To evaluate the efficacy and safety of TCM virtual hanging therapy combined with mesenchymal stem cellsin the treatment of CD anal fistula. To establish the standard of clinical diagnosis and treatment and thestandard procedure of operation for the treatment of CD anal fistula by virtual hanging therapy combinedwith mesenchymal stem cells.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
90
Combines TCM dummy therapy with mesenchymal stem cell injection, integrating traditional local stimulation and modern stem cell regenerative mechanisms.
Utilizes traditional thread-embedding techniques, placing specialized threads at specific sites to effectively drain inflammatory exudates and necrotic materials.
Administers mesenchymal stem cell injections directly to target areas, leveraging their differentiation and anti-inflammatory properties to enhance tissue repair.
Nanjing Hospital of Traditional Chinese Medicine (Affiliated Hospital of Nanjing University of Chinese Medicine)
Nanjing, Jiangsu, China
CD anal fistula healing rate
Post-treatment healing rate of Crohn's disease-related anal fistula, defined as clinical closure of all external fistula openings in patients, combined with MRI-confirmed fistula tract healing.
Time frame: From enrollment to the end of treatment at 24 weeks
CDAI
A clinical scoring system to quantify disease activity in Crohn's disease (CD) patients, integrating symptoms (e.g., abdominal pain, diarrhea) and laboratory parameters (e.g., hemoglobin, ESR).0\~600(\~600, theoretically no upper limit).Higher scores indicate worse disease activity (poorer outcome).
Time frame: From enrollment to the end of treatment at 24 weeks
PDAI
A standardized tool to assess the severity of perianal complications (e.g., fistulas, abscesses) in Crohn's disease, combining clinical symptoms (e.g., pain, discharge) and imaging findings.0-20.Higher scores indicate worse perianal disease activity (poorer outcome).
Time frame: From enrollment to the end of treatment at 24 weeks
IBDQ
A validated patient-reported outcome measure evaluating the quality of life in IBD patients across physical, emotional, and social domains.32-224.Higher scores indicate better health-related quality of life (better outcome).
Time frame: From enrollment to the end of treatment at 24 weeks
Van Assche
An MRI-based scoring system for perianal fistulas, grading anatomical complexity (e.g., fistula branches, abscesses) and inflammatory activity to guide therapeutic strategies.0-12.Higher scores indicate more severe perianal fistulizing disease on MRI (poorer outcome).
Time frame: From enrollment to the end of treatment at 24 weeks
VAS
A unidimensional pain assessment tool where patients mark their pain intensity on a 10-cm line (0=no pain, 10=worst pain).
Time frame: From enrollment to the end of treatment at 24 weeks
Wexner
A validated scoring system to evaluate constipation severity based on stool frequency, straining, incomplete evacuation, and associated symptoms (e.g., abdominal bloating).0-20.Higher scores indicate worse fecal incontinence severity (poorer outcome).
Time frame: From enrollment to the end of treatment at 24 weeks
Erythrocyte Sedimentation Rate (ESR)
A nonspecific inflammatory marker reflecting the rate at which red blood cells settle in a tube over one hour; elevated in infections, autoimmune diseases, or chronic inflammation.
Time frame: From enrollment to the end of treatment at 24 weeks
Fecal Calprotectin
A stool biomarker of intestinal inflammation, reflecting neutrophil activity; used to differentiate inflammatory bowel disease (IBD) from functional gastrointestinal disorders.
Time frame: From enrollment to the end of treatment at 24 weeks
C-reactive Protein (CRP)
An acute-phase protein synthesized by the liver; elevated serum levels indicate systemic inflammation, infection, or tissue damage.
Time frame: From enrollment to the end of treatment at 24 weeks
Anorectal Manometry
Primary outcome measures: Anal Resting Pressure (basal sphincter pressure at rest; normal 40-80mmHg; \<40mmHg=incontinence risk), Maximum Anal Squeeze Pressure (peak voluntary squeeze; normal 100-200mmHg; \<100mmHg=sphincter impairment), Recto-anal Pressure Gradient (rectal-anal pressure difference; normal -20 to -50mmHg; positive=dyssynergic defecation). Secondary: First Sensation Volume (minimal rectal balloon volume for sensation; normal 10-30mL; \>30mL=hyposensitivity), Urge Volume (volume for sustained defecation urge; normal 40-80mL; \>80mL=severe sensory dysfunction), Max Rectal Volume (max tolerated distension; normal 120-200mL; \<120mL=low compliance), Balloon Expulsion Time (time to expel 50mL balloon; normal ≤60s; \>60s=pelvic dyssynergia), Anal High Pressure Zone Length (axial sphincter length; normal 2.0-4.0cm; \<2.0cm=anatomical defect).
Time frame: From enrollment to the end of treatment at 24 weeks
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