Prevalence Of Travelers’ Diarrhea And Therapeutic Effect And Mechanism Research Of Sanren Decoction

As a special type of infectious diarrhea,the incidence of travelers’ diarrhea(TD)can be as high as 70%.TD not only have an impact on the health of human body,but also caused a certain economic loss.As college students go to study in the unfamiliar place from their hometown,they have the characteristics of sojourning,so they are the susceptible group of TD.Throughout epidemiological research status of TD,TD often occurs in the high temperature and humidity area or season.The greater the difference between the environment of departure and destination,the higher the incidence.The longer you stay,the lower the incidence.Xiamen which is located in the west side of the channel,with Taiwan across the sea is subtropical maritime monsoon climate.Damp-heat syndrome is the common syndrome of TD.Sanren decoction which comes from Wenbingtiaobian written by Wu Jvtong is used for the treatment of damp-heat syndrome.Therefore,this research intends to use the questionnaire survey in the freshmen of Xiamen university to know the incidence of TD and the difference between different climate zone,to observe the wet and heat stress effects on TD.And this study also observed the effect of Sanren decoction on URS in ileal tissue of diarrhea mice under the effect of damp-heat stress.To explore the pathogenesis and Sanren decoction prevention and control mechanism.Objective:1.The study aims to use the questionnaire survey in the freshmen of Xiamen university in 2014-2015 to investigate,in order to observe the influence of damp and hot environment on TD,for TD basic research and clinical prevention,diagnosis and treatment,to provide a certain basis and direction.2.1n this study,the diarrhea mice model under damp-heat stress was induced by compound factors(external damp-heat stress and E.coli ETEC infection).To observe the behavioral changes of Sanren Decoction on ETEC-induced diarrhea in mice under damp-heat stress.And discussion ATF6、GRP78、HSP70、NF-κB expression.We analyze and discuss the mechanism of heat stress on GR78 signal transduction and downstream NF-kB signal transduction,and the mechanism of Sanren decoction.Methods:1.The survey was conducted by filling out questionnaires of the students in Xiamen university in 2014-2015.According to their hometown,they were divided into seven groups:Middle Temperate Zone,South Temperate Zone,North Zub-tropical Zone,Middle Zub-tropical Zone,South Zub-tropical Zone,North Tropical Zone,Highland Climate Zone.Establish a database,the income date descriptive and inferential statistical analysis.2.100 clean BABL/c mice were used and randomized.Through the high temperature and high humidity stimulation,the toxicity of E.coli intraperitoneal injection,comprehensive construction of damp-heat diarrhea animal model,given Sanren decoction treatment,given rifaximin as a positive control.The expression of ATF6、GRP78、HSP70 and NF-κB were detected by real-time fluorescence quantitative PCR.The pathological changes of ileum were observed by HE staining.Results:1.Xiamen university freshmen in 2014-2015 overall diarrhea rate was 7.34%.The boys prevalence was 5.51%,the girls prevalence was 10.70%.Girls diarrhea rate is higher than boys,male and female diarrhea ratio of 1:1.864.The differences between male and female was statistically significant(P<0.05).The incidence of each climatic zone was respectively 3.74%(7/187),9.36%(28/299),6.67%(15/225),7.59%(34/448),8.2%(28/350),15%(3/20)and 0%(0/38).There was no statistically significant difference among each climatic zone(P>0.05).2.①In the model group,the mice in the damp-heat model group were feverish,infattuated,dull,Perianal swelling,Pond or mucus.HE staining of ileum tissue in damp-heat model mice showed mucosal congestion,edema,exudation,lymphoid tissue hyperplasia and extensive inflammatory cell infiltration.②The mRNA levels of ATF6 in the ileum tissue of the 6th hour model group were lower than blank control group,and have significant statistical differences.The mRNA levels of GRP78 in the ileum tissue of the 6th hour model group were more increasingly than the blank control group,and have significant statistical differences.The mRNA levels of NF-kB in ileum tissue of the Chinese medicine were significantly decline than those in the damp-heat model group.The mRNA levels of HSP70 in ileum tissue of the Chinese medicine group and the positive control group were significantly decline than those in blank control group.The Chinese medicine group compared with the positive control group in the other indicators no significant difference.③In the 18th hour,the mRNA levels of ATF6 in ileum tissue of the model group,the damp-heat model group,the positive control group and the Chinese medicine group were significantly decline than those in the blank control group.There were no significant difference among all the group.The mRNA levels of NF-kB in ileum tissue of the positive control group and the Chinese medicine group were significantly increase than those in the damp-heat model group.The mRNA levels of HSP70 in ileum tissue of the positive control group and the Chinese medicine group were significantly increase than those in the damp-heat model group.Conclusion:1.Xiamen university freshmen in 2014-2015 overall diarrhea rate was in low risk area of TD.The prevalence of TD female than for male,in the incidence of TD risk area level.Therefore,we should strengthen the education of TD’s in girls at the beginning of the new term.2.On the basis of the intraperitoneal injection of E.coli,artificial climate incubator,automatically adjust the temperature,humidity,heat diarrhea syndrome model system,reflecting the heat TCM syndrome stomach injuries,then induced the pathogenic characteristics.Damp-heat stress and ETEC infection can cause excessive expression of HSP70 in ileum tissue of mice at 6th hour,which is the reason for aggravating the inflammatory response.HSP70 may modulate the activation of NF-kB.Sanren decoction could protect the host cells,inhibit the transmission of GRP78 signaling pathway and delay the downstream NF-kB expression by maintaining high expression of HSP70.This will control the body inflammation,to achieve the effect of preventive treatment.