Clinical Study And Some Mechanisms Of Zhizhu Decoction On Slow Transit Constipation

ObjectiveSelecting raw rhizoma atractylodis macrocephala and fructus aurantii immaturus as the research objects and prucalopride as the control group,to study the clinical effect of different doses of Zhizhu Decoction of fructus aurantii irnmaturus combined with raw rhizoma atractylodis macrocephala by 3:7 on slow transit constipation,and to find out the best dosage of Zhizhu 3:7 compatibility,which was called Zhizhu Decoction.And futher to explore the specific efficacy advantages and partial mechanisms of Zhizhu Decoction in the treatment of slow transit constipation.Methods1.Clinical research1.1 Dose-effect analysis of fructus aurantii immaturas combined with raw rhizoma atractylodis macrocephala by 3:7 in the treatment of slow transit constipationAccording to the clinical dosage range of fructus aurantii immaturus and raw rhizoma atractylodis macrocephala by 3:7,the low dose group of Zhizhu(fructus aurantii immaturus 12g combined with raw Rhizoma Atractylodis macrocephala 28g),the medium dose group of Zhizhu(fructus aurantii irmmaturus 21 g combined with raw Rhizoma Atractylodis macrocephala 49g)and the high dose group of Zhizhu(fructus aurantii immaturus 30g combined with raw Rhizoma Atractylodis macrocephala 70g)were set up,with the Prucalopride group was as the control group.To study the clinical efficacy of high dose raw rhizoma atractylodis macrocephala combined with fructus aurantii immaturus on STC patients by evaluating the first defecation time,fecal character score,constipation symptom score and quality of life score after taking the medicine,the best effective dose of fructus aurantii immaturus combined with raw rhizoma atractylodis macrocephala by 3:7 was expected.1.2 Clinical research of Zhizhu Decoction in the Treatment of Slow Transit ConstipationThe best compatible dose of raw rhizoma atractylodis macrocephala combined with fructus aurantii immaturus(called Zhizhu Decoction)obtained from clinical research one was used to treat STC patients.Through the concrete analysis of constipation symptom score(cleveland constipation score,CCS),including seven aspects in the frequency of defecation,the difficulty of defecation,the feeling of incomplete defecation,the degree of abdominal pain,the time of every defecation,the type of assistance needed in defecation,the number of empty defecation per day,the quality of life measure score(patient assessment of constipation-quality of life,the PAC-QOL)including four aspects in the physiological,psychological,anxiety and satisfaction,to analyze the efficacy and specific advantages of Zhizhu Decoction in the treatment of STC.2.experiment researchTaking STC rats as the research object,we observed the intestinal transit function of rats and the expression of 5-HT3R and 5-HT4R in colon tissue of rats,and compared with the Prucalopride group,to explore the partial mechanisms of Zhizhu Decoction in the treatment of STC.Results1.Clinical researchWhen fructus aurantii immaturus combined with raw rhizoma atractylodis macrocephala by 3:7,the first defecation time was significantly shorter with the greater of the ZhiZhu dose(P<0.05).The first defecation time of the high dose group of Zhizhu was similar to that of the Prucalopride group(P>0.05).The score of fecal traits in the low dose group of Zhizhu was lower than that in the high dose group of Zhizhu and the Prucalopride group,and the difference was statistically significant(P<0.05).Two comparisons among the low dose group of Zhizhu,the medium dose group of Zhizhu and the high dose group of Zhizhu,the CCS and the PAC-QOL scores lift were more obvious with the increase of drug dosage.After treatment with Zhizhu Decoction,the frequency of defecation,the difficulty of defecation,the feeling of incomplete defecation,the time of every defecation and the number of empty defecation per day were significantly improved compared with those before treatment(P<0.05),the physiological,psychological,anxiety and satisfaction were significantly improved compared with those before treatment(P<0.05).2.experiment researchThe promote rate of carbon powder of rats in the Zhizhu group,the Prucalopride group and the healthy control group were similar(P>0.05),which were significantly higher than that in the model control group(P<0.05).The expression of 5-HT3R and 5-HT4R protein and mRNA in colon tissue of rats in the Zhizhu group were similar to those in the Prucalopride group(P>0.05),which were significantly higher than those in the model control group(P<0.05)and lower than those in the healthy control group(P<0.05).ConclusionFructus aurantii immaturus 30g combined with raw rhizoma atractylodis macrocephala 70g by 3:7 which was called Zhizhu Decoction had the strongest intestinal motility,which could significantly improve the constipation symptoms and the life quality of patients.It may promote intestinal peristalsis by upregulating the expression of 5-HT3R and 5-HT4R in colon tissue.