| Objective:This study is based on the preliminary clinical research on the efficacy of Changtong ointment in the treatment of postoperative abdominal distension,using metabonomics technology to initially explore the plasma of patients with gastrointestinal dysfunction before and after the treatment of Changtong ointment after gastrointestinal surgery The difference in metabolites will lay a foundation for further elucidating the effect mechanism of Changtong ointment in the treatment of gastrointestinal dysfunction after gastrointestinal surgery,and also provide strong scientific support for the further promotion and use of Changtong ointment.Methods:A total of 22 patients with gastrointestinal dysfunction after gastrointestinal surgery were enrolled in this study.According to the principle of randomized control,they were divided into the experimental group and the control group with 11 cases each.All the tested patients were from the Second Department of Gastroenterology,Affiliated Hospital of North Sichuan Medical College.The experimental group was treated with "Changtong Ointment" and multi-source therapeutic apparatus,while the control group was only treated with multi-source therapeutic apparatus.Collect the fasting plasma samples of the patients before and on the 5th day after postoperative treatment,and mark them one by one in order.At the same time,the gender,age,hospitalization number,diagnosis,name and location of surgery,abdominal distension and bowel sounds of the two groups of patients were collected.And other information for detailed records.And analyze all collected plasma by liquid chromatography-mass spectrometry,and explore the different metabolites of each group and between groups.Results:1.Clinical evaluation:the scores of abdominal distension and intestinal sound in the experimental group at 24 hours,48 hours and 72 hours after operation were significantly lower than those in the control group(all P<0.05).2.Metabonomic analysis:through multivariate statistical analysis,univariate statistical analysis and differential metabolites screening,the results showed that the differential metabolites between the two groups showed great differences,and finally determined the top 20 differential metabolites.The top 20 differential metabolites in the test group were glycerol phospholipid,5-octadecanoic acid,uric acid,p-toluenesulfonic acid,3-methyl-4-(sulfonyl)-2-enoic acid,phosphonoyl-CMP,benzo[b]naphthalene[21e lmurd]thiophene,hydroxyethyl promethazine,3B.12A-dihydroxy-5a-cholic acid,boric acid,uridine 5-diphosphate,citric acid,oxalazine-O-sulfate,mangoic acid,2-methyl-1-mine 4-naphthalenediol(dihydrogen phosphate),maltotriol,3 color O-caffeyl-1 color O-methyl quinic acid,deoxycholic acid,benzoyl phosphate.The top 20 differential metabolites in the control group were L-norleucine,(E)-3-(4-hydroxyphenyl)-2-propofol,proline betaine,m-coumaric acid,mesobilirubinogen,bilirubin,isoniazid pyruvate,indole sulfate,(E)-2-pentene-1-ol,Hypoxanthine,citric acid,pilocarpine glycine,phenylacetamide-4rel O-sulfate,stearic acid,quinic acid,indole sulfate.N-acetyl-L-tyrosine,3 β-hydroxy-5-cholestenate,citrulline,3-(3).4-dihydroxy-5-methoxy)-2-acrylic acid,indole-3-propionic acid.Conclusion:1.External application of Changtong ointment can effectively improve the degree of abdominal distension,accelerate the recovery of gastrointestinal function and improve gastrointestinal dysfunction.2.The same differential metabolite in the top 20 of the test group and the control group was citric acid.Citric acid as an intermediate participates in the citric acid cycle of all aerobic metabolism.Citric acid may play an anti-inflammatory role by activating relevant inflammatory signaling pathways and participate in the pathological process of gastrointestinal dysfunction after gastrointestinal surgery.3.The results of this study also showed that some differential metabolites had effects on gastrointestinal function,but due to the small sample size and other reasons,the specific effect of "Changtong ointment" on metabolites could not be determined.In the future research,we need to further improve the research program,increase the sample size,and combined with metabonomic targeting study to further explore the effects of Changtong ointment on metabolites and metabolic pathway in patients with gastrointestinal dysfunction. |
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