Effects Of Huangshu Enema On The Levels Of TNF-α In Patients With Irritable Bowel Syndrome

Objective:To investigate the effect of Chinese medicine Huangshu Enema (HSE) on thelevel of TNF-α (tumor necrosis factor, TNF-α) in the serum of IBS (irritable bowelsyndrome) and to explore therapeutic mechanism.Method:60IBS patients were randomly divided into HSE treatment group andpinaverium bromide treatment group, HSE treatment group include18patients withIBS-D(diarrhea-predominant irritable bowel syndrome,IBS–D),12patients withIBS-C (constipation-predominant irritable bowel syndrome, IBS-C), the pinaveriumbromide treatment group include17patients with IBS-D,13patients with IBS-C.theHSE treatment group was given Huangshu enema for10days, the pinaveriumbromide treatment group was given pinaverium bromide Tablets for10days, Thelevel of TNF-α and the symptoms score were measured before and after treatment.Results:1.For patients with IBS-D, diarrhea, abdominal pain, abdominal distention score,total score and the level of TNF-α after treatment were significantly lower than beforetreatment in the HSE treatment group (1.44±0.70vs2.17±0.79;1.00±0.77vs2.22±0.55;0.73±0.67vs1.22±0.72;3.12±1.34vs5.61±1.42;42.73±11.45vs53.06±6.49, P <0.05), abdominal pain score after treatment was lower than beforetreatment in the pinaverium bromide treatment group (1.53±0.62vs2.24±0.56, P <0.05), but the diarrhea, abdominal distension, total score and the level of TNF-α wereno significant difference between after treatment and before treatment (2.17±0.73vs2.24±0.75;1.35±0.49vs1.29±0.69;5.00±1.71vs5.76±1.30;44.34±10.25vs50.00±6.75, P>0.05).2. For patients with IBS-C, constipation, abdominal pain, abdominal distentionscore and total score after treatment were significantly lower than before treatment inthe HSE treatment group (1.42±0.52vs2.08±0.79;1.17±0.71vs2.17±0.58; 0.72±0.52vs1.17±0.50;3.31±1.00vs5.42±3.08, P <0.05), but the level of TNF-αwas no significant difference between after treatment and before treatment(23.89±5.92vs23.94±4.62, P>0.05), abdominal pain score after treatment waslower than before treatment in the pinaverium bromide treatment group (1.46±0.66vs2.23±0.60, P <0.05), but the constipation, abdominal distension,total score and thelevel of TNF-α were no significant difference between after treatment and beforetreatment (2.08±0.76vs2.15±0.80;1.30±0.48vs1.23±0.73;4.77±1.09vs5.62±1.26;22.87±1.64vs23.53±4.53, P>0.05).Conclusions:1.Huangshu enema can effectively improve the symptoms of irritable bowelsyndrome.2. Huangshu enema can inhibitto the IBS-D expression level of serum TNF-α.3. The expression of TNF-α play an important role in the pathogenesis ofIBS-D.