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Abstract

Objective

Pressure injury (PI) severely affect the quality of life of patients. Infection and inflammation are key factors contributing to the progression of PI; therefore, their inhibition plays a crucial role in preventing the worsening of the condition. Huanglian Jiedu Decoction (HLJDD), as a typical traditional Chinese medicine with heat-clearing and detoxicating effects, has good broad-spectrum antibacterial and anti-inflammatory effects. It is commonly used in the treatment of clinically infected external wounds. However, the therapeutic effects of HLJDD on PI remains unclear.

Methods

The extract of HLJDD was prepared using the water extraction and alcohol precipitation method. Sixty male SD rats were randomly divided into five groups (n = 12/group): control group, model group, normal saline group (negative control group), iodophor group (positive control group), and HLJDD group (test group). Except for the control group, magnet clamping and the inoculation method were used to construct the model of stage 3 PI infection wound in the other groups. After irrigating the wound, the healing rate, bacterial concentration, concentrations of IL-1, IL-6, and TNFα, and the protein expression levels of TLR2, MyD88, and NF-Bp65 were examined. Skin and ocular mucosal irritation tests were conducted to evaluate the safety of the topical application of HLJDD.

Results

Rats treated with HLJDD exhibited an improved wound healing rate, along with reduced bacterial concentration on the wound surface and a significant decrease in the content of inflammatory cytokines (IL-1β, IL-6, and TNF-α). The protein expression levels of TLR2, MyD88, and NF-κBp65 were down-regulated after the administration of HLJDD. The prepared HLJDD did not cause any irritation.

Conclusion

HLJDD can promote the healing of PI wounds and has a protective effect on PI through its anti-inflammatory and anti-bacterial properties.

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2025-05-13
2025-10-30

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References

  1. Li Z. Lin F. Thalib L. Chaboyer W. Global prevalence and incidence of pressure injuries in hospitalised adult patients: A systematic review and meta-analysis. Int. J. Nurs. Stud. 2020 105 103546 10.1016/j.ijnurstu.2020.103546 32113142
    [Google Scholar]
  2. Edsberg L.E. Black J.M. Goldberg M. McNichol L. Moore L. Sieggreen M. Revised national pressure ulcer advisory panel pressure injury staging system. J. Wound Ostomy Continence Nurs. 2016 43 6 585 597 10.1097/WON.0000000000000281 27749790
    [Google Scholar]
  3. Lyder C.H. Wang Y. Metersky M. Curry M. Kliman R. Verzier N.R. Hunt D.R. Hospital-acquired pressure ulcers: results from the national medicare patient safety monitoring system study. J. Am. Geriatr. Soc. 2012 60 9 1603 1608 10.1111/j.1532‑5415.2012.04106.x 22985136
    [Google Scholar]
  4. Wu L. Zhou J. Jiang Q. Nursing difficulties and clinical characters of patients of stage IV stress injury with secondary squamous cell carcinoma and its interventions: a 2- case study. Journal of Nursing(China) 2020 27 65 68
    [Google Scholar]
  5. Niemiec S.M. Louiselle A.E. Liechty K.W. Zgheib C. Role of microRNAs in pressure ulcer immune response, pathogenesis, and treatment. Int. J. Mol. Sci. 2020 22 1 64 10.3390/ijms22010064 33374656
    [Google Scholar]
  6. Mansfield S. Obraczka K. Roy S. Pressure injury prevention: a survey. IEEE Rev. Biomed. Eng. 2020 13 352 368 10.1109/RBME.2019.2927200 31283488
    [Google Scholar]
  7. Padula W.V. Delarmente B.A. The national cost of hospital‐acquired pressure injuries in the United States. Int. Wound J. 2019 16 3 634 640 10.1111/iwj.13071 30693644
    [Google Scholar]
  8. Niezgoda J.A. Mendez-Eastman S. The effective management of pressure ulcers. Adv. Skin Wound Care 2006 19 Suppl. 1 3 15 10.1097/00129334‑200601001‑00001 16565615
    [Google Scholar]
  9. Heyneman A. Vanderwee K. Grypdonck M. Defloor T. Effectiveness of two cushions in the prevention of heel pressure ulcers. Worldviews Evid. Based Nurs. 2009 6 2 114 120 10.1111/j.1741‑6787.2009.00153.x 19422672
    [Google Scholar]
  10. Lerman B. Oldenbrook L. Eichstadt S.L. Ryu J. Fong K.D. Schubart P.J. Evaluation of chronic wound treatment with the SNaP wound care system versus modern dressing protocols. Plast. Reconstr. Surg. 2010 126 4 1253 1261 10.1097/PRS.0b013e3181ea4559 20885246
    [Google Scholar]
  11. Nandhini J. Karthikeyan E. Rajeshkumar S. Nanomaterials for wound healing: Current status and futuristic frontier. Biomedical Technology 2024 6 26 45 10.1016/j.bmt.2023.10.001
    [Google Scholar]
  12. Zhang Q.H. Sun Z.R. Yue J.H. Ren X. Qiu L.B. Lv X.L. Du W. Traditional Chinese medicine for pressure ulcer: a meta‐analysis. Int. Wound J. 2013 10 2 221 231 10.1111/j.1742‑481X.2012.00969.x 22512889
    [Google Scholar]
  13. Wang Y.F. Que H.F. Xu J.N. Tang H.J. Xiang H.Y. Liu X.D. Zhang Z. Xing J. Shen L. Shan W. Liu A.M. Qiu L.Y. Deng D.Y. Gao D. Assessment of external methods of traditional Chinese medicine in patients with chronic ulcer of the lower extremities: study protocol of a multicenter, randomized, parallel-group, prospective trial. J. Chin. Integr. Med. 2012 10 2 166 175 10.3736/jcim20120207 22313884
    [Google Scholar]
  14. Chen Y. Xian Y. Lai Z. Loo S. Chan W.Y. Lin Z.X. Anti-inflammatory and anti-allergic effects and underlying mechanisms of Huang-Lian-Jie-Du extract: Implication for atopic dermatitis treatment. J. Ethnopharmacol. 2016 185 41 52 10.1016/j.jep.2016.03.028 26976763
    [Google Scholar]
  15. Gao S. Zhao J. Xu X. Xu W. Wang L. Chen G. Study on anti-systemic inflammatory response syndrome activity of Huanglian Jiedu Decoction. J. Pharma Res. 2018 37 15 56
    [Google Scholar]
  16. Gu X-R. Fang S-Y. Ren W. Wang H-J. Yang J. Si N. Bian B.L. Zhao H.Y. Pharmacodynamics of Huanglian Jiedu decoction in Alzheimer’s disease (AD) model rats and effect on improvement of inflammation microenvironment in brain. Zhongguo Zhongyao Zazhi 2018 43 14 3006 3011 30111062
    [Google Scholar]
  17. Hao S. He Q. Study on blood lipid metabolism of Huanglianjiedu decoction in treating hyperlipidemia rats. J. Yan’an Univer. 2018 16 18 21
    [Google Scholar]
  18. Zhou B. Luo S. Cai H. Progress in pharmacology and clinical application of Huanglian Jiedu Decoction. Zhongchengyao 1991 1 38 39
    [Google Scholar]
  19. Dong Y. Liu B. Xue E. Anti-inflammatory Effect of Huanglian Jiedutang and Clinical Application: A Review. Zhongguo Shiyan Fangjixue Zazhi 2021 27 245 250
    [Google Scholar]
  20. Luo H. Guan Z. Li Y. Huang J. Huang S. Li M. Study on the antibacterial effect of Huang-Lian-Jie-Du-Tang in different dosage-forms. Clini. Medi. Enginee. 2011 18 647 648
    [Google Scholar]
  21. Jiang L. Zuo Q. Zhang X. Luo Y. Li X. Guo W. In vitro bacteriostatic effect of coptis chinensis on intestinal pathogenic bacteria. Shipin Yu Fajiao Gongye 2022 48 101 105
    [Google Scholar]
  22. da Silva A.R. de Andrade Neto J.B. da Silva C.R. Campos R.S. Costa Silva R.A. Freitas D.D. do Nascimento F.B.S.A. de Andrade L.N.D. Sampaio L.S. Grangeiro T.B. Magalhães H.I.F. Cavalcanti B.C. de Moraes M.O. Nobre Júnior H.V. Berberine antifungal activity in fluconazole-resistant pathogenic yeasts: action mechanism evaluated by flow cytometry and biofilm growth inhibition in Candida spp. Antimicrob. Agents Chemother. 2016 60 6 3551 3557 10.1128/AAC.01846‑15 27021328
    [Google Scholar]
  23. Zhou F. Yang W. Wang L. In vitro antibacterial effect of coptidis decoction on 100 isolates of multi-drug resistant bacteria. Int. J. Lab. Med. 2018 39 3061 3065
    [Google Scholar]
  24. Loerakker S. Manders E. Strijkers G.J. Nicolay K. Baaijens F.P.T. Bader D.L. Oomens C.W.J. The effects of deformation, ischemia, and reperfusion on the development of muscle damage during prolonged loading. J. Appl. Physiol. 2011 111 4 1168 1177 10.1152/japplphysiol.00389.2011 21757578
    [Google Scholar]
  25. He J. Liu D. Zhao L. Zhou D. Rong J. Zhang L. Xia Z. Myocardial ischemia/reperfusion injury: Mechanisms of injury and implications for management.(Review) Exp. Ther. Med. 2022 23 6 430 10.3892/etm.2022.11357 35607376
    [Google Scholar]
  26. Zuidema M.Y. Zhang C. Ischemia/reperfusion injury: The role of immune cells. World J. Cardiol. 2010 2 10 325 332 10.4330/wjc.v2.i10.325 21160610
    [Google Scholar]
  27. Zhou F. Bian B. Wang L. Antimicrobial effect of Huanglian Jiedu Decoction combined with antibiotics on methicillinResistant staphylococcus aureus in vitro. Chin. J. Integr. Tradit. West. Medi. 2021 41 1377 1382
    [Google Scholar]
  28. Stadler I. Zhang R-Y. Oskoui P. Whittaker M.B.S. Lanzafame R.J. Development of a simple, noninvasive, clinically relevant model of pressure ulcers in the mouse. J. Invest. Surg. 2004 17 4 221 227 10.1080/08941930490472046 15371164
    [Google Scholar]
  29. Nakagami G. Morohoshi T. Ikeda T. Ohta Y. Sagara H. Huang L. Nagase T. Sugama J. Sanada H. Contribution of quorum sensing to the virulence of Pseudomonas aeruginosa in pressure ulcer infection in rats. Wound Repair Regen. 2011 19 2 214 222 10.1111/j.1524‑475X.2010.00653.x 21362089
    [Google Scholar]
  30. Niao F. Yang C. Cao L. Qian C. Zhuang J. Guo J. Cold atmospheric plasma promoting wound healing in rats with acute suppurative wound. Zhongguo Pifu Xingbingxue Zazhi 2021 35 855 860
    [Google Scholar]
  31. Sm P. Tc S. Gt R. Ischemia-reperfusion injury in chronic pressure ulcer formation: a skin model in the rat. Wound Repair Regen. 2000 8 1 68 76 10.1046/j.1524‑475x.2000.00068.x 10760216
    [Google Scholar]
  32. Dong W. Ye J. Wang W. Yang Y. Wang H. Sun T. Gao L. Liu Y. Self-assembled lecithin/chitosan nanoparticles based on phospholipid complex: a feasible strategy to improve entrapment efficiency and transdermal delivery of poorly lipophilic drug. Int. J. Nanomedicine 2020 15 5629 5643 10.2147/IJN.S261162 32801706
    [Google Scholar]
  33. Rincón M. Calpena A.C. Fabrega M.J. Garduño-Ramírez M.L. Espina M. Rodríguez-Lagunas M.J. García M.L. Abrego G. Development of pranoprofen loaded nanostructured lipid carriers to improve its release and therapeutic efficacy in skin inflammatory disorders. Nanomaterials (Basel) 2018 8 12 1022 10.3390/nano8121022 30544628
    [Google Scholar]
  34. National Pressure Injury Advisory Panel, Pan Pacific PressureInjury Alliance. Prevention and treatment of pressure ulcers/injuries:clinical practice guideline. Amsterdam, Netherlands EPUAP/NPIAP/PPPIA 2019 1 6
    [Google Scholar]
  35. Gupta V. Tyagi A. A rat model of polymicrobial infection in full-thickness excision wounds. J. Tissue Viability 2021 30 4 537 543 10.1016/j.jtv.2021.06.003 34148717
    [Google Scholar]
  36. Shan J. Chen H. Wen Y. Zhong G. Zhu J. Advances in research of TLR/MyD88/NF-KB signaling pathway in different diseases. Zhongguo Yaolixue Tongbao 2019 35 451 455
    [Google Scholar]
  37. Wang Y. Dai Y. Piao J. Liu C. Li M. Jiang L. The expressions and functions of inflammatory cytokines, growth factors and apoptosis factors in the late stage of pressure ulcer chronic wounds. Zhongguo Ying Yong Sheng Li Xue Za Zhi 2017 33 2 181 184 10.12047/j.cjap.5425.2017.046 29931928
    [Google Scholar]
  38. Sun H. Zhu L. Li R. Zeng H. Ma Y. Effect of Huanglian Jiedu Decoction containing serum on the function of neutrophils. Chin. J. Integ. Tradi. West. Med. 2021 41 212 217
    [Google Scholar]
  39. Xia M. Zuo Q. Ran Y. Yuan L. Huang P. Study on myocardial protective effect of Huanglian Jiedu Decoction on mice with coronary heart disease based on TLR4/NF-KB/NLRP3 signaling pathway. J. Clini. Experi. Med. 2024 23 225 229
    [Google Scholar]
  40. Liu Y. Zhang F. Sun H. Zhao H. Bian B. Analysis on anti-inflammatory mechanism of Huanglian Jiedu Decoction based on integrated pharmacology strategy. Zhonghua Zhongyiyao Zazhi 2019 34 4877 4880
    [Google Scholar]
  41. Parra A. Clares B. Rosselló A. Garduño-Ramírez M.L. Abrego G. García M.L. Calpena A.C. Ex vivo permeation of carprofen from nanoparticles: A comprehensive study through human, porcine and bovine skin as anti-inflammatory agent. Int. J. Pharm. 2016 501 1-2 10 17 10.1016/j.ijpharm.2016.01.056 26826569
    [Google Scholar]
  42. Wang H. Li Z. Xue Y. Advances in pharmacologic studies on treatments of allergic diseases by Chinese materia medica. Chin. Tradit. Herbal Drugs 2015 46 1542 1555
    [Google Scholar]
  43. Qi Y. Zhang Q. Zhu H. Huang-Lian Jie-Du decoction: a review on phytochemical, pharmacological and pharmacokinetic investigations. Chin. Med. 2019 14 1 57 10.1186/s13020‑019‑0277‑2 31867052
    [Google Scholar]
  44. Zheng R. Shi S. Zhang Q. Yuan S. Guo T. Guo J. Jiang P. Molecular mechanisms of Huanglian Jiedu decoction in treating Alzheimer’s disease by regulating microbiome via network pharmacology and molecular docking analysis. Front. Cell. Infect. Microbiol. 2023 13 1140945 10.3389/fcimb.2023.1140945 37009506
    [Google Scholar]
  45. Du H. Zhang G. Yang G. Tian W. Wang W. Wang P. He G. Study on the Effect of Huanglian Jiedu Decoction on the Composition of Gut Microflora in SD Rats Based on 16S rRNA Sequencing. Evid. Based Complement. Alternat. Med. 2020 2020 1 8872439 10.1155/2020/8872439 33376503
    [Google Scholar]
  46. Wu W. Zhang Y. Liu G. Chi Z. Zhang A. Miao S. Lin C. Xu Q. Zhang Y. Potential protective effects of Huanglian Jiedu Decoction against COVID-19-associated acute kidney injury: A network-based pharmacological and molecular docking study. Open Med. (Wars.) 2023 18 1 20230746 10.1515/med‑2023‑0746 37533739
    [Google Scholar]
  47. Yang S. Su P. Li L. Liu S. Wang Y. Advances and mechanisms of traditional Chinese medicine and its active ingredients against antibiotic-resistant Escherichia coli infections. J. Pharm. Anal. 2024 22 101117 10.1016/j.jpha.2024.101117
    [Google Scholar]
  48. Lee M.Y. Lin M.Y. Chang Y.J. Tseng Y.T. Huang I.A. Huang W.T. Liu Y-W. Efficacy and safety of modified huang-lian-jie-du decoction cream on cancer patients with skin side effects caused by EGFR inhibition. Processes (Basel) 2021 9 7 1081 10.3390/pr9071081
    [Google Scholar]
  49. Zhi X. Si S. Wang Y. Weng S. Clinical observation of modified huanglian jiedu decoction for the treatment of sepsis-associated acute kidney injury. J. Guang. Univer. Tradi. Chin. Med. 2023 40 609 614
    [Google Scholar]
  50. Han Q. Fan X. Wu J. Time and concentration dependence of antibacterial drugs and after-effects of antibacterial drugs. Xinji. Med. J. 2006 232 234
    [Google Scholar]
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A Study on the Anti-Inflammatory and Antibacterial Effects of Huanglian Jiedu Decoction in the Treatment of Pressure Injuries
Bentham Science Publishers ; https://doi.org/10.2174/0113862073240207250424192712
/content/journals/cchts/10.2174/0113862073240207250424192712
/content/journals/cchts/10.2174/0113862073240207250424192712
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  • Article Type:     Research Article
Keywords: anti-bacteria ; pressure injury ; antibacterial ; huanglian Jiedu decoction ; Traditional chinese medicine ; safety

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