Study On Clinical Efficacy Of Simo Decoction On Patients With Functional Dyspepsia And Influence Of Ghrelin,GHSR Of Model Mice Expression

Objective:To study the clinical curative effect of Simo Decoction on patients with Postprandial distress syndrome of functional dyspepsia.Explore spirit psychological factors and FD relationship,and from brain gut peptide, brain-gut interaction, brain-gut axis imbalances, discusses the mechanism. Simultaneously,to observe how Simo Decoction affect the chronic stress of gastrointestinal function of mice, gastrointestinal tract and Ghrelin and its receptor expression in brain regions.The thesis provide Chinese medicine, liver and spleen related theory of modern biological basis with brain-gut axis imbalances hypothesis, esearching clinical and experimental basis.Methods:1.Patients with postprandial distress syndrome of functional dyspepsia being selected, are randomly divided into treatment group and control group, correspondly given Simo Decoction, and then observe the patients'gastrointestinal emptying-function, symptoms and brain gut peptide, levels of plasma Ghrelin before and after treatment to evaluate their curative effect.2.Applying the model group of gastrointestinal-emptying impediment by the method of unpredictable chronic stress, next,randomly dividing the mice into model group, Simo Decoction group, domperidone group,and then respectively giving different treatment to observe the situation of animals'carbonpowder-promoting,the residual rate in stomach, to examinate the levels of motilin, gastrin, Ghrelin in serum, Ghrelin and GHSR expression in the stomach, brain and small intestine.Results:1. Clinical ResearchIn two groups of patients with total efficiency compare difference not to have statistical significance (P>0.05)。But the markedly effective rate in treatment group than in control group (P<0.05). For the healing effect of the symptoms of belching and acid reflux, restlessness,regular sigh, constipation, the treatment group is superior to control group(P<0.05) there is no statistical significance between the levels of Ghrelin in plasma and gastric evacuation rate (P>0.05).The comparison between the treatment group after being treated and normal group in respect of the level of Ghrelin (P<0.05),after being treated,the control group is markedly deduced,comparing with normal group (P<0.01). FD patients, with anxiety symptoms and depressive symptoms account for31.67%and25%respectively. Compared with China's general population standard,the grade of SAS and SDS for patients is significantly higher (P<0.01).The number of patients with serious condition accompanying anxiety and depression apparently higher than those with moderate condition. After treatment,the grade of SAS and SDS for patients is decreased and the comparison between the two groups exist no statistical significance (P>0.05). But for the treatment groups, the comparison between after and before treatment in aspect of standard score of SAS P<0.052.Experimental StudyUnpredictable chronic stress can set appetite, body mass and the rate of gastric emptying, intestinal propulsive function deducing apparently.(P <0.01)There is no significant pathology change in gastrointestinal tissue. The contents of MTL, GAS, Ghrelin in experimental mice serum(P<0.01) and brain, stomach and duodenum Ghrelin and GHSR mRNA lower distinctly(P<0.01). For the indicators of Simo Decoction group and domperidone group,appetite and weight significantly grow(P<0.01). Gastric emptying, intestinal propulsive function can be restored(P<0.05).The contents of MTL, GAS, Ghrelin of serum cause an increase.The two groups exist no statistical significance (P>0.05). In positive expression aspect of Ghrelin and its receptor GHSR mRNA in brain and gastric tissue, Simo Decoction group compared with the model group increased significantly(P<0.01),domperidone group compared with the model group increase (P<0.05). In positive expression aspect of Ghrelin and its receptor GHSR mRNA in duodenum tissue, Two groups group compared with model are elevated (P<0.05), Simo decoction group and domperidone groups exist no statistical significance (P>0.05).Conclusion:1.Simo Decoction can effectively improve symptoms and gastrointestinal-emptying of FD patients.Clinical efficacy of Simo Decoction is equivalent to Domperidone groups.2.The Ghrelin content of plasma in FD patients is apparently reduced and assumes the inverse correlation with the condition order of severity. Simo Decoction can adjust patients'plasma Ghrelin levels, slightly better than Domperidone group.3. FD patients with anxiety, depression significantly higher than the normal people, the extent of dyspepsia symptoms and the grade of SAS and SDS are positively correlated. Simo Decoction reduce the grade of SAS and SDS, improve anxiety condition but there is no improvement for depression situations.4.Simo Decoction not only can promote the rate of gastric emptying in chronic stress of mice and increase appetite,weight for unpredictable chronic stress of mice but also adjust the level of MTL, GAS, Ghrelin of serum and brain, stomach, and small intestine Ghrelin and GHSR mRNA expressions.5. The possibility of the treatment of FD with the mechanism of Simo Decoction could be achieved by adjusting the level of braingut peptide and balance of brain-gut axis.Furthermore,it provide Chinese medicine, liver and spleen related theory of modern biological basis with brain-gut axis imbalances hypothesis.