| Objective: This study firstly evaluated the clinical efficacy of Liumo Decoction in the treatment of slow transit constipation(Qi stagnation)through clinical research.Then established a rat model of slow transit constipation,and to observe the effect of Liumo Decoction on intestinal digestive enzyme and nitric oxide synthase(NOS)expression of rats with slow transit constipation(STC),and to explore its therapeutic mechanism.Methods: 1.Select 60 patients who were diagnosed with slow transit constipation(Qi stagnation)in the gastrointestinal anal surgery clinic or ward of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from March 2017 to December 2018.There were 30 cases in the Chinese medicine group and the western medicine group.The Chinese medicine group was treated with oral Liumo Decoction.The western medicine group was treated with mosapride citrate.The symptom scores,quality of life scores,anxiety,depression scores and clinical outcomes of the two groups were compared before andafter treatment.2.Thirty SPF-level Wistar rats were randomly divided into normal group(n=10)and model group(n=20).The rat model of slow transit constipation was established by feeding the compound containing compound phenethylpiperidine.After successful modeling,it was randomly divided into normal saline group(n=10)and Liumo Decoction group(n=10).In the saline group,each rat in the saline group was given normal saline by gavage,and the Liumo Decoction group was given Liumo Decoction by gavage according to the “ equivalent dose ”calculation method.After the intervention,the intestinal cellulase,xylanase,amylase,protease activity and NOS expression of the rats in each group were detected.Results: 1.In the clinical study,the total effective rate of the Chinese medicine group was 86.67%,and the recurrence rate was 19.23%.The total effective rate of the western medicine group was 73.33%,and the recurrence rate was 54.54%.At different time points,the fecal traits and the laxative scores of the two groups were compared,and the repeated measures analysis of variance was performed,suggesting that the difference between the groups was not obvious(P>0.05).The time and interaction effects were significantly different(P<0.01).At different time points,the two groups of defecation time,defecation frequency,abdominal distension and total score were compared,and repeated measures analysis of variance was performed,suggesting that there wassignificant difference between groups,time and interaction,which was statistically significant(P < 0.05).At different time points,the two dimensions of social psychology,worry and anxiety were compared,and the repeated measures analysis of variance was performed,suggesting that the inter-group effect was not obvious(P > 0.05).The time and interaction effects were significantly different(P < 0.01).At different time points,the two groups of physiological status,satisfaction two dimensional integrals and total scores were compared,and repeated measures analysis of variance was performed,suggesting that there was a statistically significant difference between groups,time and interaction(P< 0.05).At different time points,the two groups of depression scores were compared,and the repeated measures analysis of variance was performed,suggesting that the effect between groups was not obvious(P>0.05),and the time and interaction effects were significantly different(P < 0.01).At different time points,the total scores of anxiety were compared,and repeated measures analysis of variance was performed,suggesting that there was a statistically significant difference between groups,time and interaction(P<0.05).2.In the animal experiment,the discharge time of the first black stool in the saline group was significantly longer than that in the normal group(P<0.05).The discharge time of the first black stool in the Liumo Decoction group was significantly shorter than that in the normal saline group(P<0.05).And close to the normalgroup(P > 0.05).Compared with the normal group,the activity of intestinal xylanase,cellulase and protease in the saline group was significantly decreased,and the amylase activity was increased(P<0.05).The Liumo Decoction group was compared with the saline group,the activities of intestinal amylase and xylanase in Liuliutang group were significantly increased(P < 0.05),and the activities of cellulase and protease were not changed(P>0.05).In the normal group,the colonic nerve structure was evenly distributed,and no plexus lesions were observed.In the saline group,the colonic plexus structure was disordered,and the number of NOS positive expression in the colon tissue was significantly increased.The number of NOS positive expression in the colon tissue was significantly reduced and the structure of the nerve plexus was restored in the Liumo Decoction group.In the semi-quantitative analysis of immunohistochemistry,the positive expression rate of NOS in the colon tissue of the saline group was significantly higher than that of the normal group(P<0.05).The positive expression rate of NOS in the colon tissue of Liumo Decoction group was significantly lower than that of the saline group(P<0.05).The positive expression rate of NOS in colon tissue of Liumo Decoction group was not significantly different from that of normal group(P>0.05).Conclusion: 1.Liumo Decoction is a better treatment for slow transit constipation(Qi stagnation)than patients with better quality of life,depression and anxiety,lower constipation total score and clinical efficacy,and the recurrence rate is lower.2.Liumo Decoction can improve the symptoms of constipation by increasing the activity of intestinal amylase and xylanase in stc rats,but the regulation effect on the activity of intestinal protease and xylanase is not obvious.3.Liumo Decoction can repair the damaged intermuscular nerve plexus structure of STC rats,reduce the expression of NOS in the colon tissue of stc rats,reduce the formation of NO,relieve the inhibition of smooth muscle,restore colonic peristalsis,there by improving intestinal transmission function. |
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