Study On Treatment Regularity Of Professor Huang Suiping And Experiments On Treating Functional Dyspepsia Of Spleen Deficiency With The Decoction Of Si Junzi

ObjectiveFunctional dyspepsia is extremely common.Within the Rome? FD criteria,two subgroups are included,which are postprandial distress syndrome(PDS)and Epigastric pain syndrome(EPS)is characterized by postprandial fullness or early satiation.Based on the theory of TCM,PDS belongs to "Fullnessand and Oppression",EPS belongs to "Stomach Pain".Stomach pain includes EPS and overlapping PDS-EPS,so we studied the literatures of stomach pain in order to provide more theoretical support,including the disease cause,the pathogenesis,syndrome differentiation and treatment variation.On the other hand,we systematically studied the related literature about the pathogenesis of functional dyspepsia in recent years.We collected the information of Professor Huang Suiping basis for the stomach pain related to functional dyspepsia,called FD-stomach pain in short,to establish the database.And then based on the association rules and factor analysis,the clinical regularity of syndrome of FD-stomach pain and and Chinese herbs compatibility on Professor Huang Suiping's treatment of FD-stomach pain were analyzed by data mining.By analyzing the rules and fators,the new couple Chinese herbs was found out,and Professor Huang's academic thought and characteristics of syndrome differentiation and treatment variation of FD-stomach pain was combed and summarized,which facilitated the clinical experience of heritage,and provided the basis for clinical diagnosis and treatment of FD-stomach pain.We established the visceral hypersensitivity model of functional dyspepsia with spleen deficiency syndrome and treated the rats with sijunzi decoction in the experimental part.Through the experimental research,we explored the mechanism of the visceral hypersensitivity model of functional dyspepsia with spleen deficiency syndrome,and observed the curative effect of Si Junzi decoction on functional dyspepsia to provide objective and quantitative indicators of the mechanism of the treatment of traditional Chinese medicine.MethodsData mining research of FD-stomach pain:We collected the medical records of stomach pain from traditional chinese medicine hospital of Guangdong province,which were treated by Professor Huang XX from June 2015 to June 2016.Finally,the medical records of FD-stomach pain were selected.And then the raw data were established a standardized Excel database.On this basis,we made an analysis of the FD-stomach pain data by SPSS 19.0 and Clementine12.0 software.The methods of data mining were frequent item sets,association rules and factor analysis.The epidemiology,syndromes distribution,commonly used Chinese herbs and commonly used Chinese herbs pairs and the relationship between syndromes and Chinese herbs pairs were analyzed in order to comb and summarize the academic thinking of Professor Huang.Animal experiment researchThe male SD rat(36)as the research object,randomly divided into four groups,as the healthy group,model group,Si Junzi Decoction,mosapride group,9 rats in each group.The rats in healthy group were not modeled,while the other rats were modeled as spleen deficiency syndrome of functional dyspepsia model by iodoacetamide,the hunger disorder and overstrain.Rats in the healthy group and the model group received physiologicalsaline,traditional Chinese medicine group received Si Junzi decoction,western medicine group received mosapride,respectively,for 14 days.The symptoms and body weight of rats were observed.And electromyographic responses to gastric distention were recorded from the acromiotrapezius muscle at 60mmHg.Also,we tested the expression of nerve growth factor(NGF),phospholipase C gamma(PLC y)and transient receptor potential vanilloid 1(TRPV1)by immuno-histochemical staining and Real-time PCR techniques in tissues of antrum of stomach.ResultsClinical research:In the cases with age and sex record,89.65%of the patients were young and middle-aged people,73.16%of the patients were women.The etiologies of most of the cases were dietary factor.There were twelve different syndromes according to the analysis,which was deficiency of spleen and qi stagnation,deficient cold of spleen and stomach,liver depression and spleen deficiency,spleen deficiency wet-sheng and so on.The most common Chinese herbs as medicine Professor Huang used mostly top 10 were codonopsis radix,aucklandiae radix,pinelliae rhizome,cory dal is rhizome,prepared liquorice root,citri reticulatae pericarpium,atractylodis macrocephalae rhizome,amomi fructus,foria,magnolia officinalls cortex.Nineteen groups with two medicines,6 groups with five medicines and the relationship of three different syndromes between medicines were excavated in this study.There were seven common factors on biasis of factor anlysis,of which five common factors was significant.That's the second,the third,the sixth and the seventh common factor.The second common factor included atractylodis macrocephalae rhizome,dioscoreae rhizome,roasted atractylodis macrocephalae rhizome and lablab semen album.The third common factor included foria,poria with hostwood and albiziae cortex.The sixth common factor included mangnolia officinalis cortex,sepiae endoconcha and aurantii fructus immaturus.The seventh common factor included platycodonis radix.Experimental part:General performances,the changes of weight and the electromyogram(EGG)activity of visceromotor responses were observed after spleen deficient model was built to confirm the success of the model.The rat of spleen-deficiency model group was curled,fatigue,weak,lazy,slow response,dull color,lax,weight loss,complying with the performance of TCM spleen deficiency.Compared with healthy rat,the weight of model group of rats were significant differences(P<0.05);Given si junzi decoction,compared with the model group rats,no significant differences were found in increased weight(P<0.05).The result was same to mosapride group.The balloon for gastric distent was placed in the fundus of stomach.Representative EMG records of visceromotor responses to 60mmHg gastric distent recorded from acromiotrapezius muscles showed that the increase of frequency and extent in EMG activity when comparing the healthy rats and model rats.It's known as the success of visceral hypersensitivity of FD.And the visceromotor responses to 60mmHg gastric distent was decreased when comparing the model rats and treatment rats.The positive expression of NGF was in the cytoplasm.When comparing the healthy rat and the model rats,the positive expression was increased,but there's no difference after drug treatment.The positive expression of PLC? was also in the cytoplasm.When comparing the healthy rat and the model rats,the positive expression was increased,And there's significantly difference after the treatment of Si Junzi decoction(P<0.05).The positive expression of TRPV1 was also in the cytoplasm.When comparing the healthy rat and the model rats,the positive expression was increased,And there's significantly difference after the treatment of Si Junzi decoction(P<0.05).The model group showed higher expression levels of PLC? and TRPV1 mRNA compared with those of the control group.Control with Si Junzi decoction showed significant reductions in the expression of PLC? and TRPV1(all P<0.05).ConclusionClinical researchIn the cases with age and sex record,most of the patients were young and middle-aged people,most of the patients were women.The dietary factor of the etiologies was important.There were twelve different syndromes according to the analysis.And the most of syndromes was deficiency of spleen and qi stagnation.The most common Chinese herbs as medicine Professor Huang used were spleen-strengthening drugs,qi-regulating drugs,antalgesic drugs,dampness-eliminating drugs.Common durg pairs showed that the flexibility in the use of the classic classic spleen and stomach recipe of Professor Huang,such as Erchen decoction,Si Junzi decoction,Yigong San,Liu Junzi decoction and Xiangsha Liujunzi decoction.Groups of five medicine suggested that the variant Xiangsha Liujunzi decoction or variant Liu Junzi decoction or variant Xiangsha Liujunzi and corydalis rhizoma decoction or variant Liu Junzi decoction and corydalis rhizoma were the main prescriptions of Professor Huang to treat FD-stomach pain.The analysis of syndromes and Chinese herbs showed that deficiency of spleen and qi stagnation syndrome had relevance to Xiangsha Liujunzi decoction,liver depression and spleen deficiency syndrome had relevance to Xiaoyao San,and deficient cold of spleen and stomach had relevance to Lizhong decoction.There are four common factors,respectively,to show the unique medication which was used by Professor Huang in the treatment of spleen deficiency,insomnia,stomach fullness,pharyngeal disease,according to the factor analysis.By the date mining of medicine records,we concluded Professor Huang's treatment of infertility.That was to explore disease cause,strengthen the spleen and stomach,with relugating qi,relieving pain,eliminating dampness,clearing heat.The expression of NGF,PLC?,and TRPV1 channel may be associated with the pathogenesis of spleen-deficiency syndrome of visceral hypersisitivity with FD.Si Junzi decoction therapy could be beneficial for the patients of spleen-deficiency syndrome with FD by means of reducing the visceral hypersensitivity through PLC-TRPV1 signal channel.