| Objective:To investigate the clinical efficacy and effect of Daishi decoction on the quality of life in patients with post-infection irritable bowel syndrome(PI-IBS).To confirm the existence of mechanical barrier dysfunction of intestinal mucosa in PI-IBS rats,and to explore the effect of Baishi decoction on the microstructure of mechanical barrier of intestinal mucosa.Methods:60 patients with clinical compliance with PI-IBS were selected and divided into treatment group(30 cases)and control group(30 cases).The treatment group was treated with Baishi decoction,while the control group was treated with piveronium bromide tables for 4 weeks.The total score of TCM syndromes,the scores of individual symptoms and the scores of Irritable Bowel Syndrome Quality of Life scale(IBS-QOL)before and after treatment were observed and recorded to evaluate the efficacy.Meanwhile,40 SD rats were randomly divided into normal group,blank control group,positive control group and Baishi Decoction group.The rat model of PI-IBS was established by acetic acid enema.Administration of the drug or distilled water once a day for 2 weeks began 6 days after recovery.The general conditions of the rats were observed,the visceral sensitivity of the rats was evaluated by detecting the abdominal wall withdrawal reflex(AWR),and the intestinal mucosal barrier was evaluated by observing the epithelial microstructure of the rats under electron microscopy.Results:Clinical observation indicated that the total score of TCM syndromes in both groups improved after treatment compared with before treatment(P<0.001),and the treatment group was better than the control group(P<0.001).In terms of single symptom score,both groups improved after treatment compared with before treatment(P<0.05).The treatment group was superior to the control group in terms of stool frequency,stool characteristics,sense of urgency in defecation,bitter or halitosis in mouth,attack or aggravation after cold,and intestinal rumination(P<0.05).The total effective rate was 93.33%in the treatment group and 86.67%in the control group,and the curative effect of the treatment group was better than that of the control group(P<0.05).In terms of quality of life score,both groups showed a decrease after treatment compared with before treatment(P<0.001),and the treatment group was better than the control group(P<0.05),especially in the dimension of dysphoria(P<0.001).The recurrence rate was 17.86%in the treatment group,46.15%in the control group,and lower in the treatment group than in the control group(P<0.05).The results of animal experiments indicated that when AWR=3 in the blank control group,the injection volume was lower than that in the normal control group(P<0.01),while that in the positive control group and the Baishi Decoction group was higher than that in the blank control group(P<0.05),indicating that Baishi Decoction could reduce the visceral sensitivity of PI-IBS rats.Under electron microscopy,the intestinal mucosal barrier of rats in the blank control group was damaged.The mucosal performance of rats in the Baishi Decoction group was improved compared with that in the blank control group,and was better than that in the positive control group,which was close to the normal group,suggesting that Baishi Decoction could repair the intestinal mucosal barrier damage in PI-IBS rats.Conclusion:The mechanism of Baishi decoction in treating irritable bowel syndrome after infection may be related to repairing the damaged intestinal mucosal mechanical barrier,reducing visceral sensitivity and intestinal permeability. |
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