Clinical Study on the Treatment of Complex Anal Fistula by Phased Chinese Herbal Sitz Bath Based on "Fuzheng Quxie" Theory.

Objective: To evaluate the clinical efficacy of a phased Chinese herbal sitz bath for the treatment of complex anal fistula based on the traditional Chinese medicine theory of "Fuzheng Quxie." Methods: We enrolled 200 patients with complex anal fistula who were hospitalized and treated surgically in the Department of Anorectal Medicine of Suining Central Hospital from June 2021 to December 2022. The patients were randomly divided into 2 groups of 100 patients each: sitz bath group 1 (postoperation, the patients used a sitz bath with a self-formulated decoction of "Qingre Zaoshi Zhitong" formula, once in the morning and once in the evening) and sitz bath group 2 (postoperation, the patients used the same decoction as the sitz bath group 1, and when the incision began to heal, the patients then used a sitz bath with a self-formulated decoction of "Yiqi Fuzheng" formula, once in the morning and once in the evening). Both groups were treated for 6 weeks. The assessments included wound symptom score, incision healing time, clinical efficacy after treatment, and serum-related growth factor concentrations and anorectal dynamics indicators before and after treatment. Results: After treatment, sitz bath group 2 had less wound pain, edema, exudate, and granulation growth scores than sitz bath group 1 (P < .05). Postoperative incision healing time was faster in sitz bath group 2 22.96 (1.96) d than in sitz bath group 1 26.19 (2.62) d (t = 9.872, P < .001). The total effective rate after treatment was higher in sitz bath group 2 96% (96/100) than in sitz bath group 1 88% (88/100) (χ2 = 4.4, P = .04). Serum transforming growth factor ß, epidermal growth factor, and basic fibroblast growth factor concentrations were higher in both groups after treatment than before treatment, and the concentrations of the growth factors after treatment were higher for sitz bath group 2 than for sitz bath group 1 (P < .001). Anal rest pressure and anal maximum contraction pressure were higher in both groups after treatment than before treatment, and the pressures after treatment were higher for sitz bath group 2 than for sitz bath group 1 (P < .05). Conclusion: Based on the theory of Fuzheng Quxie, the effectiveness and superiority of a phased Chinese herbal sitz bath for the treatment of complex anal fistula were remarkable, which could promote the improvement of wound symptoms and anal function. This may be related to increases in growth factor concentrations and anorectal dynamics indicators.

Improvement of Diarrhea-Type Defecation Habit Changes and Other Complications After Dixon Surgery for Rectal Cancer With Discriminative Chinese Herbs Combined With Levator Ani Muscle Training.

Objective: To evaluate the clinical efficacy of discriminative Chinese herbs combined with levator ani muscle training in improving diarrhea-type defecation habit changes and other complications after Dixon surgery for rectal cancer. Methods: 200 patients with Dixon surgery for rectal cancer who were hospitalized in the Department of Gastrointestinal Surgery of Suining Central Hospital from June 2021 to December 2022 were selected, and all patients were divided into 100 cases each in the control and experimental groups by the random number table method. The control group was taken Live Combined Bifidobacterium and Lactobacillus Tablets and Montmorillonite Powder orally after surgery, and the experimental group was treated by discriminative Chinese herbs combined with levator ani muscle training after surgery. Both groups adhered to treatment until 3 months postoperatively. The anal rectal pressure was assessed in both groups at 3 months postoperatively, the anal function and European Organization for Research and Treatment of cancer quality of life questionnaire-colorectal cancer 30 (EORTC QLQ-C30) score before and after treatment were compared between the two groups and the incidence of other perianal complications at 3 months postoperatively was counted. Results: After treatment, the anal canal rest pressure (ARP) in the experimental group (50.80±7.80) mmHg was higher than that in the control group (46.64±7.92) mmHg (P < .05), and the anal canal maximum contraction pressure (AMCP) in the experimental group (89.81±19.39) mmHg was higher than that in the control group (72.02±17.27) mmHg (P < .05). Before treatment, there were 0, 14, 34, 34 and 52 persons with excellent, good, general and poor anal function in the control group and 0, 17, 28 and 55 persons in the experimental group, respectively, after treatment, there were 3, 36, 50, and 11 persons with excellent, good, general and poor anal function in the control group and 12, 44, 42 and 2 persons in the experimental group, respectively, after treatment, the anal function grade improved in both groups, and the experimental group was better than the control group (P < .05). After treatment, the functional modules and overall health scores of the EORTC QLQ-C30 scale increased in both groups compared with those before treatment, and the experimental group was higher than the control group (P < .05), after treatment, the frequency of symptom modules in the experimental group was lower than that before treatment and lower than that in the control group after treatment (P < .05). Within 3 months after surgery, the total incidence of other perianal complications in the control group was 16.00% (16/100), which was higher than the total incidence of other perianal complications in the experimental group 7.00% (7/100) (P < .05). Conclusion: The treatment of diarrhea-type defecation habit changes after Dixon surgery for rectal cancer with discriminative Chinese herbs combined with levator ani muscle training is effective in enhancing patients' anal function, relieving diarrhea symptoms, improving survival quality and reducing the risk of other perianal complications.

Effect of Compound Polyethylene Glycol Electrolyte Powder on the Quality of Gastrobowel Preparation before Enteroscopy Intervention.

Objective: To study the effect of compound polyethylene glycol electrolyte powder (PGEP) on the quality of gastrobowel preparation before enteroscopy intervention. Methods: From March 2021 to January 2022, among the patients who needed enteroscopy in our hospital, 280 patients who volunteered for this study were randomly selected as the research objects. All the subjects were randomly divided into the control group (140 cases) and the observation group (140 cases). Both groups received routine treatment before enteroscopy intervention. On this basis, patients in the control group were given 9 g of senna every day before operation, and 250 ml of 20% mannitol and 2500 ml of water were taken orally from 9:00 am to 11:00 am on the day of examination. Patients in the observation group took PGEP orally from 9:00 am to 11:00 am. The effective rate of bowel cleaning, the frequency of defecation and duration of diarrhea, the levels of blood electrolyte indexes such as Na+, K+, and Cl- before and after the intervention, and the incidence of adverse reactions were compared between the two groups. Results: The effective rate of bowel cleaning in the observation group was significantly higher than that in the control group (P < 0.05). The frequency of defecation and duration of diarrhea in the observation group were significantly lower than those in the control group (P < 0.05). Compared with the control group, the levels of blood electrolyte indexes in the observation group after the intervention were not statistically significant (P > 0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion: Using PGEP for gastrobowel preparation before enteroscopy intervention can achieve high bowel cleaning efficiency, short bowel preparation time, and low incidence of adverse reactions, which does not affect the water-electrolyte balance of patients, and the psychological state of patients before enteroscopy intervention is more stable. This program is worthy of clinical promotion.