Clinical Effect Of Si Mo And Wu Ren Decoction On Patients With Liver Qi Stagnation Type IBS-C And Its Influence On Plasma VIP And CGRP

Objective:1.The research aimed to observe the clinical efficacy and impact on the quality of life of Si Mo and Wu Ren Decoction in treatment for liver qi stagnation type Irritable Bowel Syndrome with Predominant Constipation(IBS-C).2.Detected the changes in Vasoactive Intestinal Peptide(VIP)and Calcitonin Gene-related Peptide(CGRP)in peripheral plasma before and after treatment,And explored the potential mechanism between liver qi stagnation type IBS-C and the prescription.3.Explored the relationship between plasma VIP 5and CGRP levels and IBS-C.Methods:1.The clinical have collected the inclusion criteria of liver qi stagnation type IBS-C of 72 patients were in random.According to random number table method,72 patients who suffered from IBS-C were selected and divided randomly into two groups-Chinese medicine treatment group(n=36)and Western medicine control group(n=36).Another 36 healthy volunteers from the physical examination center of the hospital were taken as healthy control group.2.The Chinese medicine treatment group was given Si Mo and Wu Ren Decoction,Lactulose Oral Solution control group was received for 2 weeks.3.Collected and recorded the general data of the patient's age,gender,course of disease,et al.The clinical symptoms score and IBS–QOL score were observed and recorded before and after treatment and at follow–up.The ELISA method was used to detect plasma VIP and CGRP content during the time.Results:1.Comparison of general data: There was no statistically significant difference in age,gender,and duration of disease between the Chinese medicine treatment group and the western medicine control group.The IBS-C patients were mostly female,with a male to female ratio of about 1:1.96.2.Comparison of clinical symptoms: Statistical analysis of the two groups of pre-treatment single symptom scores and total symptom scores,their P values were >0.05,and the difference was not statistically significant,which was comparable.The Chinese medicine treatment group had a certain decreased in single symptom scores and symptom scores after treatment and follow-up(P<0.05),and it was better than the western medicine control group(P<0.05),except in the number of defecations.It had a stable effect,especially in abdominal pain frequency and chest tightness(compared with the western medicine group,P<0.01).3.Comparison of comprehensive efficacy: The total effective rate of the patients with IBS-C was 88.2%.The Chinese medicine treatment group was superior to the western medicine control group(P<0.01).4.Comparison of living quality: Statistical analysis of the two groups of pre-treatment IBS-QOL single scores and total scores of all dimensions,their P values were >0.05,and the difference was not statistically significant,which was comparable.There was a certain improvement effect in IBS-QOL scores after treatment and follow-up(P<0.05).Among the scores of each dimension,the Chinese medicine treatment group was superior to the western medicine control group in the five dimensions of anxiety,behavioral disorder,health anxiety,social function and interpersonal relationship(P<0.05),and the total scores is higher than the western medicine control group(P<0.05).5.Comparison of plasma VIP and CGRP contents: The plasma VIP and CGRP levels in the Chinese medicine treatment group and the western medicine control group were higher than those in the healthy control group(P<0.05).There was no significant difference between the two groups(P>0.05),which was comparable.The plasma VIP and CGRP contents in the two groups were significantly lower than those before treatment(P<0.01),and the degree of decline in the Chinese medicine treatment group was superior to the western medicine control group(P<0.05).6.Correlation analysis: The difference of single symptom in liver qi stagnation type IBS-C patients,compared with the changes of plasma VIP and CGRP levels,all of them were positively correlated,except for no relevance between the number of defecations and the VIP content.The difference between the total scores of symptoms in IBS-C patients before and after treatment was positively correlated with the changes of plasma VIP and CGRP levels.There was no essential correlation between the difference of IBS-QOL total score and the changes of plasma VIP and CGRP content.In conclusion:1.Si Mo and Wu Ren Decoction has a good and stable clinical effect on patients with liver qi stagnation type IBS-C,which can enhance patients' quality of life.2.Reducing the levels of plasma VIP and CGRP and correcting the abnormal secretion of brain-gut peptide may be one of the mechanisms of Si Mo and Wu Ren Decoction in the treatment of IBS-C.3.Plasma VIP and CGRP levels in patients with IBS-C are significantly higher than those in healthy volunteers,and are associated with related symptoms,which can be used as a reference indicator to reflect the severity of IBS-C.