白及多糖-壳聚糖水凝胶联合中药熏洗坐浴对重度混合痔术后创面愈合的影响及抗炎机制研究OA

Objective To investigate the effect of bletilla striata polysaccharide-chitosan hydrogel combined with Chinese medicinal fumigation and sitz bath on wound healing after surgery for severe mixed hemorrhoids,and to explore its anti-inflammatory mechanism based on the interleukin-6(IL-6)/tumor necrosis factor-α(TNF-α)/IL-10 axis.Methods A total of 80 patients undergoing surgery for severe mixed hemorrhoids admitted to our hospital from January 2023 to December 2024 were enrolled and divided into an observation group and a control group by random number table method,with 40 cases in each group.The control group received routine dressing change and potassium permanganate sitz bath postoperatively,while the observation group was treated with external application of bletilla striata polysaccharide-chitosan hydrogel on wounds com-bined with Chinese medicinal fumigation and sitz bath.The wound microenvironment,levels of inflammatory mediators,pain and neural sensitization,short-and long-term wound healing indicators,and safety were com-pared between the two groups before and after treatment.Results After treatment,the levels of vascular endothelial growth factor(VEGF)and transforming growth factor-β1(TGF-β1)in the observation group were significantly higher than those in the control group(P<0.05).The levels of IL-6 and TNF-α were lower than those in the control group(P<0.05),while the level of IL-10 was higher than that in the control group(P<0.05).The pain score,serum substance P and norepinephrine levels of the observation group were all lower than those of the control group(P<0.05).The pain score,serum substance P and norepinephrine levels in the observation group were all lower than those in the control group(P<0.05).The pain disappearance time,edema disappearance time and wound healing time were all shorter than those in the control group(P<0.05).The Vancouver Scar Scale score at 3 months after surgery in the observation group was lower than that in the control group(P<0.05),and the wound healing rates at 14 d and 30 d after surgery were higher than those in the control group(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group,without statistically significant difference(P>0.05).Conclusion Bletilla striata polysaccharide-chitosan hydrogel combined with Chinese medicinal fumigation and sitz bath can accelerate wound healing after surgery for severe mixed hemorrhoids.Its mechanism may be closely related to optimizing the wound microenvironment,regulating the balance of IL-6/TNF-α/IL-10 inflammatory axis,inhibiting neu-ral sensitization and alleviating excessive inflammatory response.