文献类型：期刊文献

中文题名：基于共生菌群探讨生肌玉红膏“煨脓长肉”促进肛瘘术后创面修复的机制

英文题名：Discussion on the mechanism of the Shengji Yuhong ointment promoting wound repair after anal fistula surgery by“promoting suppuration to regenerate flesh”based on symbiotic microbiota

作者：崔西[1];刘翠翠[1];柳芹芹[1];李航航[1];翟睿[1];史树勋[2]

第一作者：崔西

机构：[1]甘肃中医药大学,甘肃兰州730000;[2]甘肃中医药大学附属医院,甘肃兰州730000

第一机构：甘肃中医药大学

年份：2025

卷号：17

期号：30

起止页码：27

中文期刊名：中医临床研究

外文期刊名：Clinical Journal Of Chinese Medicine

基金：甘肃中医药大学联合科研基金项目(HXLH-XTCX01);兰州市科技发展指导性计划项目(2024-9-83);甘肃省高校教师创新基金项目(2025B-114)。

语种：中文

中文关键词：共生菌群;生肌玉红膏;煨脓长肉;肛瘘术后创面;免疫微环境

外文关键词：Symbiotic microbiota;The Shengji Yuhong ointment;Promoting suppuration to regenerate flesh;Post-anal fistula wound;Immune microenvironment

摘要：肛瘘术后创面易发展为慢性创面,传统中医“煨脓长肉”疗法疗效显著但机制不明。近期研究发现,共生菌群在慢性创面治疗中意义重大,能调节免疫、促进愈合,完全无菌的环境反而不利于创面恢复。目前,在肛瘘术后换药中主要应用传统的湿性愈合理论。该理论认为,在无菌条件下使用湿性敷料进行创面管理可以保持创面的湿度,提高表皮细胞的增殖、分化和移行以及肉芽组织生长的速度,组织渗液中的活性物质可得到有效保留,从而促进创面愈合。同时,湿性敷料作用下不易形成痂块,有效避免了换药时的机械损伤,使伤口更快地愈合,避免瘢痕的形成。湿性敷料可避免神经末梢直接暴露在空气中,从而有效缓解神经刺激引发的疼痛。“煨脓长肉”理论注重脓液动态平衡与整体气血调节的动态作用,而非单纯物理保湿,不仅继承了湿性愈合在保湿、减痛和防瘢方面的优点,更进一步通过“药-创的相互作用”机制主动调节脓液成分与气血状态,实现从被动保湿到主动调控的跨越,从而在动态平衡中显著加速创面愈合,体现出独到的中医整体观与临床实用价值。本研究从共生菌群调控的角度阐释生肌玉红膏“煨脓长肉”促进肛瘘术后创面修复的机制:调控创面菌群结构、创面酸碱度(pH值)和免疫微环境(如巨噬细胞极化),为传统中医理论“煨脓长肉”提供现代医学依据,为肛瘘术后创面治疗提供新策略,从而促进肛瘘术后创面修复。
Postoperative anal fistula wounds are prone to developing into chronic wounds.“Promoting suppuration to regenerate flesh”therapy of traditional Chinese medicine(TCM)demonstrates significant efficacy,though its mechanism remains unclear.Recent studies reveal that the symbiotic microbiota plays a crucial role in chronic wound healing by regulating immunity and promoting tissue regeneration.A completely sterile environment,conversely,impedes wound recovery.Currently,wound dressing changes after anal fistula surgery primarily follow the traditional moist wound healing theory.This theory posits that under sterile conditions,using moist dressings for wound management maintains wound moisture,enhances epidermal cell proliferation,differentiation,and migration,accelerates granulation tissue growth,and effectively preserves active substances in tissue exudate,thereby promoting wound healing.Simultaneously,moist dressings inhibit scab formation,minimizing mechanical damage during dressing changes and accelerating wound closure while preventing scarring.By shielding nerve endings from direct exposure to air,these dressings effectively alleviate pain caused by neural stimulation.The“Promoting suppuration to regenerate flesh”theory emphasizes the dynamic interplay between pus equilibrium and holistic Qi-blood regulation,transcending mere physical moisture retention.It not only inherits the advantages of moist wound healing in hydration,pain reduction,and scar prevention but further actively modulates pus composition and Qi-blood status through the“drug-wound interaction”mechanism.This achieves a leap from passive hydration to active regulation,significantly accelerating wound healing through dynamic equilibrium,demonstrating the unique holistic perspective and clinical utility of TCM.This study elucidates the mechanism by which the Shengji Yuhong ointment(生肌玉红膏)promotes post-anal fistula surgery wound repair through symbiotic microbiota regulation:it modulates wound microbial structure,wound pH,and the immune microenvironment(such as macrophage polarization),providing modern medical evidence for the TCM theory of“Promoting suppuration to regenerate flesh”and offering a new therapeutic strategy for post-anal fistula surgery wound care.This approach effectively enhances wound repair following anal fistula surgery.