| Objective In this study,xiahuang granule was taken as the research object.Firstly,the clinical effect of xiahuang Granule on the constipation caused by opioids was observed.Then,the mechanism of action was discussed by the influence of xiahuang Granule on the defecation function and small intestine movement function of mice,and on the level of SP,VIP and c-kit in the intestinal tissue of mice.It will lay a foundation for further research and development of convenient,effective and safe pure Chinese medicine to alleviate the constipation caused by opioids.Methods1.In clinical research,sixty patients with opioid related constipation in oncology department were selected according to the standard of natriuretic excretion,and they were divided into two groups according to the ratio of 1:1.The treatment group 30 cases were treated with xiahuang granule 6g Tid,and the control group were treated with compound aloe capsule 0.5g Bid.The two groups of patients received 2 weeks of treatment.The improvement of constipation symptom,the change of constipation symptom score,the change of Karnofsky score and the observation of medication safety were observed in the two groups.2.Animal experiment: Sixty mice were randomly divided into 6 groups(10 mice in each group): blank group,model control group,compound aloe capsule group,low-dose xiahuang granule group,middle dose xiahuang granule group and high-dose xiahuang granule group.Except the blank group,the constipation model was established in the other five groups(construction method: morphine hydrochloride was injected subcutaneously for 45 days,and the daily injection dose was 2.5mg/kg).After the success of modeling,each group was given corresponding drug treatment.After 1 week treatment,the defecation function of each group of mice(observation index: the small intestine ink propulsion rate)and the small intestine movement function(observation index: the first black stool discharge time,the number and weight of black stool in 6 hours)were compared.3.The contents of SP,VIP and c-kit in the colon of mice in each group were detected by ELISA.Result1.Xiahuang granule has the function of detoxification and purging turbidity,clearing Fu organs and stomach.It has good clinical effect in the treatment of opioid induced constipation.In the improvement of constipation symptoms(observation index: the total effective rate of constipation treatment),the difference between the two groups was statistically significant,which was 93.3% in the treatment group and 76.7% in the control group.Both drugs could effectively reduce the constipation symptom score,while xiahuang granule was slightly better in improving defecation and abdominal distension;in terms of improving the quality of life,xiahuang granule was better than compound aloe capsule in improving the quality of life In the aspect of medication safety,both drugs had no negative effect on the hemogram indexes of patients.2.Xiahuang granule can effectively improve the defecation function and small intestine movement function of mice.Compared with the model group,the high and medium dose groups of xiahuang granules were able to significantly shorten the first black stool excretion time,and increase the number of black stool particles in 6 hours,the weight of black stool in 6hours and the small intestine propulsion rate after 7 days of administration(P < 0.05);there were no significant differences in the small intestine propulsion rate,the first black stool excretion time,the number of black stool particles in 6 hours and the weight of black stool in6 hours between the middle dose group of xiahuang granules and the compound aloe capsule group(P > 0.05)Compared with the compound aloe capsule group,the weight of mice in the middle dose group can be increased to a certain extent when the defecation effect is equivalent to that in the middle dose group.3.Xiahuang granule can obviously intervene the contents of SP,VIP and c-kit in colon tissue of mice.Compared with the model group,after 7 days of administration,xiahuang granule high and medium dose groups could significantly increase the levels of SP and c-kit in colon tissue of mice,and significantly reduce the level of VIP(P < 0.05).The gastrointestinal peristalsis function was promoted with the recovery of gastrointestinal smooth muscle peristaltic contraction and the increase of water and electrolyte secretion of gastrointestinal mucosa,thus relieving constipation.There was no significant difference in SP,VIP and c-kit levels between xiahuang granule medium dose group and compound aloe capsule group(P >0.05).Conclusion1.Xiahuang granule has a good defecation effect on the constipation caused by opiates,can effectively improve the quality of life of patients,and the side effects are not significant,so it can be used safely.2.Animal experiments show that xiahuang granule has obvious promoting effect on small intestine movement of mice with opioid induced constipation,which can effectively promote defecation and shorten defecation time,and the effect is positively correlated with the dosage.3.Xiahuang granule can significantly increase the level of SP and decrease the level of VIP in colon tissue of mice.The gastrointestinal peristalsis function can be promoted with the recovery of gastrointestinal smooth muscle peristaltic contractioncontraction and the increase of water and electrolyte secretion of gastrointestinal mucosa.The promoting effect of interstitial cells of Cajal on gastrointestinal activity can also be restored with the significant increase of c-kit level,thus effectively enhancing the colonic peristalsis to relieve constipation.To sum up,xiahuang granule has significant clinical efficacy,and its mechanism of action is related to the regulation of SP,VIP and c-kit levels in intestinal tissue,which provides theoretical support for its effective alleviation of opioid related constipation,and there is no obvious adverse reaction in the research process,so it is worthy of clinical application. |
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