| Objective:To observe the clinical efficacy of Chang Kang Fang in the treatment of irritable bowel syndrome-constipation(liver depression and qi stagnation syndrome).And to explore the partial mechanism of Chang Kang Fang in the treatment of irritable bowel syndrome-constipation.Methods:Clinical observation:Sixty patients with irritable bowel syndrome-constipation(liver depression and qi stagnation syndrome)were divided into observation group and control group.The two groups were treated with Chang Kang Fang(1 dose/day,morning and evening)and mosapride citrate tablets(5 mg/time,3 times per day)for 4 weeks.The changes of TCM syndrome score and IBS-SSS scale score were analyzed before and after the course of treatment.Animal experiment:The rat model of irritable bowel syndrome-constipation was established by intragastric administration of ice water.Then they were divided into 6 groups:Chang Kang Fang high,middle and low dose group,positive drug group,model group and blank group,with 10 rats in each group.After 14 days of administration,the intragastric administration volume was 2 ml per rat per day,in which the positive drug group was given 0.156 mg/ml mosapride citrate suspension,the low,middle and high dose Chang Kang Fang groups were given intragastric administration of 0.47 g/ml,0.94 g/ml and 1.88 g/ml Chang Kang Fang respectively,and the model group and blank group were given normal saline.The general condition,defecation,abdominal wall withdrawal reflex score and intestinal ink propulsion rate of rats in each group were observed and compared before and after administration.Results:1.Clinical observation:(1)There was no significant difference in general data(sex,age)between the two groups(P>0.05).(2)TCM syndrome scores:①Before treatment,there was no significant difference between the total scores and individual scores of the two groups of patients(P>0.05).After 4 weeks of treatment,the total effective rate(90.00%)of the observation group was significantly higher than that of the control group(60.00%)(P<0.05).③The total scores of the two groups were lower than before treatment(P<0.05),and the total scores of the observation group were significantly lower(P<0.05),indicating that the overall condition of the observation group was improved more significantly.④The scores of TCM single syndrome in the observation group were lower than those before(P<0.05),and those in the control group were also lower than those in the control group(P<0.05),and there was no significant difference in the scores of constipation,abdominal pain and abdominal distension between the two groups(P>0.05).However,the scores of difficult defecation,chest distension,belching and irritability in the observation group were lower than those in the observation group(P<0.05).(3)The scores of IBS-SSS scale:①Before treatment,there was no significant difference in the total score and individual score of IBS-SSS scale between the two groups(P>0.05).After 4 weeks of treatment.②The total effective rate of the observation group(86.67%)was higher than that of the control group(63.33%)(P<0.05).③The total score of the IBS-SSS scale of the two groups was lower than that before treatment(P<0.05),and the total score of the observation group was significantly lower(P<0.05).It means that the comprehensive improvement effect of the observation group is relatively better.④The individual IBS-SSS scores of the two groups were significantly lower than before treatment(P<0.05);the two groups had the same curative effect in improving the degree of abdominal pain(P>0.05),while the observation group was able to reduce the number of days of abdominal pain,improve abdominal distension,and increase bowel satisfaction.It is more advantageous to reduce the impact on life(P<0.05).2.Animal experiments:(1)The rat model in accordance with the characteristics of IBS-C can be successfully established by intragastric administration of ice water.The results showed that the mental state of the rats was poor,the coat color was dry and dull,the activity,diet and drinking water of the rats were less than those of the blank group,and they liked to gather together,and the number of particles in feces decreased(P<0.05)and the moisture content decreased,which was consistent with the relevant reports.In addition,the AWR score of the model group also increased significantly(P<0.05).(2)After drug intervention.①The state of rats in the high,middle and low dose groups and the positive drug group were improved,the spirit improved,the hair gradually returned to light,and the diet and activity increased.②)The fecal quality of rats in each group became softer,the number of fecal particles increased(P<0.05)and the water content increased,but there was no significant difference in the number of fecal particles between the Chang Kang Fang group and the positive drug group(P>0.05).③Compared with the model group,there was no significant difference in AWR score under 40 mmHg balloon pressure in positive drug group(P>0.05),but there was significant difference in AWR score in other treatment groups under 20,40,60 and 80 mmHg balloon pressure(P<0.05).Compared with the positive drug group,there was significant difference in AWR score under 40mmHg balloon pressure in the middle dose group except Chang Kang Fang group,but there was no significant difference in AWR score between each Chang Kang Fang group and the positive drug group under each gradient balloon pressure(P>0.05).The results showed that both Chang Kang Fang and mosapride could reduce visceral sensitivity in IBS-C model rats,but there was no significant difference between them.④The intestinal ink propulsion rate in the model group was significantly lower than that in the other groups(P<0.01),and the intestinal ink propulsion rate in each Chang Kang Fang group was lower than that in the positive drug group(P<0.05).The results showed that both Chang Kang Fang and mosapride could improve the intestinal motility of IBS-C model rats,but the effect of Chang Kang Fang was not as good as that of mosapride.Conclusion:Clinical observation found that Chang Kang Fang has a good effect on irritable bowel syndrome-constipation(liver depression and qi stagnation type).It has a certain effect on difficult defecation,fullness of chest and flank,belching,irritability,improving the degree of abdominal distension,reducing the days of abdominal pain,improving defecation satisfaction,reducing the impact on life and so on.Animal experiments found that the therapeutic mechanism of Chang Kang Fang was related to the improvement of visceral sensitivity and intestinal motility in rats with irritable bowel syndrome-constipation. |
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