The Value Of Ruyihuanghuangsan In The Treatment Of Appendix Abscess

Part Ⅰ:Clinical study of Ruyi Jinhuang Powder to shorten the course of periappendiceal abscess.To compare the differences in clinical efficacy between the two groups of patients treated with Ruyi Jinhuang San topically combined with antibiotics and those treated with antibiotics alone for periappendiceal abscess,and to evaluate the role of Ruyi Jinhuang San in the treatment of periappendiceal abscess and its possible mechanism of action.Objective:To investigate the therapeutic value of Ruyi Jinhuang Powder for patients with periappendiceal abscess by using Ruyi Jinhuang Powder as a topical intervention treatment.Methods:The data of 122 patients who were hospitalized in Shaanxi Provincial People’s Hospital from January 2018 to January 2022 with the first diagnosis of periappendiceal abscess and more complete clinical data were selected,and the patients were divided into two groups according to whether they received topical treatment with Ruyi Jinhuang Powder,and the length of hospitalization,time of antibiotic use,time of disappearance of abdominal pain,total cost of hospitalization,size of abscess after 7 d of treatment,and the presence or absence of puncture treatment.SPSS 22.0 was used to compare and analyze the general clinical data and relevant indexes of the patients in the two groups after treatment.Results:1.The abscess was significantly smaller in the treatment group than in the control group after 7 days of treatment by ultrasound,and the difference was more significant(P<0.05).2.The length of hospital stay was shorter in the treatment group compared with the control group(P<0.05).3.The abdominal pain disappearance time was shortened in the treatment group compared with the control group(P<0.05),and it was inferred from the disappearance time of abdominal pain that the effect of Ruyi Jinhuang Powder started at day 2-4.4.The time of antibiotic use was shortened in the treatment group compared with the control group(P<0.05),suggesting that Ruyi Jinhuang Powder could reduce the inflammatory response of the organism.Conclusion:Ruyi Jinhuang Powder can shorten the course of periappendiceal abscess and may reduce the inflammatory response of the organism.Part II:Study on the effect and mechanism of Ruyi Jinhuang Powder to reduce local abdominal abscess in rats.To verify the effect of Ruyi Jinhuang Powder on periappendiceal abscess,we established a restricted appendiceal abscess model to simulate periappendiceal abscess.The therapeutic effect of Ruyi Jinhuang Powder on periappendiceal abscess was investigated by HE staining,IL-6 immunofluorescence staining and TUNEL/CK19 double immunofluorescence staining.Objective:A rat model of limited cecum abscess was produced to investigate the potential effects and mechanisms of Ruyi Jinhuang Powder to reduce local abdominal abscess in rats.Methods:Thirty SPF-grade male Sprague-Dawley(SD)rats were randomly divided into three groups:the Ruyi Jinhuang Powder group,the sham-operated group and the control group,10 rats in each group,all rats had free access to water and food,and a restricted cecum abscess model was established.The rats in the sham-operated group underwent open surgery only,and the rats in the remaining two groups underwent local cecum abscess model surgery.Postoperatively,iodophor was applied daily to the right lower abdomen in the sham-operated and control groups,and Ruyi Jinhuang Powder(Beijing Tong Ren Tang,Beijing,China)was applied daily in the Ruyi Jinhuang Powder group.On postoperative day 7,cecum and abdominal wall tissues were collected,and HE staining was used to evaluate abscess formation in each group;immunohistochemical staining of IL-6 in peritoneal tissues was performed to compare the immunohistochemical scores of IL-6 in peritoneal tissues in each group;CK19 and TUNEL double immunofluorescence were used to detect mesothelial cell apoptosis in peritoneal tissues.Results:The inflammation score and IL-6 immunohistochemistry score of peritoneal tissues in the control group were higher than those in the Ruyi Jinhuang Powder group.Apoptosis of mesothelial cells in peritoneal tissues was lower in the Ruyi Jinhuang Powder-treated group.Conclusion:Ruyi Jinhuang Powder inhibited the inflammatory response and reduced the apoptosis of mesothelial cells in peritoneal tissues in a rat model.