Exploring the Mechanism of Xiangpi Shengji Ointment Promoting Wound Repair after Anal Fistula Based on PI3K/Akt Pathway
Objective:To explore the therapeutic effect of Xiangpi Shengji Ointment on the wounds of rats after anal fistula resection and its correlation with PI3K/Akt/mTOR pathway.Methods:SD male rats were randomly divided into four groups:sham operation group,model group,Xiangpi Shengji ointment group,and MEBO group,with 10 rats in each group.All four groups were used to create an anal fistula model using No.0 steel wire.After successful modeling,except for the sham operation group,anal fistula resection was performed under anesthesia,and the wound was kept open to form an infectious anal fistula postoperative wound that was"open,oozing blood,oozing fluid,and purulent secretion."The sham operation group retained the fistula without changing the dressing.The model group was rinsed with physiological saline and disinfected with complex iodine without changing the dressing.The treatment group was given corresponding drugs to change the dressing for the wound,respectively,A total of 10 days.After 10 days,the wound healing rate and granulation tissue coverage rate of rats in the model group,the Xiangpi Shengji ointment group,and the MEBO group after anal fistula surgery were compared using conventional area detection methods;HE staining was used to observe the pathological changes of perianal tissues of rats in each group;The expression levels of bFGF,EGF,and VEGF in serum of rats in each group were detected by ELISA,and the protein expression levels of PI3K,Akt,mTOR,p70 S6K,p-PI3K(S473),p-AKT(S473),p-mTOR(Ser2448),and p-p70 S6K in perianal granulation tissue of rats in each group were compared by WB detection.Results:Compared with the model group,the wound healing rate and granulation tissue filling rate of the Xiangpi Shengji Ointment group and the MEBO group significantly increased on the 3rd,7th,and 10th day of treatment(P＜0.01);Pathological sections showed that in the sham operation group,there was less inflammatory cell infiltration,while in the other groups,there were different degrees of inflammatory cell infiltration,and different degrees of inflammatory repair type granulation tissue proliferation,collagen fiber regeneration,and vascular dilation were visible in the wound area.Pathological sections of the model group showed a large amount of inflammatory cell infiltration,significant vascular dilation,and significant vascular bleeding.Pathological sections of the Xiangpi Shengji Paste group showed fewer inflammatory cells,Fibroblasts are mature and evenly distributed,and collagen fibers are abundant and neatly arranged in the dermis.Angiogenesis is visible,without significant vasodilation and bleeding.Pathological sections in the MEBO group show a small amount of inflammatory cell infiltration and vasodilation,and fibroblasts are visible in the dermis.The results of ELISA showed that the levels of bFGF,EGF,and VEGF in the serum of the model group were significantly lower than those of the sham operation group(P＜0.01);Compared with the model group,the content of bFGF,EGF,and VEGF in the serum of the Xiangpi Shengji Ointment group was significantly increased(P＜0.01),while the content of EGF,VEGF in the serum of the rats in the MEBO group was significantly increased(P＜0.01).The WB test results showed that compared with the sham operation group,the expression of p-PI3K,p-Akt,p-mTOR,and p-p70 S6K protein in the perianal tissue of the model group was significantly decreased(P＜0.01);Compared with the model group,the expression of p-PI3K,p-Akt,p-mTOR,and p-p70 S6K protein in perianal tissue in the Xiangpi Shengji ointment group was significantly increased(P＜0.05).Conclusion:Xiangpi Shengji Ointment can effectively promote wound repair after anal fistula surgery,alleviate inflammatory reactions on the wound after anal fistula surgery,and promote the growth of wound granulation.Its healing mechanism may be related to the expression of PI3K/Akt/mTOR signal pathway related proteins,which can accelerate the process of wound repair by upregulating PI3K/Akt/mTOR signal pathway related proteins,activating PI3K/Akt/mTOR signal pathway.
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