Nourishing Intestines Treatment Of Deficiency With Chronic Functional Constipation In Clinical And Experimental Research

Traditional Chinese medicine (TCM) is one of the main method to treat chronic functional constipation(CFC) for it has no side-effect and toxicity .Recent reports of CFC are focus on clinical efficacy but not on mechanism . Professor li guodong use yangxuerunchang recipe(YXRCC) to treat CFC base on many years clinical experience .The dissertation have three parts .The research include clinical efficacy research and experimental research . First part : Documental summary。1. Summary the name, the mechanism and therapy of constipation of TCM.2. Summary the therapy of CFC by TCM in recent years .3. Summary the relationship between CFC and colonic neurotransmitter Second part: Clinical research .Objective: Clinical efficacy comparison between YXRCC and lactulose oral liquid(LOL) in treatment of XUEXU type chronic functional constipation .Method: 100 cases of XUEXU type CFC patients are enrolled in the study and randomly divided into two groups . i.e. study group(n=51) and control group(n=49). The study group is treated by YXRCC . The control group is treated by LOL .The period of the treating is two weeks . Writing down the symptoms before the treatment , the seventh day of the treatment and after the treatment , and giving rating to the symptoms. Calculate the overall rating of the two group and the respectively rating of each symptoms .Result: The cure rate of the study group is 33.3% , effective rate is 60.7% , non effective rate is 6%. The cure rate of the control group is 18.3% , effective rate is 67.4% , non effective rate is 14. 3%。 The overall rate between the two groups has significant different (P<0. 05)。 The XUEXU symptom rating between the two groups has significant different (P<0.01). The ratings of other symptoms between the two group has no statistical different (P>0.05) . Third part: Experimental research Experiment one :Objective: Research the method of making XUEXU type FCF model of experimental mice.Method:Choose 20 healthy mice and divided into two groups randomly. i. e. study group(n=10) and control group(n= 10) . The study group hypodermic inject morphine hydrochloride every day according to the weight (2. 5mg/kg/d) . The control group hypodermic inject normal saline with the same amount. The period is 45 days. In this period the study group is bleed six times. Each time bleed blood about 0. 3 ml. Every day weighed the excreta of the tow groups and observe the objective signs . In the 46th day kill all mice and observe the excreta in the colon.Result : The objective signs : The study group mice have the symptoms of XUEXU type , such as listlessness, sleepiness, pallor, decomposition, inappetence and so on. The control group has no those symptoms. The weight of every day' s excreta of the study group is (17.20 ± 3. 04g/d), the control group is (22.16 dt 1.78 g/d) . The comparison of the weight of excreta between the two groups has significant different (P<0.01). Observe the excreta in colon : The colon of the study group had more excreta than that of control group . Conclude : the XUEXU type FCF model is successful . Experiment two :Objective: Research the affection of YXRCC on MDA and SOD in mice colonic homogenate and serum.Method: Choose 72 healthy mice and divided into six groups randomly, i.e. normal group(A) ^ model group(B)> LOL group(CK slight-dose YXRCC group(D)> middle-dose YXRCC group(E) and high-dose YXRCC group(F) . The mice of group B^ C> Ds E> F are modeled according to the method of experiment one. Group A^ B are intragastic infused with normal saline. Group C are intragastic infused with LOL. Group D> E^ F are intragastic infused with different dose of YXRCC. The period of intragastic infusing is two weeks . After the experiment kill all mice and take colonic homogenate and serum . Test SOD> MDA in both colonic homogenate and serum according to the method of test kits.Result: (l)The MDA in colonic homogenate and serum :Comparison of the content of MDA in both colonic homogenate and serum between group B and group A have significant different (P<0. 05). The content of MDA of group B in both colonic homogenate and serum are higher than those of group A. Comparison of the content of MDA in both colonic homogenate and serum between group B and group C has no significant different (P>0.05). Comparison of the content of MDA in both colonic homogenate and serum between group B and group D, group B and group E, group B and group F have significant different (P<0. 05). Conclude : YXRCC can decrease the content of MDA in both colonic homogenate and serum, LOL can' t.(2)The SOD in colonic homogenate and serum '.Comparison of the content of SOD in both colonic homogenate and serum between group B and group A have significant different (P<0. 05). The content of SOD of group B in both colonic homogenate and serum are lower than those of group A. Comparison of the content of SOD in both colonic homogenate and serum between group B and group C has no significant different (P>0.05). Comparison of the content of SOD in both colonic homogenate and serum between group B and group D, group B and group E, group B and group F have significant different (P<0. 05). Conclude : YXRCC can increase the content of SOD in both colonic homogenate and serum, LOL can' t. Experiment three :Objective: Research the affection of YXRCC on NO in mice colonichomogenate and serum.Method: Choose 72 healthy mice and divided into six groups randomly, i.e. normal group (A) > model group (BK LOL group (CK slight-dose YXRCC group(D), middle-dose YXRCC group(E) and high-dose YXRCC group(F).The mice of group B> C> D^ E> F are modeled accord to the method of experiment one. Group An B are intragastic infused with normal saline. Group C is intragastic infused with LOL. Group Dn E> F are intragastic infused with different dose YXRCC. The period of intragastic infusing is two weeks. After the experiment kill all mice and take colonic homogenate and serum . Test NO in both colonic homogenaLe and serum according to the method of test kits.Result: (l)The NO in colonic homogenate :Comparison of the content of NO in colonic homogenate between group B and group A has significant different (P<0. 01). The content of NO in colonic homogenate of group B in colonic homogenate is higher than that of group A. Comparison of the content of NO in colonic homogenate between group B and group C has no significant different (P>0. 05). Comparison of the content of NO in colonic homogenate between B and D, B and E, B and F have significant different (P<0.01). Conclude : YXRCC can decrease the content of NO in colonic homogenate, LOL can' t.(2)The NO in serum :Comparison of the content of NO in serum between group B and group A has significant different (P<0.01). The content of NO in serum of group B is higher than that of group A. Comparison of the content of NO in serum between group B and group C has significant different (P<0.05). Comparison of the content of NO in serum between B and D, B and E, B and F have significant different (P<0. 01). Comparison of the content of NO in serum between group F and group C has significant different (P<0. 05). Conclude : Both YXRCC and LOL can decrease the content of NO in serum, but group F is better than group C. Experiment four:Objective: Research the affection of YXRCC on myenteric plexus in mice colon.Method: Choose 72 healthy mice and divided into six groups randomly, i. e. normal group(A) > model group(B) > LOL group(C) -. slight-dose YXRCC group(D) > middle-dose YXRCC group(E) and high-dose YXRCC group(F) . The mice of group B> C^ D> E> F are modeled accord to the method of experiment one. Group A> B are intragastic infused with normal saline. Group C are intragastic infused with LOL. Group D^ E% F are intragastic infused with different dose YXRCC. The period of intragastic infusing is two weeks .After the experiment kill all mice and take colon .Then make HE color of paraffin sections and immunohistochemical stain of frozen section .Result: (1)HE colour :The amount of myenteric plexus in colon of group B is smaller than group A. The amount of myenteric plexus in colon of groupC , D , E , F are bigger than group B.(2) immunohistochemical staining :1.Semiquantitative analysis :The quantities of positive-cells of 5-HT> AchE> VIP and SP in group A compare to group B all have significant different(P<0.05). The quantities of positive-cells of 5-HT> AchE, VIP and SP in group D> group E> group F compare to group B all have significant different(P<0. 05). The quantities of positive-cells of 5-HT, AchE, VIP and SP in group C compare to group B all have no significant different(P>0.05). Conclude : YXRCC can increase the quantities of positive-cells of 5~HT,AchE > VIP and SP in myenteric plexus of CFC modeled mice colon . Group C can' t increase the quantities of positive-cells of 5~HT> AchE n VIP and SP in myenteric plexus of CFC modeled mice colon .2. Image analysis : The area densities of positive-cells of 5-HT, AchE, VIP and SP in group A compare to group B all have significant different(P<0. 05). The area densities of positive-cells of 5~HT> AchE, VIP and SP in group D> group En group F compare to group B all have significant different(P<0. 05). The area densities of positive-cells of 5-HT, AchE, VIP and SP in group C compare to group B all have no significant different (P>0. 05). Conclude : YXRCC can increase those area densities of positive-cells of 5-HT, AchE, VIP and SP in myenteric plexus of CFC modeled mice colon. LOL can' t increase those area densities of positive-cells of 5-HT, AchE> VIP and SP in myenteric plexus of CFC modeled mice colon.