| Objective: To explore the clinical effect and mechanism of Sini powder combined with Peipishugan decoction on Irritable bowel syndrome with predominant diarrhea(IBS-D).Methods:1.Clinical study: 72 patients with IBS-D liver depression and spleen deficiency were collected in the outpatient clinic,according to the method of random number table,divided into experimental group and control group,the experimental group was given Sini powder combined with traditional Chinese medicine granule preparation of Peipishugan decoction,150ml/time,oral twice a day,the control group was given pain and diarrheal granules,5g/time,oral 3 times a day,both groups were treated for 28 days,and the total response rate,clinical symptom score,irritable bowel syndrome symptom severity scale(IBS-SSS),self-rating anxiety scale(SAS)points,and self-rating depression scale(SDS)points were compared between the two groups.2.Network pharmacology research: based on the traditional Chinese Medicine Systems pharmacology And Analysis Platform to obtain effective compounds and targets of prescription drugs,use the Uni Prot database to convert the targets into human verified standard gene names,and the human gene database,Mendelian human genetic database,The TTD database and the Drug Bank database intersected IBS-D-related target genes,the STRING database was used to establish a protein interaction network for the key targets,the results were visualized by Cytoscape software,and the gene ontology enrichment analysis of IBS-D-related target genes in the treatment of IBS-D related target genes was analyzed by the DAVID database and the Kyoto gene and genome encyclopedia.Results:1.Clinical study results: 31 cases were completed in the treatment group,2 cases were cured,20 cases were effective,8 cases were effective,1 case was ineffective,and the total effective rate was 96.77%;the control group completed the study of 31 cases,1 case was cured,6 cases were effective,20 cases were effective,4 cases were ineffective,the total effective rate was 87.10%,and the treatment group had better efficacy(P<0.05).After treatment,except fatigue,the scores of abdominal pain,stool character,frequency of stool,irritability,fullness of the two sides of the stomach and stomach in the treatment group were better than those in the control group(P<0.05).The total points of the treatment group and the control group were both lower than the previous(P<0.05),and the decrease was more obvious in the treatment group.The scores of IBS-SSS,SAS and SDS in the two groups were improved compared with those before treatment(P<0.05),and the improvement was more obvious in the treatment group.Safety testing: no adverse reactions occurred in either group during the observation period.2.Network pharmacology research results: a total of 208 active ingredients of drugs were screened,mainly including quercetin,kaempferol,beta-sitosterol,luteolin,naringenin,etc.,264 target genes after deduplication,2511 IBS-D disease-related targets,a total of 187 intersection targets of drugs and diseases,after the construction of protein interaction network,the key targets mainly include AKT1,TNF,IL6,VEGFA,STAT3,etc.,and there are 179 related signal pathways.It mainly includes PI3K-Akt signaling pathway,MAPK signaling pathway,Toll-like receptor signaling pathway,NOD-like receptor and other signaling pathways.Conclusion:1.Clinical studies shows that the treatment of IBS-D is safe and reliable,with considerable efficacy,which can reduce abdominal pain and diarrhea,relieve anxiety and depression,and improve the quality of life of patients.2.This method mainly plays the role of intervening inflammatory response and activating the immune system through PI3K-Akt signaling pathway,MAPK signaling pathway,Toll-like receptor signaling pathway,NOD-like receptor and other signaling pathways,reducing intestinal mucosal damage,maintaining intestinal microecological environment homeostasis,repairing mucosal barriers,and alleviating clinical symptoms. |
PDF Full Text Request