| Objective:This topic is divided into two parts:clinical research and experimental research.In the clinical research part,to evaluate the clinical effect by observing the treatment of Qi deficiency type of slow transmission constipation by Yiqi Jianpi Tongbian recip;The experimental part through the observation of Yiqi Jianpi Tongbian recip on expression of interstitial cells of Cajal in colon tissue of rats with slow transit constipation model and the repaired effect on SCF/c-kit signal pathway.It theoretically reveals the possible mechanism of Yiqi Jianpi Tongbian recip treats slow transit constipation.Methods:Clinical part:70 patients with Qi deficiency type of slow transmission constipation included in the standard and exclusion criteria were selected as the research object.They were randomly divided into Chinese medicine treatment group and Western medicine control group,35 cases in each group.The patients in the treatment group were given the oral treatment of Yiqi Jianpi Tongbian recip,the patients in the control group were given oral administration of Macrogol 4000 Powders,the course of treatment was 4weeks.The colon transmission function,the symptom score of constipation and the clinical effect were used as the evaluation index of the curative effect.Experiment part:40 SPF Wister rats aged 8 weeks,were randomly divided into normal group,model group,polyethylene glycol group and Yiqi Jianpi Tongbian recip group,each group had 10 rats include 5 males and 5 females.Except normal group,a rat model of slow transit constipation was established by intragastric administration of compound diphenoxylate suspension(10 mg.kg-1.d-1)in three groups of rats.After successful modeling,the corresponding drug intervention treatment was given to rats in each group,after 4 weeks of continuous treatment,observe the intestinal propulsive rate of rats in each group;Use immunohistochemical method to detect the expression of interstitial cells of Cajal and Western Blot to detect the expression of c-kit and SCF protein in the colon tissue of rats.Results:Clinical part:A total of 66 patients were included in the statistical analysis,including 34in the treatment group and 32 in the control group.After treatment,compared with before treatment,the scores of colon transmission and constipation symptoms were significantly improved in the two groups?P<0.05?;The improvement of colon transmission function and constipation symptom score in the treatment group were better than that of the control group?P>0.05?.The total effective rate of the treatment group was significantly higher than that of the control group?P<0.05?,which showed that the clinical effect of the treatment group was better than that of the control group.Experimental part:After the end of modeling,the rats in the model group suffered from mental fatigue and crunch,and the skin was not smooth,and the reaction was slow.The stool particles were small and dry,and the food intake was reduced.Compared with the normal group,the model group and polyethylene glycol group and Yiqi Jianpi Tongbian recip group rats of the first black stool discharge time were significantly increased?P<0.05?;Compared with the normal group,the number of 24h defecation particles in the model group and the polyethylene glycol group and the Yiqi Jianpi tongbian recip group were significantly reduced?P<0.05?.The results showed that the STC rat model was successfully made.The intestinal propulsion rate of rats in comparison:Compared with the normal group,the rats in the model group,its intestinal propulsive rate decreased significantly?P<0.05?;compared with the model group,the polyethylene glycol group and Yiqi Jianpi Tongbian recip group rats of the intestinal propulsive rate increased significantly?P<0.05?;The Yiqi Jianpi Tongbian recip group and and polyethylene glycol group rats of the intestinal propulsion rate had no significant difference?P>0.05?.Comparison of ICC area of colon tissue:compared with the normal group,the area of ICC in colon tissue of rats in the model group was significantly decreased?P<0.05?;compared with the model group,the polyethylene glycol group and Yiqi Jianpi Tongbian recip group rats of the colon tissue ICC area increased significantly?P<0.05?;compared with the polyethylene glycol group,Yiqi Jianpi Tongbian recip group rats of the colon tissue ICC area was significantly increased?P<0.05?.The expression of c-kit protein and SCF protein in colon tissue of rats in comparison:Compared with the normal group,the expression of c-kit protein and SCF protein in the colon tissue of the model group were significantly decreased?P<0.05?;Compared with the model group,the expression of c-kit protein and SCF protein in the colon tissue of the polyethylene glycol group and Yiqi Jianpi Tongbian recip group were significantly increased?P<0.05?.The expression of c-kit and SCF protein in the colonic tissue of the rats of Yiqi Jianpi Tongbian recip group were higher than that of the polyethylene glycol group,but there was no statistically significant difference?P>0.05?.Conclusion:1.Yiqi Jianpi Tongbian recipe in the treatment of Qi deficiency type of slow transit constipation has obvious curative effect,it is superior to the western medicine polyethylene glycol 4000 powder in the improvement of colon transmission function,symptom score of constipation and clinical efficacy.It is worthy of further application in clinical practice.2.Compound diphenoxylate used to establish the STC rat model was rapid,stable and high safety.Compound diphenoxylate on colon stimulation can induce colon tissue ICC,c-kit protein and SCF protein expression decreased and normal SCF/c-kit signaling pathway destroyed,which can lead to the structure and number of ICC changes.Thus,the colonic motility is weakened and constipation is formed,this may be one of the pathogenesis of STC.3.The general situation of STC rats'spirit,activity,reaction,diet,feces and other general conditions and colonic power were obviously improved by Yiqi Jianpi tongbian recipe.4.The therapeutic effect of Yiqi Jianpi tongbian recipe on STC is significant,and its mechanism may be related to increase the expression of ICC in colon tissue and repair SCF/c-kit signal transduction pathway,thereby,enhancing gastrointestinal pacing function and electric conduction and promoting gastrointestinal motility,increasing intestinal transport,which can promote defecation. |
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