The Clinical Study And Effect On Vasopressin And AQP1 Of Tianmazhenxuan Granules In Meniere's Disease

IntroductionMeniere's disease is idiopathic inner ear disease the endolymphatic is the basicpathological changes, clinical features of paroxysmal vertigo, deafness and tinnitus.The incidence of the cause of so far inconclusive, clinical treatment is very difficult,the help of about 1/3 of people in drug treatment after the failure of surgical treatment.Many methods of surgical treatment of clinical recent major applications of the endolymphatic sac surgery, vestibular neurectomy, lost resection and so can achieve control of vertigo, but the treatment of recurrence, the depth of deafness, facial nerve paralysis and the risk of intracranial complications, and the exact efficiency is not high.Tutor Professor Chen Baotian after 40 years of clinical experience -Tianmazhenxuan granules particles summed up an effective and well-received in the clinical efficacy. The TMZX particles mainly by the Tianma, Chuanxiong, angelica,white peony root, Rehmannia, Cinnamon Twig, Poria, Atractylodes, Licorice, Health keel, raw oysters and other drugs. Spleen dampness, nourishing blood, the expectorant Dingxuan, calming liver yang effect, clinical commonly used in the treatment of Meniere's disease. Preliminary studies of our group confirmed the TMZX particles has a sedative,hypnotic,diuretic,antiemetic,such as the role. In animal models, and promote the increase of animal urine, animal on the copper sulfate and cisplatin-induced vomiting also significantly improved. The significance of this topic is Tianma Town, dazzling particle treatment of Meniere's disease, the pharmacological mechanism of action, from the molecular level, and further expand the clinical sample, the TMZX particles develop a safe, effective Chinese patent medicines good early work.Vasopressin (also known as antidiuretic hormone) peptide hormone secreted by the hypothalamic supraoptic nucleus and paraventricular nucleus of the nerve cells release from hypothalamic neurons of giant cell axon terminals stored in the posterior pituitary lobe. Three receptor subtypes, vasopressin play a physiological regulatory role in maintaining the stability of the plasma osmolality has a key role.Aquaporin-1 in the inner ear distribution of the most widely used.Aquaporin 1 is a continuous activated aquaporin not subject to the regulation of ADH,mainly in the intermediate cells of stria vascularis, spiral ligament type ? fiber cell distribution area, the basement membrane and the round window membrane. The intermediate cells of stria vascularis widely expressed K + channels, and generate an important role in the vascular pattern of the K + transport and cochlear lymphoid potential.Suggesting an important role in the regulation of the water distribution associated with the active ion transport.We tried an observation mechanism the TMZX particles may affect the inner ear lymph circulation, two important indicators: vasopressor hormone and aquaporin.TMZX clinical efficacy of the particles observed, including short-term clinical efficacy observed. Our research group has built good endolymphatic rat model, and pharmacodynamic observation, experiment with the feasibility. Also studied Chinese traditional medicine for the vasopressor hormone and aquaporin 1 impact observation mechanisms, with innovative We hope to provide a scientific basis for drug development research by the above test.The first part The establishment of the rat the Meniere animal model and Tianmazhenxuan granules onObjectiveTo study the Tianmazhenxuan granules in rat cochlea vasopressor hormone and aquaporin 1 expression in the endolymphatic.MethodModeling using traditional methods of blocking the vestibular aqueduct, divided into six groups: Tianmazhenxuan granules high dose group (group A, 11.7g/kg),Tianmazhenxuan granules dose group (B, 5.85g/kg), the Tianmazhenxuan granules low-dose group (group C, 2.93g/kg), positive control group (group D times, Mr Tingtablets orally 14.4mg/kg), model control group (E group) and sham group (group F)(n = 8), free diet. Four weeks after the operation model. Group F for the sham surgery group (surgery to see the sigmoid sinus). Each group were selected ear surgery ear,right ear electrodes were used. ABC were treated with the intragastric administration of theTianmazhenxuan granules; D group were given betahistine tablets orally, E, F,given normal saline. Two weeks. For brainstem auditory evoked potential hearing test,and evaluation of the model is successful or not. Rat vasopressin hormone ELISA kit,vascular vasopressin levels. The Envision imunohistochemistry to detect AQP1 expression in the inner ear.ResultsAfter the model Tianmazhenxuan granules high dose group, the Tianmazhenxuan granules dose group, the hearing threshold of the of Tianmazhenxuan granules low-dose group, the western medicine group and model group compared with the sham operation group was significantly higher, statistically significant (p<0.05). The Tianmazhenxuan granules high dose group,Tianmazhenxuan granules dose group, the Tianmazhenxuan granules low dose group,the western medicine group and model group no statistically significant difference.Description of the modeling rat hearing threshold improved, suggesting that the model was successful. The Tianmazhenxuan granules after the drug particles high dose group, Tianmazhenxuan granules dose group, the Tianmazhenxuan granules low-dose group, a significant reduction in the WM group, sham operation group and model group,with statistical significance (p <0.05). Description of the Tianmazhenxuan granules can improve the rat auditory threshold. Tianmazhenxuan granules in rat cochlea vascular vasopressin influence Tianmazhenxuan granules high dose group, sham operation group and model group were significantly lower, a significant difference (p <0.05),suggesting that the Tianmazhenxuan granules can reduce rat cochlea vasopressin content.Tianmazhenxuan granules on rat cochlear AQP-1 expression, Tianmazhenxuan granules high dose group, Tianmazhenxuan granules dose group, Tianmazhenxuan granules low dose group, the WM group, sham operation group and model group significantlyincrease, a significant difference (p <0.05), prompted the Tianmazhenxuan granules can improve the content of AQP-1 in the rat cochlea.ConclusionTianmazhenxuan granules membranous labyrinth water rat cochlea vasopressor factors downregulation and upregulation of AQP-1, thereby contributing to the absorption of water in the capsule of the endolymph.The second part The clinical efficacy of Tianma town dizzy particles observedObjectiveTo observe the degree of improvement and safety evaluation of Tianma town dizzy particle treatment of Meniere patients with tinnitus and vertigo symptoms.MethodsAll patients in line with the "otorhinolaryngology" (fifth edition) diagnostic criteria of Meniere's disease; cases from the Southern Hospital of Traditional Chinese Medicine, Neurology, ENT out-patient ward, either sex, the age of 18 -70 years old, a total of 60 cases were randomly divided into observation group and control group (n?30 cases). The observation group was given the TMZX particles 45g a day, three times oral; control group Betahistine. Before and after treatment in both groups to do the three conventional liver function, kidney function tests. Vertigo and tinnitus grading standards to be assessed in accordance with the guiding principles of"Chinese medicine clinical research on new drugs.Resultsthe evaluation results of the vertigo symptoms: It can be seen from Table 2-1patients were dizziness before taking the degree of assessment was no significant difference (Z = -0.333, p = 0.739), two groups of patients can be seen from Table 2-2had after taking the dizziness assessment no significant difference (Z = -0.236, p ?0.813), that TMZX particles as effective as betahistine in improving vertigo symptoms. The evaluation results of the tinnitus symptoms can be seen that the twogroups of patients before taking the tinnitus and the degree of assessment was no significant difference (Z = -0.889, p = 0.374), two groups of patients taking the drug can be seen from Table 2-4: Table 2-3 tinnitus and the degree of assessment after a significant difference (Z = -2.283, p = 0.022), indicating the TMZX particles in the improving tinnitus symptoms than betahistine.Discussthe the TMZX particles Betahistine efficacy in improving vertigo symptoms, but the improvement of tinnitus symptoms than betahistine. Therefore, the development TMZX particles.