| ObjectiveChangJiNing decoction was used to treat patients with diarrhea of irritable bowel syndrome of liver-depression and spleen-deficiency,in this research.To observe the curative effect and clinical safety of physical and mental symptoms,so as to provide a new method for the treatment of this disease.At the same time,study its therapeutic mechanism and provide pharmacological basis for clinical application through observing the efficacy of ChangJiNing decoction in rats diarrhea of irritable bowel syndrome of liver-depression and spleen-deficiency.MethodsClinical research;Select 72 patients who met the inclusion criteria of IBS-D of liver-depression and spleen-deficiency from the out-patients and in-patients in the Guangdong Provincial Second Chinese Medicine Hospital during March 2015 to January 2017.The patients were randomly divided into experimental group(ChangJiNing decoction)and control group(TongXieNing),36 cases in each group.The course of treatment was 4 weeks.The data of clinical symptoms,Hamilton Anxiety Scale(HAMA)score and recurrence rate were recorded before and after treatment,and the data were analyzed statistically.Experimental research:80 Wistar rats were randomly divided into blank group(20 rats)and model group(60 rats).The rats in the model group were treated with forced swimming,abnormal of starvation and full,gavage of folium sennae to create diarrhea of irritable bowel syndrome of liver-depression and spleen-deficiency.After modeling the rats were randomly assigned into model group(20 rats),positive control group(20 rats),and experimental group(20 rats).The experimental group was given ChangJiNing decoction solution by intragastric administration.Positive control group had TongXieNing Granule solution in the same way.Blank group and model group were given the same amount of normal saline,14d,1 times a day gavage.Observe the general situation of rats,fecal water content,stools,dilute rate,sugar water preference index,open field test and assessment of rat colon sensitivity after 14d.Scissoring bowel from pylorus to ileocecal region.Record the total length of the small intestine and the length of the longest distance between the pyloric tube and the carbon and calculate the carbon propulsion rate.At the same time,5-HT,SP and VIP were detected by abdominal aorta blood collection,and the results were statistically analyzed.The discussion of ChangJiNing decoction therapeutic mechanism was conducted based on the analysis.ResultsClinical study:The HAMA scores:the HAMA score reduction of ChangJiNing group was 14.14±3.19,it had a higher rate than the TongXieNing group(10.89±3.66)(P<0.01).The HAMA score deduction rate:the HAMA score reduction rate of ChangJiNing group was 88.89%,it had a higher rate than the TongXieNing group(58.33%)(P<0.01).The total effective rate:the ChangJiNing group had 94.44%of the total efficiency,it was higher than the TongXieNing group(74.36%)(P<0.05).The recurrence rate:the ChangJiNing group had 4.55%of the recurrence,it was lower than the TongXieNing group(22.22%)(P<0.05).Animal experiment:The weight change:The weight gain of the model group was 4.79±6.68 g.It was lower than the ChangJiNing group(19.05±12.61g),TongXieNing group(9.38±9.23g)and blank group(20.71 ±10.Olg).Compared with the model group,there was a significant increase in the weight gain of the other three groups(P<0.01).Compared with the TongXieNing group,the weight gain of ChangJiNing group was significantly increased(P<0.01).The fecal water content:The fecal water content of model group was 31.66±2.32%,it was higher than the ChangJiNing group(20,49±2.32%),TongXieNing group(27.64±2.40%)and blank group(20.05±2.18%).Compared with the model group,the fecal water content of the other three groups was significantly lower(P<0.01).Compared with the TongXieNing group,the fecal water content of ChangJiNing group was significantly decreased(P<0.01).The loose stools index:the loose stools index of model group was 1.8685± 0.6523,it was higher than the ChangJiNing group(1.1365 ± 0.4771),TongXieNing group(1.7230±0.4483)and blank group(1.8685±0.6523),compared with the model group,the remaining three groups were significantly lower(P<0.01);compared with the ChangJiNing group group,the TongXieNing group was significantly higher(P<0.05).The loose stools rate:the loose stools rate of model group was 74.35±20.83%,it was much higher than the ChangJiNing group(34.38 ± 14.76%),TongXieNing group(66.89 ± 11.92%)and blank group(35.97 ± 13.88%),compared with the model group,the remaining three groups were significantly lower(P<0.01);compared with the ChangJiNing group group,the TongXieNing group was significantly higher(P<0.05).The saccharine preference index:the saccharine preference of model group was 90.57±1.19%,it was lower than the ChangJiNing group(91.87±1.03%),TongXieNing group(90.97±1.21%)and blank group(90.57±1.19%).Compared with the model group,the remaining three groups were significantly higher(P<0.01).Compared with the ChangJiNing group,the TongXieNing group was significantly lower(P<0.05).The score of open-field:the total scores of model group was 109.40 ± 11.07,it was lower than the ChangJiNing group(126.80 ± 12.6),TongXieNing group(115.70 ±9.49)and blank group(137.20 ± 8.77),compared with the model group,the remaining three groups were significantly higher(P<10.07);compared with the ChangJiNing group group,the TongXieNing group was significantly lower(P<0.05).The crossing score of TongXieNing group was also lower(P<0.05),while the rearing scores was a little lower(P>0.05).The abdominal withdrawal reflex sensation threshold:the abdomen raised sensation threshold of model group was 29.54±3.07mmHg,it was lower than the ChangJiNing group(34.12±4.86mmHg),TongXieNing group(31.37±4.42mmHg)and blank group(35.31 ± 4.82mmHg).Compared with the model group,the remaining three groups were significantly higher(P<0.01);compared with the ChangJiNing group,the TongXieNing group was significantly lower(P<0.05).The back arched sensation threshold of model group was 32.54 ± 3.04mmHg,it was lower than the ChangJiNing group(38.00±4.50mmHg),TongXieNing group(34.78±4.06mmHg)and blank group(39.98±4.03mmHg).Compared with the model group,the others were significantly higher(P<0.01);compared with the ChangJiNing group,the TongXieNing group was significantly lower(P<0.05).The small intestinal propulsion index:the index of model group was 55.06±5.95%,it was much higher than the ChangJiNing group(49.28 ± 7.41%),TongXieNing group(54.30±5.81%)and blank group(49.79±6.68%).Compared with the model group,the remaining three groups were significantly lower(P<0.01);compared with the ChangJiNing group,the TongXieNing group was significantly higher(P<0.05).5-HT:the average level of 5-HT in model group was 58.80±5.56ng/ml,the ChangJiNing group was 48.88±9.01 ng/ml,TongXieNing group was 53.46±6.20 ng/ml,blank group was 44.05 ± 5.58ng/ml.Compared with the model group,the remaining three groups were significantly lower(P<0.01);compared with the ChangJiNing group,the TongXieNing group was significantly lower(P<0.05).VIP:the average level of VIP in model group was 198.25 ± 38.08pg/ml,the ChangJiNing group was 174.54 ± 35.99 pg/ml,TongXieNing group was 149.53±23.78 pg/ml,blank group was 132.39±39.96 pg/ml.Compared with the model group,the remaining three groups were significantly lower(P<0.01);compared with the ChangJiNing group,the TongXieNing group was significantly lower(P<0.05).SP:the average level of SP in model group was 2632.62±926.92pg/ml,the ChangJiNing group was 1920.69±606.59 pg/ml,TongXieNing group was 2397.56±585.89pg/ml,blank group was 1778.94±686.92 pg/ml.Compared with the model group,the remaining three groups were significantly lower(P<0.01);compared with the ChangJiNing group,the TongXieNing group was significantly lower(P<0.05).ConclusionClinical survey show that:1.ChangJiNing decoction has visible effect in treating diarrhea of irritable bowel syndrome of liver-depression and spleen-deficiency,which can relieve the symptoms and prevent the recrudesce.2.ChangJiNing decoction can decrease patients’ HAMA scores and improve the anxiety state significantly.3.There was no obvious main complaint about side effects during and after the period of ChangJiNing decoction treatment.Animal experiments show that:1.The ChangJiNing decoction can treat diarrhea of irritable bowel syndrome of liver-depression and spleen-deficiency with its functions of adjusting the contents of 5-HT、VIP、SP.2.The ChangJiNing decoction can improve loose stools,motoractivity and emotion in rats.In summary,it means ChangJiNing decoction is safe and effective in treating diarrhea of irritable bowel syndrome of liver-depression and sple en-deficiency,and no adverse reaction.It is worthy of clinical application. |
