| Objective: To study the mechanism of compound Nepeta herb fuming and washing agent involved in postoperative pain relief from the molecular level,and to observe the effect of compound Nepeta fumigation lotion on pain after mixed hemorrhoidectomy,improve the understanding of compound Nepeta herb formula in the treatment of postoperative pain,give full play to the preponderance of external treatment of traditional Chinese medicine,provide more experimental theories for clinical therapy and expand clinical application prospects.Methods:(1)Part I Animal experiment: 60 rats,half male and half female,were randomly segmented into blank group,model group,negative control group,positive control group and compound Nepeta fumigant group according to random number table.Firstly,the rat incision pain model was prepared,and then the chemotactic factor CXCL12 and its receptor CXCR4 were observed in the dorsal root ganglion of rats by immunofluorescence method,fluorescence microscope was used to observe the effect of compound Nepeta herb fumigation on the expression of signal pathway,so as to clarify the postoperative analgesic mechanism of compound Nepeta fumigation agent.(2)Part II clinical trials:80 patients were randomly segmented into therapy group and control group according to random number table method.There were 40 patients in each group.Mixed hemorrhoidectomy was performed in both groups,and combined lumbar anesthesia with epidural anesthesia(CSEA)was used as anesthesia.The treatment group was treated with compound Nepeta fumigation reagent sitting bath + postoperative groove treatment,and the control group was approached with postoperative groove treatment.The pain score,wound edema of patients before treatment,day 1,day 3,day 5 and day 7 of treatment were observed and recorded,and the expressions of CXCL12 and CXCR4 signaling pathways in blood samples of patients were detected for statistical analysis.Results:(1)Part I Animal experiment: Compared with blank group,the expression of CXCL12/CXCR4 in saline group and model group was increased(P<0.05).The expression of CXCL12/CXCR4 in Nepeta sinensis formula group was decreased(P<0.05).(2)Part II clinical trials: In the comparison of general data,there was no statistical significance in gender and age between the two groups(P>0.05);Before drug treatment,there were no outstanding discrepancies in pain score,wound edema and CXCL12 and CXCR4 signaling pathway expression between the two groups(P>0.05).Pain scores of patients decreased gradually with the extension of recording time(P<0.05);There was no statistically significant difference in edema score between the treatment group and the control group on the first day of postoperative treatment(P>0.05),indicating that the treatment group was not superior to the control group in improving edema after the first day of treatment.On the 3rd,5th and7 th day after surgery,the score difference between the two groups was statistically significant(P<0.05).The wound edema score of the two groups gradually decreased with time,indicating that the treatment group was better than the control group in improving the edema condition with the extension of treatment time.Conclusion: Compound Nepeta fumigation agent can promote the growth of postoperative wound granulation,and has a significant clinical effect on the improvement of postoperative pain,wound edema and wound secretion.It can effectively relieve edema in the operative area,play the role of antibacterial and anti-inflammatory,and reduce postoperative pain.Moreover,compound Nepeta fumigation agent can effectively inhibit the expression of CXCL12/CXCR4 signaling pathway,and play a clear analgesic role,providing a new idea for further exploration of the treatment mechanism of postoperative pain. |
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