Rapid Recovery Strategy of Treating Hemorrhoids in Perioperative Period by Multimodal Analgesia with Traditional Chinese Medicine

Objective:To explore the application effect of TCM multimodal analgesia rapid rehabilitation strategies in perioperative period of hemorrhoids.Methods:A total of 90 patients with mixed hemorrhoid who received traditional Milligan-Morgan surgical treatment from May 2018 to April 2019 in our hospital were selected.They were randomly divided into the control group and treatment group according to different analgesic strategies,with 45 cases in each group.The control group was given western medicine of analgesia,and the treatment group was given TCM multimodal of analgesia.The visual analogue scale(VAS)in the 2 groups after analgesic strategies were analyzed and compared to explore its effect and evaluate its application value.Results:From the 2^nd day to the 7^th day after the operation,VAS scores in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).The overall analgesic efficiency in the treatment group was higher than the control group.The incidence of postoperative complications was lower than the control group,and the hospitalization time was significantly shortened,with statistically significant differences(P<0.05).Conclusion:Compared with the western analgesic strategy,the pain of hemorrhoid patients treated by TCM multimodal analgesia was significantly relieved after hemorrhoid surgery.The rapid recovery strategy has fewer postoperative complications,quick recovery,patient satisfaction,and remarkable results.

Integrated network pharmacology and experimental verification to explore the mechanism of Sangqi Qingxuan formula against hypertensive vascular remodeling

Objective: To investigate the bioactive components of Sangqi Qingxuan formula(SQQX), predict the pharmacological targets, and explore the mechanism of hypertensive vascular remodeling(HVR).Methods: Network pharmacology was adopted to predict how SQQX acts in HVR. The effectiveness was assessed by blood pressure measurements and pathological morphology observation based on a spontaneously hypertensive rat model, while the mechanism of SQQX on HVR was validated by immunohistochemistry(IHC) and western blot(WB) according to the results of network pharmacology.Results: There were 130 bioactive components of SQQX and 231 drug targets predicted by the Traditional Chinese Medicine Systems Pharmacology Database. Subsequently, 181 common targets were identified for SQQX against HVR, with TP53, MAPK1, and AKT1 as the core targets. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses was employed to identify the top 20 enriched functions and the top 20 pathways(P <.01). Finally, the key role of the ERK/MAPK signaling pathway in HVR was determined. The in vivo results suggested that SQQX reduced systolic blood pressure and increased the ratio of thoracic aortic wall thickness to lumen diameter. Additionally, compared with the model group, SQQX increased the expression of smooth muscle 22 alpha(IHC: P <.001;WB:P <.05) and decreased the expression of osteopontin(IHC: P <.001;WB: P <.05), ERK1/2(IHC: P <.001;WB: ERK1 & ERK2, all P <.05), p-ERK1/2(IHC: P <.001;WB: ERK1 & ERK2, all P <.05), and the ratio of pERK1/2 to ERK1/2 protein(IHC: P <.001).Conclusions: SQQX, which has multiple bioactive ingredients and potential targets, is an effective treatment for HVR. The mechanism of antihypertensive and vascular protection may be related to the inhibition of phenotypic transformation of vascular smooth muscle cells and the ERK/MAPK signaling pathway.

Acupuncture for atopic eczema:Evidence mapping-based randomized controlled trials,systematic reviews,and meta-analyses

Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic eczema(AE)using evidence mapping of randomized controlled trials(RCTs),systematic reviews(SRs),and metaanalyses.Methods:We searched eight databases from inception to October 30,2021,for RCTs,SRs,and metaanalyses of acupuncture for patients with AE.Two reviewers screened the papers,before extracting the data and assessing the quality of the included studies.The basic and clinical characteristics,and quality of assessment of the studies were assessed using descriptive statistics and qualitative analyses.A bubble plot was used to visualize the evidence map to indicate the relationship between the type and frequency of outcomes,the quality and overall effects of acupuncture,and the outcomes of the studies.Results:Forty-five studies(Forty RCTs,five SRs,and meta-analyses)were included.The number of publications increased rapidly after 2013 and peaked in 2019.The most frequently applied intervention was one type of acupuncture therapy.The most frequent comparison was between acupuncture and active medicine.The symptomatic outcome was the most commonly used,and the quality of the included studies was relatively low.All included studies showed a significantly better outcome in the acupuncture group compared to the control group(P<0.05).Most outcomes in the included studies were of low or critically low quality.Several symptomatic outcomes and health-related quality of life outcomes in the included RCTs indicated moderate quality,while some symptomatic outcomes and global symptom improvement in the included SRs and meta-analyses indicated low quality.Conclusion:The majority of studies related to acupuncture for AE indicated promising results,but with relatively low quality;thus,further studies with more robust designs should be conducted to validate the results.