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Tongyangxiao Lotion for Postoperative Wound Healing After Anal Fistula Surgery

26. april 2026 opdateret af: Yongkang An

Tongyangxiao Lotion Accelerates Postoperative Wound Healing in Anal Fistula Surgery by Activating the PI3K-Akt-mTOR Pathway

This study tests whether a traditional Chinese herbal bath called Tongyangxiao (TYX) lotion helps surgical wounds heal faster in patients who have had anal fistula surgery. Anal fistulas are abnormal tunnels near the anus that often require surgery, but the wound is usually left open and heals slowly. The study compares TYX lotion with a standard antiseptic bath (potassium permanganate). Patients use one of the two baths once daily for 14 days after surgery. The main goal is to see how long it takes for the wound to close completely. The study also measures pain, wound size, inflammation, and proteins involved in healing. A total of 115 patients took part, and laboratory experiments with human skin cells were also performed to understand how TYX works.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This prospective, single-blind, randomized controlled trial was conducted at two hospitals in China (The First Affiliated Hospital of Hebei University of Chinese Medicine and The First Affiliated Hospital of Henan University of Chinese Medicine) from June 2023 to June 2024. The study enrolled 115 patients aged 18-65 years with low simple anal fistula who underwent low anal fistulectomy. Patients were randomly assigned to either the Tongyangxiao (TYX) group (n=58) or the potassium permanganate (PP) group (n=57). Starting on postoperative day 2, the TYX group received a 15-minute sitz bath once daily with 1500 mL of TYX decoction (40°C) for 14 days. The TYX decoction contains ten herbs: Huangbai, Kushen, Danggui, Cangzhu, Qinjiao, Xixin, Fangfeng, Chuanjiao, Mingfan, and Mangxiao. The PP group received a 15-minute sitz bath with 1:5000 potassium permanganate solution (40°C) for the same duration.

The primary outcome was wound healing time (days from surgery to complete epithelialization). Secondary outcomes included wound area (measured by ImageJ at days 5,7,14), exudate score, pain by visual analog scale (VAS, days 5,10,14), serum and tissue levels of inflammatory cytokines (TNF-α, IL-6, IL-1β) by ELISA and immunohistochemistry, expression of PI3K-Akt-mTOR pathway proteins (p-PI3K, p-Akt, p-mTOR) by Western blot and immunohistochemistry, and collagen I/III expression by Western blot, qPCR, and immunohistochemistry. Safety was monitored by recording adverse events.

In parallel, network pharmacology predicted PI3K-Akt as a core pathway. An in vitro experiment using human fibroblast HFF-1 cells treated with TNF-α (50 ng/mL) was performed to model inflammation. Cells were treated with TYX lyophilized powder (0.1 or 0.5 mg/mL), the PI3K activator 740Y-P, or their combination. Cell migration was assessed by Transwell assay; pathway protein expression and collagen were measured by Western blot and immunofluorescence.

The study was approved by the Ethics Committee of Hebei University of Chinese Medicine (YXLL2021010) and the sub-center (2021HL-248-01). All patients gave written informed consent. No U.S. government funding or IND/IDE was involved.

Results demonstrate that TYX significantly shortened wound healing time, reduced pain and exudate, decreased inflammatory cytokines, and upregulated PI3K-Akt-mTOR phosphorylation and collagen deposition. In vitro, TYX reversed TNF-α-induced suppression of fibroblast migration and pathway activity. These findings support the clinical use of TYX lotion to accelerate postoperative wound healing in anal fistula surgery by activating the PI3K-Akt-mTOR signaling pathway.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

115

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Henan
      • Zhengzhou, Henan, Kina, 450000,
        • The First Affiliated Hospital of Henan University of Chinese Medicine

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

Age 18 to 65 years

Diagnosis of low simple anal fistula according to the Chinese expert consensus on diagnosis and treatment of anal fistula (2020 edition)

Traditional Chinese medicine pattern of damp-heat downward infusion

Underwent low anal fistulectomy

No surgical contraindications

Exclusion Criteria:

Complex or high anal fistula

Inflammatory bowel disease, diabetes mellitus, or severe cardiac / liver / renal dysfunction

Allergy to any component of Tongyangxiao lotion or potassium permanganate

Pregnancy or lactation

Participation in another clinical trial within 3 months

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Tongyangxiao (TYX) group
Patients receive a 15-minute sitz bath once daily with 1500 mL of Tongyangxiao decoction (40°C) from postoperative day 2 for 14 consecutive days. The decoction contains ten herbs: Huangbai (Phellodendron chinense), Kushen (Sophora flavescens), Danggui (Angelica sinensis), Cangzhu (Atractylodes lancea), Qinjiao (Gentiana macrophylla), Xixin (Asarum sieboldii), Fangfeng (Saposhnikovia divaricata), Chuanjiao (Zanthoxylum bungeanum), Mingfan (Alumen), and Mangxiao (Natrii Sulfas).
Patients receive a 15-minute sitz bath once daily with 1500 mL of Tongyangxiao decoction (40°C) from postoperative day 2 for 14 consecutive days. The decoction contains ten herbs: Huangbai (Phellodendron chinense), Kushen (Sophora flavescens), Danggui (Angelica sinensis), Cangzhu (Atractylodes lancea), Qinjiao (Gentiana macrophylla), Xixin (Asarum sieboldii), Fangfeng (Saposhnikovia divaricata), Chuanjiao (Zanthoxylum bungeanum), Mingfan (Alumen), and Mangxiao (Natrii Sulfas).
atients receive a 15-minute sitz bath once daily with 1500 mL of 1:5000 potassium permanganate solution (40°C) from postoperative day 2 for 14 consecutive days.
Andre navne:
  • Aktiv komparator
Aktiv komparator: Potassium permanganate (PP) group
Patients receive a 15-minute sitz bath once daily with 1500 mL of 1:5000 potassium permanganate solution (40°C) from postoperative day 2 for 14 consecutive days.
Patients receive a 15-minute sitz bath once daily with 1500 mL of Tongyangxiao decoction (40°C) from postoperative day 2 for 14 consecutive days. The decoction contains ten herbs: Huangbai (Phellodendron chinense), Kushen (Sophora flavescens), Danggui (Angelica sinensis), Cangzhu (Atractylodes lancea), Qinjiao (Gentiana macrophylla), Xixin (Asarum sieboldii), Fangfeng (Saposhnikovia divaricata), Chuanjiao (Zanthoxylum bungeanum), Mingfan (Alumen), and Mangxiao (Natrii Sulfas).
atients receive a 15-minute sitz bath once daily with 1500 mL of 1:5000 potassium permanganate solution (40°C) from postoperative day 2 for 14 consecutive days.
Andre navne:
  • Aktiv komparator

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Wound healing time
Tidsramme: From date of surgery until complete epithelialization, assessed daily up to 60 days
Number of days from surgery to complete wound closure (complete epithelialization without need for dressing).Time Frame
From date of surgery until complete epithelialization, assessed daily up to 60 days

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Wound area
Tidsramme: Postoperative days 5, 7, and 14
Description: Wound area (cm²) measured by tracing the wound margin on transparent film and calculated using ImageJ software.
Postoperative days 5, 7, and 14
Exudate score
Tidsramme: Postoperative days 5, 7, and 14
Graded as 0=none, 1=mild (only on dressing), 2=moderate (soaking < half of dressing), 3=severe (soaking ≥ half of dressing).
Postoperative days 5, 7, and 14
Pain score (VAS)
Tidsramme: Postoperative days 5, 10, and 14
Visual analog scale from 0 (no pain) to 10 (worst pain).
Postoperative days 5, 10, and 14
Inflammatory cytokines (TNF-α, IL-6, IL-1β)
Tidsramme: Postoperative days 7 and 14
Measured in serum by ELISA and in wound tissue by immunohistochemistry.
Postoperative days 7 and 14
PI3K-Akt-mTOR pathway proteins (p-PI3K, p-Akt, p-mTOR)
Tidsramme: Postoperative days 7 and 14
Expression levels and phosphorylation ratios measured by Western blot and immunohistochemistry in wound tissue.
Postoperative days 7 and 14
Collagen I and Collagen III
Tidsramme: Postoperative days 7 and 14
Protein and mRNA expression measured by Western blot, immunohistochemistry, and RT-qPCR in wound tissue
Postoperative days 7 and 14

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Sponsor

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. juni 2023

Primær færdiggørelse (Faktiske)

30. juni 2024

Studieafslutning (Faktiske)

30. juni 2024

Datoer for studieregistrering

Først indsendt

26. april 2026

Først indsendt, der opfyldte QC-kriterier

26. april 2026

Først opslået (Faktiske)

1. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

1. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

26. april 2026

Sidst verificeret

1. april 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • YXLL2021010

Plan for individuelle deltagerdata (IPD)

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INGEN

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