Clinical Research On TCM Syndromes Of Irritable Bowel Syndrome And Correlations Of Brain Gut Peptide

BackgroundIrritable bowel syndrome is a symptom-based diagnosis characterized by chronic abdominal pain, discomfort, bloating, and change of bowel habits. There is no obvious morphological and biochemical characteristics of the test in the diagnosis of this disease. Modern medicine has not been fully effects of drugs for treatment of this disease in different subtypes. In terms of treatment, the use of holism and treatment based on syndrome differentiation of Traditional Chinese Medicine has made a good effect. The study of pathogenesis, symptoms can improve the level of diagnosis and treatment. To study various laboratory tests may find syndrome of liver-depression and spleen-deficiency, weakness of the spleen and stomach syndrome and other syndromes nature. Analysis the correlation between these test projects can promote to develop the modernization of TCM.ObjectiveAnalysis of the patient’s clinical symptoms and signs, summed medical evidence law, can further improve medical diagnosis and treatment of IBS. In order to further explore the pathogenesis of IBS, testing blood indicators to study the correlation between these indicators, and to find the correlations between these indicators and Traditional Chinese Medicine.MethodIn this study,the clinical investigation is divided into two parts, the first part is a symptom research component, the second part is the indicators component. The first reference to the relevant theories and methods of social research, sorting through a large number of Chinese literature, as well as the latest research progress at home and abroad, consulting experts and professors, guidance, and ultimately establish information table and database. Contents include:general information,history, physical examination, the overall symptoms, head facial symptoms, symptoms of chest, abdomen, waist and limb symptoms, diet flavors, mainland conditions, mental symptoms, tongue and pulse condition, etc. Blood testing include:5-serotonin, corticosteroids, angiotensinⅡ, adrenocorticotropic hormone, melatonin, homocysteine, tumor necrosis factor-alpha, nitric oxide,neuropeptide Y. Through the analysis of variance, factor analysis, principal component analysis and cluster analysis, correlation analysis and other statistical methods, finishing summed up the information sheet and test results.Result1. TCM symptoms1.1A total of149cases, including63male patients(42.3%), mean age33.34+13.80years;86females(57.7%), mean age43.93±13.66years old. The average duration of the149patients with IBS patients was4.7±5.5years.50.3%of people think that there were aggravating factors. Food accidentally, cold, anxiety, tension, irritability were common aggravating factors.1.2IBS-D was the most common type, accounting for88.6%. IBS-C accounted for7.4%, IBS-M accounted for2.7%, IBS-U accounted for1.3%. In Chinese medicine, the spleen deficiency syndrome accounted for77.3%, hepatic depression syndrome accounted for47.7%; syndrome of liver-depression and spleen-deficiency accounted for47.7%, weakness of the spleen and stomach syndrome accounted for24.2%.1.3After factor analysis, clustering results of the analysis, syndrome of liver-depression and spleen-deficiency,weakness of the spleen and stomach syndrome, spleen deficiency and dampness syndrome are the characteristics of TCM’s pathogenesis. The heavier mental symptoms in patients with IBS-D, the more severe gastrointestinal symptoms.2. Analysis of test indicators2.1ACTH, AT-Ⅱ,5-HT, GC, MT, NO, HCY, TNF-α, NPY, these indicators have no significant differences in groups of IBS-C, IBS-D, IBS-M subtypes (P>0.05).2.2ACTH, AT-Ⅱ,5-HT, GC, MT, NO, HCY, TNF-α, NPY, these indicators have no significant differences in groups of liver-depression and spleen-deficiency syndrome, weakness of the spleen and stomach syndrome, spleen deficiency and dampness syndrome(P>0.05).2.3In IBS-D group, men’s level of AT-Ⅱ is higher than women’s (P<0.05). ACTH,5-HT, GC, MT, NO, HCY, TNF-α, NPY have no significant differences in gender (P>0.05).2.4The level of ACTH, AT-Ⅱ,5-HT, GC, MT, NO, HCY, TNF-α, NPY and diarrhea, stool, abdominal pain, bloating and other digestive symptoms severity were no correlations (P>0.05). The level of ACTH, AT-Ⅱ,5-HT, GC, MT, NO, HCY, TNF-α, NPY and irritability, depression, anxiety and other psychiatric symptoms severity were no correlations(P>0.05). Principal component analysis showed that5-HT, HCY, TNF-alpha, ACTH, MT, GC were important indexes of IBS test indexes. Cluster analysis showed that divided into four categories:the first category ACTH, NPY; second category AT-Ⅱ, GC, HCY, MT;third category NO, TNF-α; fourth category5-HT. Divided into three categories:the first category ACTH, NPY; second category AT-Ⅱ, GC, HCY, MT, NO, TNF-α; third category5-HT. Divided into two categories:ACTH,NPY, AT-II, GC, HCY, MT, NO, TNF-α normalized as a class;5-HT classified as a class.Conclusion1. TCM symptoms1.1IBS-D is the most common subtype of the four subtypes.1.2Common aggravating factors include careless diet, cold, anxiety, tension, irritability. Patients often accompanied by changes in psychiatric symptoms.1.3The syndrome of liver-depression and spleen-deficiency is most common syndrome of this disease. Insufficiency of the spleen is the basis of the disease. Liver stagnation is a common influencing factor.1.4The level of ACTH, AT-Ⅱ,5-HT, GC, MT, NO, HCY, TNF-α, NPY and diarrhea, stool, abdominal pain, bloating and other digestive symptoms severity are no correlations. The inspection indicators can be divided into two types of ACTH, NPY,AT-Ⅱ,GC,HCY,MT,NO, TNF-α and5-HT.