The effect of fumigation I formula in postoperative damp-heat-injected mixed hemorrhoids Abstract Objective:To observe the clinical efficacy of fumigation I formula in promoting wound healing after damp-heat-injected mixed hemorrhoids. Methods:Sixty cases of postoperative damp heat-injected mixed hemorrhoids were divided into 30 cases in the treatment group and 30 cases in the control group, and were treated with fumigation I and potassium permanganate solution in sitz bath twice a day, respectively. Results:The cure rate of the treatment group was statistically significant compared with that of the control group (P<0.05), and the curative effect of the treatment group was significantly better than that of the control group. Conclusion:Fumigation I can significantly reduce postoperative pain, decrease bleeding and promote wound healing. The results are reported as follows: From June 2007 to June 2008, we applied Fumigation I to promote postoperative wound healing of mixed hemorrhoids. 1.Clinical data There were 60 cases in this group, 33 men and 27 women. The age ranged from 28 to 75 years old, with an average of 57.5±8.9 years old. The group was divided into 30 cases each in the treatment group and the control group according to the order of consultation. In the study group, there were 18 cases with a disease duration of less than 5 years and 12 cases with a disease duration of more than 5 years. In the control group, there were 16 cases with a disease duration of less than 5 years and 14 cases with a disease duration of more than 5 years. There was no significant difference between the basic data of the two groups (P>0.05). 2. Methods 2.1 Drugs The fumigation I lotion was composed of bitter ginseng, cypress, hashishcha, wu bai zi, aconite, camphor, frankincense, myrrh and other traditional Chinese medicines (purchased from the Traditional Chinese Medicine Department of Liuan City Hospital), mixed in the mass ratio of 20, 20, 10, 5, 10, 10, 15, 15, and measured 180g of mixed raw herbs, added 500ml of water, and decocted for 30 minutes. The decoction was concentrated by filtration to 1.0g/ml of raw medicine and stored at 4℃. 2.2 Treatment Both groups were treated with external peeling and internal ligation of mixed hemorrhoids. On the day of surgery, tranexamic acid sodium chloride (0.4g intravenous drip, 1d 1 time) was routinely used to prevent postoperative bleeding, cefotaxime sodium (2.0g intravenous drip, 1d 1 time) for 3 d to prevent infection, and 0.2% Neosporin was used to disinfect the wound after daily fumigation from the second day after surgery, and Ma Yinglong musk hemorrhoid cream was used to change the medicine. During the treatment period, no spicy and fried food, avoid overwork, and keep the bowel movement smooth. Fumigation method:Fumigation I Chinese medicine juice heated water diluted to 2000ml, in the daily after the stool first fumigation with hot air 5min, wait for the liquid to drop to 38 ℃ ~ 40 ℃, sit in the bath for 20min, to soak the anal lesion site as degree. Control group: Fumigation with compound potassium permanganate instant tablets (compound potassium permanganate instant tablets: Jinan Qinghua Disinfection Products Factory). Configured into 2000ml solution in the ratio of 1:5000, fumigated with hot air for 5min after the daily stool, and then sat in the bath for 20min when the solution dropped to 38℃～40℃, in order to soak the anal lesion site. Twice a day, 7d is a course of treatment, a total of 4 courses of treatment. 2.3 Statistical treatment The data were expressed as mean ± standard deviation ( ± s), paired t-test for comparison before and after treatment, one-way ANOVA for comparison between groups, x2 test for counting data, Ridit analysis for comparison of efficacy, and SPSS13.0 statistical package for statistical analysis, with (P<0.05) as the difference with statistical significance. 3. Treatment results 3.1 Criteria for judging therapeutic efficacy The criteria were formulated with reference to the relevant standards promulgated by the State Administration of Traditional Chinese Medicine. Cured: crusting and peeling off of the wound surface and repair of local tissues. Improvement: The trauma surface shrinks, becomes shallow, and the bleeding is reduced. Ineffective: no local change or aggravation. 3.2 Treatment results Both groups were cured in one operation, and there were no postoperative complications such as hemorrhage, infection and anal canal stenosis. The treatment group showed significant differences in hospitalization time and wound healing time compared with the control group (P<0.05), see Tables 1 and 2. Postoperative complications such as edema, pain, and difficulty in urination were significantly different between the two groups (P<0.05), see Table 3. The efficacy of the treatment group was better than that of the control group (U=-4.32,P<0.05). This indicates that fumigation I lotion was significantly better than compound potassium permanganate in promoting wound healing. Postoperative pain refers to the need for postoperative pain medication. No significant adverse drug reactions were observed in both groups. Table 1 Efficacy of cases in both groups at 21 d postoperatively (n) n Cured Improved Ineffective Cured rate Control group 30 7 23 0 23.3%* Treatment group 30 19 11 0 63.3% Note: Compared with the treatment group, *P<0.05 Table 2 Mean healing of wounds and length of hospital stay in both groups (d) n Mean healing time Length of hospital stay Control group 30 22.20±2.84 20.01±3.27* Treatment group 30 18.23±2.10 16.12±2.32 Note: Compared with the treatment group, *P<0.05 Table 3 Number of postoperative complications in both groups (n) n Postoperative edema Postoperative pain Stool bleeding Anal leakage Urinary retention Control group 20 14 13 12 7 9* Treatment group 20 1 2 7 1 2 Note: Compared with the treatment group, *P<0.05 4. The nerve distribution around the anus is rich, plus the trauma formed after mixed hemorrhoid surgery is stimulated by feces and bacterial infection, which is very likely to lead to pain, which in turn can trigger constipation. In addition, symptoms such as bleeding and edema can be painful, thus affecting the healing of the wound. After the surgery, the lesion is removed, but the skin and muscles are damaged, causing the veins to be broken, the meridians are agitated, the qi and blood are stagnant outside the veins, and the meridians are not smooth, plus the damp heat and poisonous evil stays and does not go, causing the new meat to grow slowly. The overall pathogenesis of the disease should be damp-heat internalized, and the meridians are blocked. Fumigation therapy has a long history and a long history. Fumigation I is an experienced formula in the clinical work of our department, which has the effect of clearing heat and dispelling dampness, reducing swelling and relieving pain. As early as in the "Treatise on Typhoid Fever", there are records of external treatment with bitter ginseng soup, which has remarkable clinical efficacy. This formula takes bitter ginseng as the ruler, which can clear heat, dry dampness and detoxify, dispel wind and relieve itching, and is supplemented by cypress to clear heat and dry dampness, relieve fire and detoxify, reduce heat and remove steam, pedicel to invigorate blood and heal wounds, stop bleeding and astringent sores, wuzi to detoxify and reduce swelling, collect dampness and astringent sores to stop bleeding, aconite to dispel wind and remove dampness, dispel cold and relieve pain, frankincense and myrrh to invigorate blood, move qi and relieve pain, reduce swelling and create muscle, camphor to remove dampness, warm and dispel pain. With the combination of the above drugs, the dampness and heat in the wound can be dispelled, the flow of Qi and blood can be facilitated, and the generation of new flesh can be promoted, thus facilitating the healing of the wound. Modern studies have concluded that [1.2.3.4.5] bitter ginseng, cypress, catechu and wu bai zi can inhibit a variety of pathogenic bacteria in vitro such as Bacillus dysenteriae, Escherichia coli and Staphylococcus aureus, and have anti-inflammatory and analgesic effects. Phellodendron has a protective effect on platelets, and topical application can promote the absorption of subcutaneous blood exudation; Aconite [6] has anesthetic and analgesic effects; camphor [7] has a cooling sensation when applied to the skin, and has analgesic, antipruritic and weak local anesthetic and antiseptic effects; Schisandra [8] mainly contains gallnut tannins and acids, which have a precipitating effect on proteins, and after contact with the ulcerated surface of skin and mucous membranes, its tissue proteins are coagulated, resulting in a layer of perithelium and an astringent effect. The protein of glandular cells is coagulated to cause inhibition of secretion, producing dryness of mucous membrane and precipitation of protein of nerve endings, which can present a weak local anesthetic phenomenon. The combination of the above drugs can promote wound healing. In contrast, the control group of potassium permanganate has only a bactericidal effect and has an irritating effect on the new granulation tissue, which delays wound healing. In addition, fumigation therapy has the feature of acting directly on the diseased area to obtain rapid results. Since the anorectal disease site is limited and connected to the outside world, fumigation is convenient and effective. In this study, the fumigation of the anorectal wound area with the medicinal solution can make the active ingredients of the drug act directly on the wound, and the warm stimulation of the medicinal solution can accelerate the blood circulation around the wound and improve the blood return to the venous plexus, thus promoting local inflammation, reducing postoperative pain and swelling, reducing bleeding, promoting tissue repair, and shortening the healing time of the postoperative wound of mixed hemorrhoids. The combination of the drugs improved local microcirculation and tissue nutrition, accelerated the growth of granulation, reduced various complications, and promoted wound healing more quickly, and no adverse effects were observed, with remarkable efficacy. References: [1] Liao J. The anti-inflammatory effect of oxidized bitter ginseng alkaloids [J]. Journal of Beijing Medical University, 1988, 20(4): 313. [2] Di Dalin, Li Faqing, Chen Lei, et al. 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