Clinical Evaluation And Network Pharmacology Study Of The Secret Prescription For The Perioperative Treatment Of Mixed Hemorrhoids In Patients With Damp-heat Accumulation Type Constipatio

Purpose: 1.To observe the clinical effect of Shimi recipe in the perioperative period of mixed hemorrhoids in patients with constipation of damp-heat accumulation type.2.To explore the mechanism of Shimi recipe in the treatment of constipation by using the method of network pharmacology.Methods: 1.The patients with constipation with mixed hemorrhoids were randomly divided into two groups.The operation was performed after treating with Shimi recipe and Duphalac for 7 days respectively,and the drugs were taken after operation.The differences of observation indexes were compared.2.The effective ingredients,targets and constipation-related targets of Shimi recipe were screened by database,and the network diagram of "traditional Chinese medicinecomponent-disease target" was constructed.The protein protein interation of the target was analyzed and the core target was screened.The mechanism was studied by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment pathway analysis.Results: 1.(1)A total of 98 patients with constipation with mixed hemorrhoids were collected,49 cases in each group and 1 case in each group.(2)The scores of stool character,defecation effort,and perianal falling sense in the two groups were significantly improved as compared with those before treatment(P<0.01),and more in the traditional Chinese medicine group(P<0.05,P<0.01).(3)In terms of curative effect index,the effective rate of the western medicine group was better than that of the traditional Chinese medicine group after treatment for 7 days and 14 days(P<0.05,P<0.01).After 35 days of treatment,the effective rate of the traditional Chinese medicine group was better than that of the western medicine group(P<0.05).(4)The scores of Self-rating Anxiety and Self-rating Depression in the traditional Chinese medicine group were better than those in the western medicine group(P<0.05,P<0.01).(5)The Gastrointestinal Quality of Life Index score of the traditional Chinese medicine group was better than that of the western medicine group(P<0.05).(6)The postoperative pain,bleeding and edema were significantly relieved with the treatment time in the traditional Chinese medicine group and western medicine group(P<0.01),and the relief was more obvious in the traditional Chinese medicine group(P<0.05,P<0.01).Postoperative urinary retention decreased significantly in both groups(P<0.01).(7)There was no significant difference in wound healing time between the traditional Chinese medicine and western medicine group(P>0.05).2.There are 174 chemical components in 13 kinds of traditional Chinese medicine of Shimi recipe,corresponding to 4653 targets and 350 targets related to constipation.Through protein-protein interaction,20 core targets were obtained,and 1951 biological processes,74 molecular functions and 41 cell components were obtained by Gene Ontology pathway enrichment analysis.The Kyoto Encyclopedia of Genes and Genomes pathway was enriched and screened to obtain 130 signal pathways.Conclusion: 1.The improvement of stool character,defecation effort,falling sense and the total score of defecation in the traditional Chinese medicine group was better than that in the western medicine group,and the effective rate in the later stage of the traditional Chinese medicine group was higher than that of the western medicine group.The traditional Chinese medicine group was superior to the western medicine group in Selfrating Anxiety Scale,Self-rating Depression Scale,Gastrointestinal Quality of Life Index score and the improvement of postoperative pain,bleeding and edema.The perioperative application of traditional Chinese medicine in patients with mixed hemorrhoids with constipation can significantly alleviate the symptoms of constipation,improve the perioperative anxiety and depression of mixed hemorrhoids,improve the quality of gastrointestinal life and reduce postoperative complications.2.Based on the analysis of network pharmacology,it is concluded that Shimi recipe may play a role in the treatment of constipation through key proteins such as estrogen receptor α,interleukin-6,tumor necrosis factor and protein kinase B.Regulate endocrine resistance,tumor necrosis factor and other signal pathways to play a role in the treatment of constipation.