Study Of The Clinical Observation And Experiments On Treating Diarrhea-Irritable Bowel Syndrome (D-IBS) Of Deficiency Of Spleen And Kidney With The Decoction Of Aconitum Lizhong

Objective:Irritable bowel syndrome (IBS)is a common clinical gastrointestinal functional diseases, which including abdominal pain, abdominal distention associated with changes in bowel habits and abnormal stool, these clinical manifestations of the syndrome persistent or intermittent seizures, but found no evidence of organic disease of damage. IBS has become a global gastrointestinal functional diseases, serious impact on the patient’s quality of life, and has caused tremendous economic and emotional burden to individuals, families and society. So far, the etiology and pathogenesis of IBS is not completely clear, most scholars believe that the psychological, diet, inflammation, genetic and other common causes of the disease, the known relevant factors including dysfunction of gastrointestinal motility and intestinal smooth muscle,abnormal psychological and visceral sensory abnormalities, gastrointestinal hormone secretion, brain-gut axis doctrine, stress, and intestinal infections, etc. IBS is considered to be the result of various factors. There is no ideal method of treatment in the treatment of more than symptomatic treatment. The treatment of IBS drugs including antispasmodic agents, conduct laxatives, antidiarrheal agents, intestinal motility sensory modulation, probiotics, and antidepressants. IBS is a disease of the characteristic advantages of Chinese medicine treatment. The TCM treatment withChinese herbal medicine and combined with acupuncture, massage and other methods to obtain a better efficacy overall treatment of the disease.In this study, we chose deficiency of spleen and kidney syndrome D-IBS patients in recent years increasing as object, fuzilizhong decoction group and dicetel group controlled clinical study was designed to observe the clinical efficacy and situation to improve patients’quality of life. In order to investigate the onset mechanism of the Fuzi Lizhong Decoction, design the animal experiments, from inflammation, visceral sensitivity and expression of AOP8mRNA, TLR4and so many angles to study its possible mechanism, process and targets.Methods:The clinical part:Divided62patients who meet the inclusion criteria into treatment group of32patients and in the control group of30cases. Fuzilizhong soup is taken by each patients in treatment group, dicetel is taken by each patients in control group. Both groups were treated for4weeks. TCM syndromes, symptom score, the overall efficiency, quality of life changes were observed before and after treatment,Experimental part:50of SPF rats were randomly divided into normal control group, model group, get the dicetel group, Lizhong Tang low-dose group, Lizhong Tang high-dose group (n=10). Half male and half female.Using rhubarb laxation and ice water stimulation replication diarrhea type in rat model. The model was successful, start the medication, the normal group and model group rats daily to normal saline; the remaining three groups were fed with different doses of fuzilizhong soup side and get Dicetel, a total of medication for14days.Observed changes in body weight of rats after treatment, the diarrhea rate diarrhea index and intestinal tissue morphological changes; determination of the serum levels of IL-8, serum5-the HT level changes; determination of each rat colonic mucosa samples of TLR4AQP8is the mRNA expression levels.Results:1Results of clinical studies1.1After clinical treatment, whether it is traditional Chinese medicine group or western medicine group, abdominal pain or abdominal discomfort, stool frequency, stool consistency, bowel movement a sense of urgency, mucus symptom scores are lower, paired t-test show the before and after treatment the total symptom score were significantly different. Compared to the total symptom score after the treatment of traditional Chinese medicine group and western medicine group,there is differences (P=0.000). 1.2After treatment, the traditional Chinese medicine group and western medicine group in abdominal discomfort, stool frequency, stool consistency, bowel movement a sense of urgency, bloating, mucus and other symptoms points than before treatment have decreased. Chinese medicine group in the stool, bowel movement a sense of urgency, bloating, mucus improvement better than the western medicine group.1.3After treatment, the quality of life of the two groups of patients were improved to varying degrees:the SF-36integral treatment group in the physiological function of the physiological functions, bodily pain, general health, vitality, role emotional, mental health integration were significantly higher (P<0.05); the control group only in the physiological functions, the integral of bodily pain improved significantly (P<0.05); treatment groups in the improvement of physiological functions, physical pain, emotional function and mental health were better than the control group (P<0.05).1.4After treatment of IBS-QOL in all aspects, integration of patients in treatment group with anxiety, behavioral disorders, physical roles, health concerns, dietary restrictions, social response points were significantly improved (P<0.05), in the control group in anxiety, health concerns and dietary restrictions were significantly improved (P<0.05). treatment groups in the improvement of anxiety, behavioral disorders, physical character, health concerns, dietary restrictions were better than control group.2The experimental results2.1Lizhong Tang group, different doses allows serum IL-8levels tended to be normal; the Dicetel group of IL-8levels higher than the normal group (P <0.05), compared to model group declined slightly, but statistically the analysis showed no significant difference (P>0.05).2.2The study of animal experiment found that Fuzilizhong Decoction of different dose group could decrease5-HT content in serum of D-IBS rat model, compared to Dicetel group, its efficacy had no significant difference (P>0.05).2.3TLR4expression of the intestinal mucosa of the model group were higher than the normal control group were significantly different (P<0.01). Lizhong Tang intestinal mucosa of intervention allows the expression of TLR4is normal, but no significant difference with the normal group. Have Dicetel group compared to the normal group TLR4expression was increased significantly (P <0.01). 2.4The expression of AQP8in rat colon tissue of model group decreased (P <0.05),after the intervention by Lizhong Tang, the expression of AQP8is normal, no difference in the expression of AQP8in the Dicetel group intervention compared with the model group.Conclusions:The clinical trials show that fuziLizhong decoction for deficiency of spleen and kidney syndrome D-IBS patients has a good therapeutic effect in clinical symptoms, quality of life; control group also shows a certain therapeutic effect, fuziLizhong decoction clinical overall efficacy was significantly superiorin the control agent.Animal experiments in terms of inflammation, visceral sensitivity, immunity, and water metabolism study Fuzi Lizhong decoction treatment of deficiency of spleen and kidney syndrome D-IBS possible mechanism, to infer the mechanism of Lizhong Tang treatment of deficiency of spleen and kidney syndrome D-IBS may be it can reduce the inflammatory response, reducing visceral sensitivity, and reduce the immune response, and recovery of water metabolism and other factors.