Clinical efficacy of Radix Arnebiae oil in patients undergoing incision and drainage of perianal abscess and its effects on pyroptosis.

OBJECTIVE: The aim of this study was to assess the clinical efficacy of Radix Arnebiae oil (RAO) in patients undergoing incision and drainage of perianal abscess and to investigate its effects on pyroptosis-related factors, thereby providing evidence to support its clinical application and offering insights into its potential mechanism of action. METHODS: Ninety patients were randomly assigned to three groups (n = 30 per group) using a random number table: the RAO group, the Moist Exposed Burn Ointment (MEBO) group, and the petrolatum group. Beginning on postoperative day (POD) 1, the assigned topical agent was applied to the wound in each group and continued until complete wound healing. Pain and wound exudate scores were assessed on PODs 3, 7, and 14. In addition, wound healing rates and healing duration were recorded. Protein expression levels of caspase-1, interleukin (IL)-1β, and IL-18 were assessed using enzyme-linked immunosorbent assay (ELISA) and immunohistochemical (IHC) staining. RESULTS: Treatment with RAO significantly alleviated postoperative pain and reduced wound exudation following incision and drainage of perianal abscess. On POD 14, the corresponding scores in the RAO group were significantly lower than those in the MEBO and petrolatum groups (p < 0.05). The RAO group demonstrated a higher wound healing rate and a significantly shorter healing duration than the MEBO and petrolatum groups (both p < 0.05). The overall clinical efficacy was significantly greater in the RAO group than in the other two treatment groups (p < 0.05). ELISA findings on POD 14 showed significantly lower protein expression levels of caspase-1, IL-1β, and IL-18 in the RAO group than in the petrolatum and MEBO groups, with statistically significant differences (all p < 0.05). Consistent with these findings, IHC staining demonstrated reduced expression of these proteins in the RAO group compared with the MEBO and petrolatum groups. CONCLUSION: RAO alleviates postoperative pain, reduces wound exudation, and promotes wound healing in patients undergoing incision and drainage of perianal abscess. Its mechanism of action may be associated with the regulation of pyroptosis-related mediators, including caspase-1, IL-1β, and IL-18.