Intervention Study Of Jiedu Fumigation And Washing Decoction On IL-6 And TNF-α In Patients With Chronic Venous Ulcer

Objective: By observing the effects of Jiedu fumigation and washing decoction on serum interleukin-6 and tumour necrosis factor-α levels in patients with chronic venous ulcers,and discussing the mechanism of action of Jiedu fumigation and washing decoction in the treatment of chronic venous ulcers in conjunction with network pharmacology,we provide new ideas for the clinical treatment of chronic venous ulcers.Methods: Study 1: 60 patients with chronic venous ulcers admitted to the peripheral vascular disease department of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were selected and randomly divided into 30 cases in the observation group(Jiedu fumigation and washing decoction group)and 30 cases in the control group(Kangfuxin liquid group).The TCM evidence points of the wounds before and after treatment were counted,and the serum interleukin-6 and tumour necrosis factor-α levels of the patients before and after treatment were measured.The data obtained were collated and analysed statistically.Study 2: To investigate the relevant targets and pathways of Jiedu fumigation and washing decoction in the treatment of chronic venous ulcers through a network pharmacological study.Results: Study 1:(1)Total effective rate: The total effective rate of the observation group was 90%,and the total effective rate of the control group was 66.67%.The difference was statistically significant(P<0.05)when compared between the two groups.(2)Chinese medicine evidence points: compared with day 0 of treatment,the Chinese medicine evidence points of the observation group decreased significantly on day 14 of treatment,and the difference was statistically significant(P<0.01).On the 14 th day of treatment,compared with the control group,the efficacy of the observation group was better than that of the control group in reducing the amount of traumatic exudate and traumatic flesh,increasing the amount of traumatic new granulation tissue and new epithelial tissue,improving peri-traumatic itching,peri-traumatic colour,peri-traumatic swelling and peri-traumatic temperature,and the difference was statistically significant(P<0.05).On the 14 th day of treatment,the difference was statistically significant(P<0.01)when comparing the total TCM evidence points between the two groups.(3)Comparison of serum interleukin-6 and tumour necrosis factor-α levels: compared with day 0 of treatment,the serum interleukin-6 and tumour necrosis factor-α levels of patients in the observation group decreased significantly on day 14 of treatment,and the difference was statistically significant(P<0.01).On day 14 of treatment,the difference was statistically significant(P<0.05)when compared between the two groups.Study 2: The results of the network pharmacology study showed that the main ingredients of Jiedu fumigation and washing decoction for the treatment of chronic venous ulcers are quercetin,taraxerol,taraxasterol,choline,baicalin,kaempferol and flavopiridol,etc.The key targets involve interleukin-6,tumour necrosis factor,interleukin-1β,chemokine ligand 2 and vascular endothelial growth factor A.The main signalling pathways are cancer signalling pathway,hypoxia-inducible factor signalling pathway and phosphatidylinositol 3 kinase/protein kinase B signalling pathway,etc.Conclusion:(1)The treatment of chronic venous ulcers with Jiedu fumigation and washing decoction soaked in sweat has the effect of improving the wounds and periwound evidence,reducing serum interleukin-6and tumour necrosis factor-α levels,reducing inflammatory response and accelerating wound healing in patients.(2)The network pharmacology results suggest that its mechanism of action is related to the regulation of key targets such as IL-6,TNF,IL1 B,CCL2,VEGFA,cancer signalling pathway,hypoxia-inducible factor signalling pathway,phosphatidylinositol 3-kinase/protein kinase B signalling pathway and other pathways,thus exerting therapeutic effects.