Clinical Observation Of Liumo Decoction And Sini Powder In The Treatment Of Functional Constipation(Qi Stagnation Type) Combined With Anxiety

Objective:1.To observe the clinical efficacy and safety of Liumo Decoction and Sini Powder in the treatment of functional constipation(FC)(qi stagnation type)combined with anxiety.2.To explore the relationship between serum serotonin(5-HT),transmembrane protein 16A(TMEM16A)and FC(qi stagnation)with anxiety state.3.To observe the changes of serum 5-HT and TMEM16 A in FC patients with anxiety state before and after treatment with Liumo Decoction and Sini Powder,and to explore the possible modern medical mechanism of Liumo Decoction and Sini Powder in the treatment of FC patients with anxiety state.Methods:1.A total of 72 patients with FC(qi stagnation type)who were admitted to the outpatient department of digestive department of our hospital from January 2021 to December 2021 were randomly divided into traditional Chinese medicine treatment group(n=36)and western medicine control group(n=36).At the same time,36 healthy subjects from the physical examination center of our hospital were selected as the healthy control group.2.The course of treatment in the experimental group was 4 weeks.A total of 8patients were excluded from the two experimental groups(see text for details),and the clinical data of the remaining 64 patients were included in the results of the study.3.Collect and count the sex,age,course of disease and other clinical data of all patients;record and count the TCM symptom scores and SAS scores of patients in the two test groups before and after treatment;use ELISA method to detect and record the contents of serum 5-HT and TMEM16 A in healthy control group and patients in the two test groups before and after treatment.Results:1.Comparison of clinical data: there was no significant difference in sex composition and age distribution among the three groups(P>0.05).There was no significant difference in the course of disease between the two experimental groups(P>0.05).The majority of FC patients in the two experimental groups were female,with a male-to-female ratio of about 1 to 2,and the middle-aged and elderly patients accounted for about 70%.2.Comparison of clinical symptoms: before treatment,there was no significant difference in the scores of individual symptoms and the total scores of TCM symptoms between the two groups(P>0.05),but after treatment,the scores of individual symptoms and the total scores of TCM symptoms in the traditional Chinese medicine treatment group decreased significantly(P<0.01).There was no significant difference between the two groups in the symptoms of "abdominal pain,abdominal distension","frequency of defecation","intestinal ringing and sagittal qi"(P>0.05),but the symptom of "defecation" was better than that of the control group(P<0.05).The two groups had obvious advantages in the symptoms of "uncomfortable defecation","aggravation when feeling bad","chest fullness,belching frequency"(P<0.01).3.Comparison of the curative effect of TCM syndrome: the total effective rate of the traditional Chinese medicine treatment group was 87.50%,and that of the western medicine control group was 75.00%.The curative effect of the traditional Chinese medicine treatment group was better than that of the western medicine control group(P<0.05).4.Comparison of SAS score: before treatment,there was no significant difference in SAS score between the two groups(P>0.05),but after treatment,the SAS score in the western medicine control group decreased significantly(P<0.05),and the SAS score in the traditional Chinese medicine treatment group decreased significantly compared with that before treatment(P<0.01),and the decrease in the traditional Chinese medicine treatment group was greater than that in the western medicine control group(P<0.01).5.Comparison of serum 5-HT and TMEM16 A contents: the serum 5-HT and TMEM16 A contents of the two test groups were significantly lower than those of the healthy control group(P<0.01).Before treatment,there was no significant difference in the contents of serum 5-HT and TMEM16 A between the two groups(P>0.05).After treatment,the contents of serum 5-HT and TMEM16 A in the traditional Chinese medicine treatment group were significantly higher than those before treatment(P<0.01),and the contents of serum 5-HT and TMEM16 A in the western medicine control group were slightly higher than those before treatment,but the difference was not statistically significant(P>0.05).The content of serum 5-HT and TMEM16 A in the traditional Chinese medicine treatment group was significantly higher than that in the western medicine control group(P<0.01).Conclusion:1.Liumo Decoction and Sini Powder can improve constipation symptoms and anxiety state of FC(qi stagnation type)patients with anxiety state,with good clinical efficacy,high safety and no obvious adverse reactions.2.The levels of serum 5-HT and TMEM16 A in patients with FC(qi stagnation)with anxiety state are lower than those in healthy subjects,suggesting that 5-HT secretion disorder and abnormal ICC function may be one of the pathogenesis of FC(qi stagnation)patients with anxiety state.3.After treatment with Liumo decoction and Sini Powder,the contents of serum5-HT and TMEM16 A in patients with FC with anxiety state increased,suggesting that increasing the content of serum 5-HT and TMEM16 A,correcting the disorder of 5-HT secretion and regulating the function of ICC may be one of the mechanisms of Liumo decoction combined with Sini Powder in the treatment of FC patients with anxiety state.