The Effects of Phellodendron Decoction on Wound Healing of Anal Fistula after Anal Fistulotomy

Abstract

Objective: To analyze the therapeutic effect of Compound Phellodendron decoction on wounds after anal fistulotomy.

Methods: 100 patients with anal fistula who underwent anal fistulotomy from April 2019 to April 2021 were included in the study group and control group according to the random number table method. 50 patients in the study group were treated with Compound Phellodendron decoction by fumigation and sitting bath, while warm water replaced Compound Phellodendron decoction in the control group. Perianal pain, wound edema, and exudation were scored on postoperative days 3 and 7, and wound healing time was recorded. Interleukin-2(IL-2), IL-5, IL-6, and IL-12 were measured via a double-antibody sandwich enzyme-linked immunosorbent assay. Hematoxylin-eosin (HE) staining and immunofluorescence were used to quantitatively analyze the capillary number and CD4+ and CD8+ lymphocytes in granulation tissue on postoperative days 7.

Results: The scores of pain, edema, and exudation in 2 groups on postoperative day 7 were lower than those on the 3rd postoperative day. Compared with the control group, the pain, edema, and exudation scores in the study group were decreased, and the wound healing time was shortened; the expressions of IL-2 and IL-12 in the study group were significantly increased, while the expressions of IL-5 and IL-6 were decreased; the number of capillaries and CD4+ lymphocytes in the study group was increased, while the number of CD8+ lymphocytes was decreased.

Conclusion: Compound Phellodendron decoction had efficacy in promoting wound healing, reducing complications, and changing lymphocyte aggregation and alleviating local inflammatory response.

Figure 1

The diagram of participant flow describing the screening, randomization, allocation, and completion.

Figure 2

The fumigation and sitting bath treatment with Compound Phellodendron decoction. (a) The temperature can be adjusted by the fumigating and sitting bath apparatus. (b) The Compound Phellodendron decoction was continuously heated and exposed to the anal fistula wound.

Figure 3

The wound photos of the two patients on the 3rd and 7th day after surgery. (a) In the study group, the wound surface was moist on the third day after surgery, but the skin exudation around the wound surface had dried up. (b) In the study group, the degree of wound wetness on the 7th postoperative day was less than that on the 3rd postoperative day. (c) On the third day after surgery, the wound surface of the control group was oozing, accompanied by a large area of surrounding skin wet. (d) Fluid that can flow is still visible on the surface of the wound, although there is no obvious fluid in the skin surrounding the wound.

Figure 4

The wound photos of the two patients on the 42th day after surgery. (a) Surgical wounds in the study group were completely healed on the 42nd postoperative day. (b) Wounds in the control group tended to heal on the 42nd postoperative day.

Figure 5

The comparison of immunofluorescence expression images of CD4+ and CD8+ lymphocytes in wound granulation tissue between the study group with the control group. Compared with the control group (c) and (d), the number of CD4+ lymphocytes in the study group (a) was significantly increased, while the number of CD8+ lymphocytes (b) was significantly decreased.

Figure 6

The comparison of the number of capillaries in wound granulation tissue between the two groups. Compared with the control group (c) and (d), the number of capillaries in the study group (a) and (b) was significantly increased. The number of capillaries on day 7 (b) and (d) was larger than that on day 3 (a) and (c) in both groups.

Figure 7

The number comparison chart of capillaries in wound granulation tissue between the two groups. Compared with the control group, the capillary count in the granulation tissue stained by HE staining in the study group was significantly higher (^∗: P < 0.05).