| Slowly Transmitting Functional Constipation(STFC)is known as the common fuctional colon diseases in clinical,with the persistent difficult and discomfort defecation.As times go on,its morbidity rises up following the changing of way of life,also disturbing people's life.STFC can be introduced oraggravated by dietary structure,heredity,mentality,hormone levels,the intestinal neurological disorders and so on.Clinicians are devoting themselves to figure out STFC's pathogenesis and to deal with it perfectly.The cause of STFC is not known very well,so the treatment options are not perfect enough for clinical services.The main suggested options in clinical are conservative methods includling changing style of life and defecation,oraling drugs,such as volume cathartics,stimulant laxatives,lubricity laxatives,intestinal dynamic drugs,promoting secretion agent,et al,and then choosing surgeriesat last.Also,sacral nerve stimulation(SNS),biofeedback combining with electrical stimulation,and botox injections can be used for functional constipation.Due to the sequelae of surgeries,clinicians usually choose the options with much more cautions.Now the treatment options for constipation are variety of kinds,though in consideration of persistence of effect and side effects,clinicians are taking positive part in studying the ideal options.Modern Traditional Chinese Medical Sciences(MTCM)on the base of traditional diagnosis and treatment idea combining with theory and technology from Modern Western Medical(MWM)style,can perfectly deal with STF constipation.How to take advantage of MTCM,and how to perfectly combine with MWM is our woking aim now.Based on transmission of TCM theory with dialectical treatment,from the point of microcosmic and holistic view to explain the mechanism about MTCM dealing with STF constipation,combining TCM syndrome with MWM indexes will be in favour of promoting the treatment and diagnosis levels of STF constipation.Decoction of Yang Xue Run Chang composed of drugs nourishing the blood,promoting blood circulation and bowel movement,was created to deal with STF constipation by Professor Li Guodong,who has been occupied himself in clinical works for more than forty years.The topic of this study is repeating the clinical observation about the decoction's effect,systematically reviewing the possible oriention of oraling Chinese herbs dealing with STF constipation,and also further researching the changing of AQP-3mRNA influenced by the decoction as well as observing if there is colocalization relationship between the AQP-3 and lipid raft(expressing on the lipid raft)from mice's colonic epithelial cells.Clinical ResearchClinical research and observation about the Prescription's efficacyObjectiveObservation about the effect of Decoction named as Yang Xue Run Chang dealing with STF constipation in blood deficiency.MethodTotal 81 cases collected from outpatient department,were randomly divided into 3 groups which were the Decoction group,the Maren Runchang pill group,and the Prucalopride group.Then we evaluated the scores of TCM syndrome and Cleveland constipation,calculating the effective rate at the forth week and also the third month.ResultEffective rate of Prucalopride group was superior to the decoction group,as well as the decoction group being superior to the Maren Runchang pill group at the forth week(P<0.05).The effective rate at the third month was the same as the rates at forth week along with almost the same effect between the Prucalopride group and decoction group.ConclusionThe effect of Decoction was stable,definite,reliable and safe.Systematic ReviewSystematic review about Chinese herbs dealing with STF constipation ObjectiveReviewing the possible oriention of the effect of the Chinese herbs used for STF constipation.MethodWe searched the Chinese article databases including CNKI,CBM and VIP as well as the English article databases including Pubmed,Medline,Embase,CINAHL and Ovid,and then brought into the study the randomized controlled trials(RCT)or quasi-randomized controlled(qRCT)clinical trials about Chinese herbs vs Chinese drugs or Western drugs.We made the meta analysis according to the Cochrane handbook and GRADE system with Revman 5.3 software.ResultTotal 10 studies were brought into the systematic review with 1227 participants,male 550,female 677.The results were being followed:1.The effect of Chinese herbs was superior to the combining effect of the Western drugs and Chinese drugs,the combined RR value of effective rate was 1.37,95%CI[1.10,1.71];2.The effect of Chinese herbs being superior to the effect of the only Western drugs,and the combined RR value of effective rate was 1.36,95%CI[1.18,1.57];3.There was no obviously difference between the effect of Chinese herbs and only Chinese drugs,and the combined RR value of effective rate was 1.29,95%CI[0.85,1.96].ConclusionWe could conclude that the Chinese herbs can possibly bring one better tendency to deal with STF constipation.Due to the study's limitation,we could not give much more reliable conclusion.Experiment ResearchExperiment 1Establishment of models of rats with blood deficiency and slowly transmitting functional constipationObjectiveTo establish blood deficiency and slowly transmitting functional constipation Wistar rats model.MethodsGavaging loperamide combining with docking was to set up STF constipation model with Wsitar rats.60 rats were randomly divided into 5 groups:blank group,model group,the middle-dose decoction group,the low-dose decoction group,and the Prucalopride group.With 3.0 mg/kg/d dose of loperamide being gavaged for mice within the first 10 days and docking tail being placed in 37-38? water for 3 min after cutted about 2.5-3mm every two days was to copy the modle,according to measurement conversion table from article,while the blank control group was gavaged with equal-volume physiological saline.Observation about the rats,general physical signs,number of the fecal grains at the first 3 hours and the first 6 hours,and the weight of excrement and water in it of 24 h.We also measured the speeds of bowel transitting by gavaging biological carbon black ink when finishing copying modle.ResultsAnalysis was made between the modle group and the blank group,about the rats,general physical signs,number of the fecal grains at the first 3 hours and the first 6 hours,and the weight of fecal or water in fecal within 24 hours.The indexes of modle mice were remarkably worse than the blank group mice(P<0.05).ConclusionWe successfully copied the Wistar rats modle with the blood deficiency and STF constipation.Experiment 2Observation about the AQP-3mRNA from intestines of Wistar rats with blood deficiency and STF constipation intervened by Yang Xue Run Chang DecoctionObjectiveTo observe the changing of AQP-3mRNA from intestines of Wistar rats with blood deficiency and STF constipation intervened by Yang Xue Run Chang decoction by RT-PCR.MethodAfter dealing with repectively group rats by the corresponding treatments for 14 days,the rats were taken off their necks to death.The specimens form their bodies were collected together and then frozen by liguid nitrogen.Using RT-PCR was to test the expression of AQP-3mRNA from these specimens of every group.ResultThe expression AQP-3mRNA of blank control group vs Prucalopride group was obviously stastically significant by the one-way analysis of variance,and the result same as the model control group vs Prucalopride group,the middle-dose decoction group vs Prucalopride group,and the low-dose decoction group vs Prucalopride group(P<0.05).ConclusionThe Decoction could down-regulate the expression of AQP-3mRNA,which may be the mechanism of Yang Xue Run Chang Decoction alleviating STF constipation with blood deficiency.Experiment 3 Observation if there is colocalization relationship between AQP-3 and lipid raft from intestines epithelial cells of Wistar ratsObjectiveTo observe if AQP-3 expressing on the lipid raft from intestines of Wistar rats by Sucrose density gradients combined with superspeed centrifugation and Western Blot.MethodWe made the preliminary experiment and collected lipid rafts from the frozen specimens of the blank control group and the modle control group rats using sucrose density gradient of superspeed centrifugation according to the literatures,and then analyzed the western blot results which were worthy of conducting following replicated and enlarged assays.So we repeated the experiment including specimens of the blank control group,model control group,the middle dose and low dose prescription groups with Prucalopride group.ResultIn the preliminary experiment,the expression of AQP-3 in fractions may be containing lipid raft in moble control group were much more than the blank control group.Meanwhile,the AQP-3 and labelled protein of lipid raft were synchronously expressing in component full of lipid raft from intestinal epithelial cells which were from both the blank control group and the moble control group Wistar rats.In the replicated and enlarged experiments,the AQP-3 was not expressing on the lipid raft from five groups.ConclusionIn the preliminary experiment,gavaging loperamide combining with docking could up-regulate the AQP-3 in component that may be containing lipid raft to set up STF constipation model by Wsitar rats,and we could indicate that AQP-3 was expressing on the lipid raft on intestinal epithelial cells from the experiment Wistar rats.However,we could not give the last and specific conclusion about the colocalization relationship between the AQP-3 and the lipid raft from these rats intestinal cells in the replicated and enlarged assays,so we analyzed the causes about the experiments procedure and results in order to go on replicating these experiments to clear their relationship. |
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