Study On The Correlation Between D - IBS Overlap With FD Liver - Qi Deficiency Syndrome And Gastrointestinal Hormones And Immune Function In Elderly Patients

[Objective] To investigate the pathogenesis of elderly patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency, detect the levels of 5-HT, SS, CCK, CGRP, VIP, SP, IL-6, IL-1β, TNF-a and T lymphocyte subsets CD4, CD8, CD4/CD8.[Methods] Elderly patients with D-IBS overlapped FD, non-elderly patients with D-IBS overlapped FD and healthy control are involved in this study, the questionaire based on general condition, gastrointestinal symptom score and SCL-90 are completed by all participants.60 elderly patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency,30 non-elderly patients and 20 healthy elderly volunteers provide peripheral blood to measure the levels of 5-HT, SS, CCK, CGRP, VIP and SP by ELISA instrument.38 patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency (including 20 elderly patients),20 healthy volunteers (including 10 elderly) provide peripheral blood to measure the levels of IL-6, IL-1β, TNF-a by ELISA and T lymphocyte subsets CD4, CD8, CD4/CD8 by flow cytometry.[Results]1. There is no significant difference of gastrointestinal symptom score between subtypes of elderly patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency.72 cases of liver stagnation and spleen deficiency (68.6%) are investigated in 105 elderly patients, including 8 cases of liver depression subtype,46 cases of spleen-deficiency subtype,18 cases of spleen yang subtype.2. Psychological abnormalities are existed in elderly patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency. Compared with elderly healthy controls, anxiety, depression and total average score were significantly increased in the Elderly patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency with liver depression and spleen yang subtypes (P<0.01, P<0.05), depression and total average score were increased in spleen-deficiency subtype (P<0.05). Depression and total average score were lower in spleen-deficiency and spleen yang subtypes than liver depression subtype (P<0.01, P<0.05).3. The pathogenesis of elderly patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency is related to gastrointestinal hormones closely. Compared with the non-elderly D-IBS overlapped FD typed liver stagnation and spleen deficiency, the levels of CCK,5-HT, VIP are significantly increased in the elderly patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency (P<0.05), SS level was significantly decreased (P <0.05). Compared with the elderly healthy controls, the levels of CCK, CGRP,5-HT, VIP and SP are significantly increased in the elderly patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency (P<0.05).4. The major or minor of syndrome types of elderly patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency is related with gastrointestinal hormones. Compared with liver depression subtype, the levels of CCK,5-HT are significantly decreased in spleen-deficiency subtype (P<0.01, P<0.05), CCK is significantly decreased in spleen yang subtype (P<0.05).5. The pathogenesis of elderly patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency is related to immune function. Compared with the elderly healthy controls, CD4, CD4/CD8 were decreased in the elderly patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency (P<0.05). Compared with the non-elderly D-IBS overlapped FD typed liver stagnation and spleen deficiency, the level of TNF-α, IL-6, IL-1β in elderly patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency were decreased (P<0.05).[Conclusions] Elderly patients with D-IBS overlapped FD typed liver stagnation and spleen deficiency exist psychological abnormalities, the pathogenesis is related to gastrointestinal hormones and immune function.