Research On The Central Mechanism Of Qi-deficiency Functional Constipation Based On Resting Brain Functional Magnetic Resonance Imaging

Objective:The patients with functional constipation were selected as the research subjects,and the clinical efficacy of Buzhong Yiqi Decoction plus in treating qi deficiency type functional constipation was observed.Amplitude of Low-Frequency Fluctuation(ALFF)of the resting state functional magnetic resonance(rs-f MRI)was used to observe the changes of spontaneous neural activity in patients with functional constipation,by comparing patients with functional constipation with healthy control group.Patients with functional constipation were compensated for the difference of brain function imaging characteristics between before and after treatment of Buzhong Yiqi Decoction plus and between patients with functional constipation treated with Buzhong Yiqi Decoction plus and healthy control group,and analysis of brain function changes with central nervous system.Methods:Twenty-six patients with functional constipation(FC group)and 25 healthy subjects(HC group)with age,gender,education level and BMI were matched for rs-f MRI,and FC group was treated with Buzhong Yiqi Decoction plus.The rs-f MRI examination was performed again 28 days later.Anxiety self-rating scale,self-rating depression questionnaire,and constipation main symptom score scale were evaluated for all subjects.The resting-state f MRI data was analyzed by statistical parameter map(SPM8)software,and the brain regions with different ALFF values between groups and groups were obtained.Results:1.Before the screening of the subjects,the two groups were tested with the Self-rating Anxiety Scale(SAS)and the Self-rating Depression Scale(SDS).The results showed that the functional constipation group was on the self-rating scale of anxiety and depression.The scores of the aspects were significantly higher than those of the healthy control group,indicating that patients with functional constipation had a higher degree of anxiety and depression.2.In the total score of the main symptoms of constipation,the total scores of the main symptoms of constipation before,during and after treatment were significantly higher than those of the healthy control group(P<0.05),and the functional constipation group before treatment,There was a significant difference in the total score between the three groups at the time of follow-up and after treatment(P<0.05).Among them,the total score at the time of follow-up was significantly lower than that before treatment,and the total score after treatment was significantly lower than that at the time of follow-up,indicating that the main clinical symptoms of patients suffering from functional constipation were significantly improved with the extension of medication time.3.Differences in the main symptoms of constipation before treatment,at the time of re-examination and after treatment were found.The main symptoms were compared at these three time points,and the differences were statistically significant(P<0.05).And the main symptoms were the lowest in the time after treatment,indicating that the severity of each symptom is the lightest at this time,suggesting that Buzhong Yiqi Decoction plus has certain clinical aspects in improving the specific symptoms of functional constipation.4.At rest-state,patients with functional constipation had significantly higher levels ofactivity in the bilateral thalamus and right parahippocampal gyrus in the cerebral region before treatment.The activity level of the right Superior frontal gyrus,dorsolateral,the left Superior frontal gyrus,medial,the right Inferior frontal gyrus,triangular part and middle frontal gyrus was significantly lower than that of the healthy subjects.Patients with functional constipation had elevated levels of brain activity in the left parahippocampal gyrus and bilateral thalamic regions before treatment;and in the right Superior frontal gyrus,dorsolateral,the left Superior frontal gyrus,medial,the right Inferior frontal gyrus,triangular part and middle frontal gyrus,the level of brain activity was reduced.Patients with functional constipation had significant differences in the bilateral Precentral gyrus and left Postcentral gyrus compared with the healthy control group after treatment,and their activity levels were significantly increased;the activity level of the right Precuneus was weakened.Conclusion:The results of this trial suggest that the use of Buzhong Yiqi Decoction plus reduction in the treatment of qi deficiency functional constipation can effectively alleviate the main clinical symptoms of patients,and thus improve the quality of life of patients.At the same time,mental and psychological factors such as anxiety and depression play an important role in the pathogenesis of patients with functional constipation.The emotional disorders such as anxiety and depression in functional constipation patients are significantly stronger than those in healthy people.The treatment with Buzhong Yiqi Decoction plus can effectively improve Anxiety,depression,and defecation disorders in patients with functional constipation may be related to the activation of brain regions associated with visceral activity,emotional management,somatosensory and motor.