Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis

My research focuses on treating ulcerative colitis and aims to explore how Chinese herbal retention enema can be used effectively for this purpose. Chinese herbal retention enema offers better efficacy and greater safety compared to conventional treatments for ulcerative colitis. We plan to conduct multicenter randomized trials and the in vivo/in vitro experiments to further validate the efficacy and explore the mechanisms of Chinese herbal retention enema.

[Narrator] To begin administer conventional treatment to the control group with oral mesalazine enteric coated tablets at a dose of four grams per day. Provide the enema group with an additional daily Chinese herbal retention enema. To prepare for the procedure, close the room's doors and windows. Adjust the room temperature to approximately 22 to 28 degrees Celsius, and use a privacy screen to protect the patient's privacy. Wash hands thoroughly and don gloves and a face mask. Inspect the perianal area for any lesions or contraindications. Inspect the skin for signs of redness, swelling, irritation, warmth, tenderness, or discharge. Palpate and visually inspect for hemorrhoids, such as swelling, prolapse, or bleeding, and check for all possible abnormalities. Clean the perianal area thoroughly to remove fecal residue or debris. Report any contraindications, such as recent surgery or infections, to the physician immediately. Position the patient in the left lateral decubitus position with knees flexed. Loosen the clothing to fully expose the anal area. Place a medical drape under the buttocks and elevate the hips by 10 centimeters using a cushion. Place a fenestrated drape over the patient's hips. Adjust the patient's position based on lesion location. Use the left lateral position for rectal and sigmoid colon lesions, and use the right lateral position for ileocecal lesions. Measure the herbal decoction temperature to ensure it is between 39 to 41 degrees Celsius, using a water thermometer. Close the enema bag tube clamp to prevent leakage and fill the disposable enema bag with no more than 200 milliliters of the decoction. Hang the enema bag, ensuring the liquid level is no more than 30 centimeters above the anus. Lubricate the rectal tube tip with paraffin oil. Instruct the patient to perform deep oral breathing and gently insert the rectal tube 15 to 25 centimeters into the rectum. Adjust the rectal tube insertion depth according to lesion location. Open the enema bag tube clamp and begin dripping the herbal decoctions slowly. Adjust the infusion rate based on the patient's condition and tolerance. Maintain the infusion over 15 to 20 minutes while continuously observing the patient and asking about their tolerance throughout the process. If the patient experiences discomfort or an urge to defecate, reduce the rate or stop the procedure. Stop the enema immediately, if the patient shows signs such as rapid pulse, pale complexion, cold sweats, severe abdominal pain, or palpitations. Clamp the enema tube once the infusion is complete. Slowly remove the tube while instructing the patient to contract the anal sphincters. Use gauze to cleanse the perianal area thoroughly. Instruct the patient to remain in a supine position with hips elevated for 60 minutes. Provide a bed pan to assist with controlled evacuation after the retention period. For patients with poor retention of less than 30 minutes, add two to three milliliters of 1% lidocaine to the herbal decoction after obtaining physician approval. Dispose of all biohazardous waste in designated containers. Disinfect all reusable equipment according to the technical specification for disinfection in healthcare facilities. Document the details of the procedure and the patient's response. The study included 22 UC patients from the Department of Gastroenterology. After treatment, the control group showed significant improvement in diarrhea, mucopurulent bloody stools, and abdominal pain scores, but not in tenesmus. The enema group showed significant improvement in all symptom scores including diarrhea, mucopurulent bloody stools, abdominal pain, and tenesmus after treatment. After treatment, the control group showed significant improvements in bowel symptoms, systemic symptoms, emotional function, and total score, but not in social function. The enema group showed significant improvement in all domains of the IBDQ, including bowel symptoms, systemic symptoms, emotional function, social function, and total score after treatment.