treatment. Both groups were treated for 7 days. WBC was detected by automatic hemorheology tester, CRP, IL-6 and TNF-α were detected by ELISA. The anus bulge, anal self-made function, wound exudation, wound pain were scored and the incision bacteria were detected after treatment. The rate and number of colonies were evaluated. Results The total effective rate was 88.89％ (40/45) in the treatment group and 73.33％ (33/45) in the control group. The total effective rate of the two groups was statistically significant (Z=-2.584, P=0.010). After treatment, the levels of WBC, CRP, IL-6, and TNF-α in the treatment group were significantly lower than those in the control group (t=-3.730, -2.385, -2.170, -3.509, P=0.007, 0.023, 0.034, 0.011). The anal bulge, wound exudation, and wound pain scores in the treatment group were significantly lower than those in the control group (t=-2.760, -2.549, -21.151, P=0.005, 0.017, 0.038),. The rate of incision bacteria was significantly lower than that in the control group (χ2=4.406, P=0.036), the number of colonies were significantly lower than that of the control group (t=5.375, P<0.01). Conclusions The Wuwei-Xiaodu decoction lavage assisted VSD can effectively reduce the number of colonies in the perianal period of patients with perianal abscess, reduce postoperative anal bulge, pain and wound exudation, and improve clinical efficacy.

Niacin ameliorates ulcerative colitis via prostaglandin D2-mediated D prostanoid receptor 1 activation.

Niacin, as an antidyslipidemic drug, elicits a strong flushing response by release of prostaglandin (PG) D2 However, whether niacin is beneficial for inflammatory bowel disease (IBD) remains unclear. Here, we observed niacin administration-enhanced PGD2 production in colon tissues in dextran sulfate sodium (DSS)-challenged mice, and protected mice against DSS or 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis in D prostanoid receptor 1 (DP1)-dependent manner. Specific ablation of DP1 receptor in vascular endothelial cells, colonic epithelium, and myeloid cells augmented DSS/TNBS-induced colitis in mice through increasing vascular permeability, promoting apoptosis of epithelial cells, and stimulating pro-inflammatory cytokine secretion of macrophages, respectively. Niacin treatment improved vascular permeability, reduced apoptotic epithelial cells, promoted epithelial cell update, and suppressed pro-inflammatory gene expression of macrophages. Moreover, treatment with niacin-containing retention enema effectively promoted UC clinical remission and mucosal healing in patients with moderately active disease. Therefore, niacin displayed multiple beneficial effects on DSS/TNBS-induced colitis in mice by activation of PGD2/DP1 axis. The potential efficacy of niacin in management of IBD warrants further investigation.

Clinical study of enema aplication of Yiyi-Fuzi-Baijiang powder combined with oral sulfasalazine in treating ulcerative colitis / 国际中医中药杂志

Objective Evaluation of enema application of Yiyi-Fuzi-Baijiang powder combined with oral sulfasalazine enteric-coated tablets in treating ulcerative colitis. Methods The patients with ulcerative colitis were randomly divided into 2 groups, 42 cases in each group. The control group was treated with sulfasalazine, and the observation group with sulfasalazine and Yiyi-Fuzi-Baijiang powder. Both groups were treated for 4 weeks. ELISA method was used to detect the levels of IL-6, IL-8 and TNF-α. The changes of disease activity index (Sutherland DAI) were observed before and after treatment, and the clinical efficacy was evaluated. Results After treatment, the Sutherland DAI (3.89 ± 0.91 vs. 4.91 ± 1.08, t=3.082) in the observation group was significantly lower than that in the control group (P=0.042). The level of TNF-α (20.82 ± 4.31 ng/L vs. 26.51 ± 5.25 ng/L, t=3.602), IL-6 (31.73 ± 4.82 ng/L vs. 40.18 ± 5.63 ng/L, t=3.817), and IL-8 (35.39 ± 4.62 ng/L vs. 40.59 ± 5.35 ng/L, t=3.341) in the observation group were significantly lower than those in the control group (P<0.05). The total efficiency of observation group was 92.9% (39/42), and the control group was 73.8% (31/42). There was significant difference between the two groups (χ2=4.200, P=0.040). Conclusions The Yiyi-Fuzi-Baijiang powder combined with sulfasalazine could relieve the clinical symptoms of ulcerative colitis patients with spleen-kidney yang deficiency, and inhibition inflammatory response.

Effects of thrombolytic surgery combined with psychological intervention on wound healing and plasma endotoxin / 中国生化药物杂志

Objective To investigate the effect of combined medication of psychological intervention and retention enema on wound healing and plasma endotoxin in patients with thrombotic hemorrhoid. Methods According to the different postoperative intervention will be January 2014-2016 year in December with hemorrhoids thrombosis in our hospital group in 90 cases as control group with normal saline retention enema,the observation group with Chinese medicine retention enema+psychological intervention;the comparative analysis of two groups of patients with various experimental data and detailed records,discusses the thrombosis of hemorrhoids after the drug retention enema combined with psychological intervention effects on wound healing and plasma endotoxin. Results The observation group(traditional Chinese medicine retention enema plus psychological intervention)clinical treatment effect is better than that of control group(saline enema)clinical curative effect,clinical symptoms of the patients were better than those in control group,plasma endotoxin level was lower than the control group,the difference between groups was statistically significant (P<0.05). Conclusion Thrombosis after hemorrhoid surgery patients choose herbal retention enema+psychological intervention clinical effect significantly ,can effectively promote wound healing ,and fully reduce plasma endotoxin.

Quality of defoamer enema combined with bellym assage on the colonic preparation in elderly patients with constipation / 中国实用护理杂志

Objective To explore the role of defoamer enema combined with bellym assage on the colonic preparation in elderly patients with constipation. Methods One hundred patients were divided into two groups by random number table method, the experimental group and the control group with 50 cases each. Patients in the control group were told to drink polyethyleneglycolelectrolytesolution 3000 ml. Patients in the experimental group were told to drink polyethyleneglycolelectrolytesolution 2000 ml. After medicinepre paration, the patients of experimental group were given defoamer enema. After that, they were undertaken counterclockwise massage for10 mins, then massageing clockwise until defecation. Results 14 patients with oral catharsis drugs failed to give up check, 46 cases of intervention group and 40 cases of control group finally complete intestinal preparation and colonoscopy. Intervention group patients after bowel preparation before the incidence of abdominal distension, abdominal pain were 6.52% (3/46), 8.70%(4/46), lower than the control group 65.00% (26/40), 25.00% (10/40), the difference was statistically significant (χ2= 32.74, 4.17, P< 0.05). Percent of pass was 65.22%(30/46) for intestinal preparation intervention group, significantly higher than the control group 35.00% (14/40), the difference was statistically significant (χ2= 7.82, P< 0.05). Intervention group intestinal cleanliness ratings of Ottawa total score was 4.00 (4.00), which was lower than the control group 7.00 (4.50), the difference was statistically significant (Z= 3.80, P< 0.05). Endoscopic check process, the intervention group arrived at the terminal ileum and mirror back time were 7.00 (3.00) and 9.00 (1.00) min, were less than 9.00(6.50) and 10.50 (3.00) min in the control group, the difference was statistically significant (Z= 2.09, 4.53, P< 0.05). Intervention group of colons polyps detection rate was 67.39% (31/46), higher than that of control group 30.00% (12/40), the difference was statistically significant (χ2 = 11.97, P< 0.05). Conclusions The bowel preparation with defoamer enema will enhance the intestinal tract cleaness and the detection rate of polyps in elderly patients with constipation.

Clinical study of Dahuang-Mudan decoction by retention enema asan adjuvant treatment for the patients with acute pelvic inflammation disease and toxic heat flourishing type / 国际中医中药杂志

Objective To study the effect of Dahuang-Mudan decoctionby retention enemafor the thepatients with acute pelvic inflammation disease (APID) and toxic heat flourishing type. Methods Ninety patients with APID (toxic heat flourishing type) were randomly divided into treatment group and control group (45 case per group). The patients in both groups were given cefamandolenafate injection and tinidazole injection;and the Dahuang-Mudan decoction by retention enema was added to the treatment group.The C-reactive protein (CRP), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and clinical symptoms scores in both groups before treatment and after 2 weeks of treatment were observed. Results After treatment, CRP (3.16 ± 1.25 mg/L vs. 8.68 ± 1.45 mg/L, t=19.126), TNF-α(4.02 ± 1.06 ng/L vs. 9.64 ± 2.08 ng/L, t=15.966), IL-6 (60.34 ± 14.35 ng/L vs. 88.24 ± 12.16 ng/L, t=9.839), temperature recovery time (3.22 ± 1.13 d vs. 4.73 ± 1.36 d, t=5.638), abdominal pain disappeared time (5.26 ± 1.43 d vs. 7.45 ± 1.32 d, t=7.418), leukocyte recovery time (7.34 ± 2.06 d vs. 9.58 ± 2.26 d, t=4.834), hospital stay time (10.24 ± 3.42 d vs. 13.43 ± 4.38 d, t=3.791) in the treatment group were significantly lower than those in the control group (P<0.01). The clinical effect rate (77.27% vs. 48.84%, χ2=7.562) in the treatment group were significantly higher than that in the control group (P<0.01). Conclusions The treatment of APID (toxic heat flourishing type) with Dahuang-Mudan decoction by retention enema can reduce the inflammatory response of pelvic, promote the absorption of exudate and adhesion in pelvic.

Clinical effect of Rhubarb retention enema combined with routine western medicine on acute pancreatitis / 国际中医中药杂志

Objective To detect the effect of Rhubarb retention enema on patients with acute pancreatitis(AP).MethodsA total of 84 AP patients were enrolled in this study. Patients were divided into the control group(n=42) and Rhubarb enema observation group(n=42). Control group was treated with fasting, continuous gastrointestinal decompression, correcting water electrolyte and acid-base imbalance, with the oral administration of octreotide and gabexatemesilate to inhibit pancreatic secretion and enzyme activity. On the basis of the control group, the observation group was treated with rhubarb retention enema. IL-17, IL-10, and IL-6 expression was detected by ELISA analysis. The clinical effect was compared.Results The clinical effect rate (85.7%vs.71.4%,χ2=2.366,P=0.043) in observation group was significantly higher than that in control group. After treatment of 7 days, IL-17 (13.53 ± 3.16 ng/mlvs. 20.63 ± 4.83 ng/ml,t=2.416) and IL-6 (22.82 ± 4.56 ng/mlvs. 31.59 ± 6.63 ng/ml,t=2.421) expression was significantly lower and IL-10 (16.32 ± 4.15 ng/mlvs. 12.17 ± 3.22 ng/ml,t=2.326) expression was significantly higher in observation group than those in control group(P<0.05). The reduction of blood amylase (125.69 ± 32.47 U/Lvs. 259.26 ± 51.44 U/L,t=7.451) and urine amylase (204.73 ± 43.83 U/Lvs. 334.25 ± 60.18 U/L,t=7.323) in the observation group was significantly higher than those in the control group(P<0.01). Abdominal pain and abdominal distension recovery time (4.24 ±1.06 dvs. 3.02 ± 0.62 d,t=2.521), exhaust gas and defecation recovery time (5.42 ± 1.25 dvs. 3.26 ± 0.73 d,t=5.124), temperature recovery time (5.63 ± 1.46 dvs. 4.58 ± 0.92 d,t=2.418), and hospitalization time (18.65 ± 4.16 dvs. 13.78 ± 3.15 d,t=2.386) were higher in control group than those in observation group (P<0.05 orP<0.01). Conclusion Rhubarb enema can regulate the IL-17/ IL-10, and inhibit the inflammatory reaction.

Clinical Observation on Promotion Effect of Wound Healing Postoperative Anal Fistula by Retention Enema of ModifiedWu-Wei Xiao-DuDecoction / 世界科学技术-中医药现代化

This study was aimed to observe the promotion effect of wound healing retention enema for postoperative anal fistula by modifiedWu-Wei Xiao-Du(WWXD) decoction, in order to explore its mechanism. A total of 60 patients who met the inclusion criteria were randomly divided into the treatment group and control group, with 30 cases in each group. Patients in both groups were diagnosed as simple low anal fistula and treated with low anal fistula incision. The retention enema of 30 mL modified WWXD decoction or complexHuang-Bai fluid were given once a day for postoperative dressing changes. Detailed observations and scores were made on wound exudate, color, and itching around the anus. The comparisons were made on carrion off time, new epithelium time, rate of wound-reducing, wound healing time, and the total clinical efficacy 21 days after operation. The results showed that the wound exudate on the 7th and 14th postoperative day was better than that of the control group. There was no significant difference on the 21st day between two groups. The wound color of the treatment group was better than that of the control group on the 7th and 14th postoperative day. The itching around anus of the treatment group was better than that of the control group on the 7th, 14th and 21st postoperative day. The carrion wound off time and new epithelium time of the treatment group were earlier than that of the control group. There was no significant difference on the rate of wound-reducing. There were no significant differences on the total clinical efficacy 21 days after operation as well as the total average healing time of both groups. It was concluded that modified WWXD decoction can shorten the inflammation phase, reduce the wound exudate and itching, promote early carrion fall and as well as the wound healing.