Based On Evidence-based Medicine Method And Animal Experiment,preliminary Discussion On The Promoting Gastrointestinal Motility And Related Mechanisms Of Banxia Xiexin Decoction

This research firstly combs the effective medical case of Professor Jiang Jian's treatment of Pi Man disease through data mining method,and concludes that “Banxia Xie xin Decoction“ is the basic prescription,and at the same time,“ regulate,digest,melt,clear and tonify “ The method is the diagnosis and treatment characteristics of the basic prescription principle;the meta-analysis is used to evaluate the effectiveness and safety of Banxia Xiexin Decoction in the treatment of functional dyspepsia,and to verify the diagnosis and treatment of Professor Jiang Jian's treatment of Pi Man disease;At the same time,animal experiments showed that Banxia Xiexin Decoction promoted gastrointestinal motility,and studied the mechanism of gastrointestinal motility induced by Banxia Xiexin Decoction from the perspective of brain-intestinalaxis and brain-gut peptide.Study 1 Based on data mining method to analyze the law of potential diagnosis and treatment in Professor Jiang Jian's caseObjective:Using data mining methods to analyze the characteristics of Professor Jiang Jian's diagnosis and treatment of suffocation.This study can not only comb the experience of Professor Jiang Jian's own clinical experience,but also find evidence-based evidence for Ban xia Xie xin Decoction in the treatment of Pi Man disease.Methods:Construct the database of Professor Jiang Jian's clinical document using Epidata software.Selecting the case of Pi Man disease from December 2016 to December 2018 at the specialist outpatient clinic of Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine,Convert text-based medical records into formats that can be identified by data mining techniques.By using Apriori nodes in IBM SPSS Modeler,through frequency analysis,description analysis,association rules,network visualization,and other methods,this article analyzes the potential interaction between the “disease-symdrome-Fang-symptom-medicine“ in Professor Jiang Jian's effective medical cases of stomach swelling.Results:Through a variety of data mining methods,the core data of the “ disease-symdrome-Fang-symptom-medicine “ interaction relationship in Professor Jiang Jian's treatment of stomach swelling.Based on the results of data mining on medical records,it can be concluded that the “ Ban xia Xie xin Decoction “ is the basic prescription,and the five principles of “regulate,digest,melt,clear and tonify“ are the basic principles for the treatment of this disease.From the perspective of evidence-based medicine,the therapeutic effect of Ban xia Xie xin Decoction on this disease was clarified.Conclusion: Frequency data analysis,description analysis,association rules,network visual maps and other data mining methods can dig out the potential interaction between “ disease-symdrome-Fang-symptom-medicine “ from text-type medical cases.The results are in line with the theoretical basis of Chinese medicine and the law of clinical practice.Data mining methods can be used as an effective tool for evidence-based research in traditional Chinese medicine.Banxia Xiexin Decoction can be used as a basic prescription for the treatment of stomach swelling.Study 2 Systematic evaluation and meta-analysis of Banxia Xiexin Decoction in the treatment of functional dyspepsiaObjective:To evaluate the efficacy and safety of Banxia Xiexin Decoction in the treatment of functional dyspepsia.Methods:This study has searched six databases including China Knowledge Network(CNKI),Weipu Chinese Journal Database(VIP),Wanfang Digital Journal Full-text Database(Wan Fang data),China Biomedical Literature Database(CBM),Pub Med,and Cochrane Library.The included literature was subjected to a bias risk assessment using the revman5.3 software provided by the Cochrane Collaboration,and data integration analysis was performed.Results:A total of 25 randomized controlled trials were included in the study,including a total of 2,428 patients,including 1264 patients in the Banxia Xiexin Decoction group,1164 patients in the control group,30 patients in the minimum sample,and 90 patients in the largest sample.Compared with the western medicine group,Banxia Xiexin Decoction or Banxia Xiexin Decoction can increase the total effective rate [OR =3.89,95% CI(3.02,5.01),Z =10.52,P <0.05];Increase cure rate [OR =2.42,95% CI(1.94,3.01),Z =7.94,P <0.05];Reduce the TCM syndrome score;There is no significant difference in the effect of Banxia Xiexin Decoction and Western medicine on increasing fasting plasma motilin[RR =2.63,95% CI(-18.86,24.12),Z =0.24,P>0.05];There is no significant difference in the effect of Banxia Xiexin Decoction and Western medicine on reducing the adverse reaction rate [OR =0.44,95% CI(0.19,1.04),Z =1.87,P >0.05].Conclusion: The evidence of the high risk of bias we have obtained demonstrates that Banxia Xiexin Decoction can effectively treat functional dyspepsia,but the interpretation of the results of this study should be cautious.The safety and efficacy of Banxia Xiexin Decoction in the treatment of functional dyspepsia need to be further validated by high-quality randomized controlled trials.Study 3 Preliminary study on the gastrointestinal motility and brain-gut peptide related mechanism of Banxia Xiexin DecoctionObjective:To explore the role of gastrointestinal motility and its mechanism in the treatment of Banxia Xiexin Decoction,and provide pharmacological basis for the clinical application of this side.Methods:1.Pharmacodynamic study:(1)After adaptive feeding,the mice were randomly divided into blank group,model group,metoclopramide group(10 mg/kg),low dose group(4.71 g/kg),equivalent dose group(9.43 g/kg),High dose group(18.86g/kg).Each group was administered by intragastric administration for 14 days.After the last administration,except for the blank group,the other groups were given intraperitoneal injection of atropine.After 20 minutes,the gastric emptying experiment and the small intestine propulsion rate experiment were performed.(2)To establish a rat model of gastric dysfunction and functional dyspepsia,and to verify the successful modeling by gastric emptying test and small intestine propulsion rate experiment,the rats with successful modeling were grouped according to the random number table and divided into model groups.,mosapride group(10mg/kg),Banxia Xiexin Decoction low dose group(3.3g/kg),equivalent dose group(6.6g/kg),high dose group(13.2g/kg),Blank group.Each group was administered intragastrically for 14 days.During the study period,changes in body weight,food consumption,and water consumption were continuously recorded,and gastric emptying experiments and small bowel propulsion rates were performed after the last administration.2.Mechanism study: Brain peptides(Ghrelin,CCK,SS,SP,CGRP,LEP,VIP,MLT)in serum,gastric tissue and hypothalamus of each group were detected by Elisa,Real-time PCR and Western blotting.The test was performed and the experimental results were processed using the SPSS21.0 statistical software package.Results:1.Pharmacodynamic study:(1)Intraperitoneal injection of atropine in mice can significantly delay gastric emptying and intestinal propulsion in mice,compared with the blank group,the difference is statistically significant(P < 0.05);mosapride group and The low-equivalent,high-dose group of Banxia Xiexin Decoction can antagonize the decrease of gastric emptying rate and the slowing of intestinal propulsion caused by atropine.Compared with the model group,the difference was statistically significant(P < 0.05);positive control drug There were no significant differences between the group and the low,middle and high dose groups of Banxia Xiexin Decoction and the blank group(P>0.05).(2)After removing some of the pathogenic factors(small platform standing)in the model group,the gastric emptying rate and the small intestine propulsion rate all rebounded to some extent.Compared with the model,the difference was statistically significant(P< 0.05).The low-dose group,the equivalent dose group,the high-dose group and the mosapride group of Banxia Xiexin Decoction group had higher gastric emptying rate and small intestine propulsion rate than the model group after group therapy.Statistically significant(P< 0.05).2.Mechanism study: Compared with the model group,Banxia Xiexin Decoction low dose group,equivalent dose group,high dose group and mosapride group can increase the secretion of ghrelin and SP to different degrees,and then increase circulating serum.And the content of hypothalamus;compared with the model group,Banxia Xiexin Decoction low dose group,equivalent dose group,high dose group and mosapride group can reduce the secretion of CCK,VIP,CGRP to varying degrees,and then Reduce the circulating serum and the content of the hypothalamus;it is worth noting that the model group SS decreased in the gastric secretion,the circulating serum content also decreased,but the expression level in the hypothalamus was reversed,the reason may be related to the circulation of blood into the lower The corresponding hormone content in the thalamus is reduced,causing negative feedback regulation,which is related to the increase of SS content in the hypothalamus.Conclusion: 1.Ban xia Xie xin Decoction has the effect of promoting gastrointestinal motility in rats with gastrointestinal motility disorder;2.Gastrointestinal dysmotility of functional dyspepsia is associated with brain-gut peptide imbalance with gastrointestinal promotion and inhibition.3.Ban xia Xie xin Decoction may play a role in improving gastrointestinal motility by regulating unbalanced brain-gut peptides.