微痛泻要方对腹泻型肠易激综合征胃肠激素影响的临床与实验研究
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摘要
第一部分：超微痛泻要方治疗腹泻型肠易激综合征临床研究
目的：评价超微痛泻要方治疗肠易激综合征的临床疗效,观察其对胃肠激素的影响。
方法：采用随机对照实验方法对60例辩证为肝气乘脾型肠易激综合症患者分为2组,分别给予传统痛泻要方,1／3剂量超微痛泻要方治疗,以15天为一观察疗程,观察各组治疗前后临床症状变化及血浆GLP-1,SS,MTL水平的变化。
结果：1.传统痛泻要方治疗组总有效率为96.7%,1／3超微组为96.7%,两者临床疗效基本一致,显效率超微组为63%,传统组为47%,超微组较传统组为优(P<0.05)。
2.与治疗前相比,痛泻要方传统组,1／3超微组均能降低GLP-1,SS及MTL水平,组间比较差异无统计学意义。
结论：痛泻要方能明显改善肠易激综合征患者临床症状,1／3剂量超微组与传统组疗效基本相当；痛泻要方能明显调节肠易激综合征患者胃肠激素水平,使之趋于正常；GLP-1与肠易激综合征关系密切,可能是其发病机理之一。
第二部分：超微痛泻要方对肠易激综合征大鼠胃肠激素的影响
目的：观察传统痛泻要方与超微痛泻要方对肠易激综合征大鼠模型组织和血浆GLP-1、SS、SP、MTL含量的影响。观察传统痛泻要方与超微痛泻要方对肠易激综合征大鼠模型组织GLP-1、SSR1mRNA表达的影响,探讨其调节相关胃肠激素水平的分子机制。
方法：取SD大鼠60只,随机分为空白对照组、模型组、传统痛泻要方组、超微痛泻要方组,1／3超微痛泻要方组。1／6超微痛泻要方组,用番泻叶及束缚方法造成肠易激综合征模型,空白组灌胃高压消毒水,其余各组灌胃番泻叶及束缚应激,3天后称量粪便干湿重及腹肌收缩试验,每天收集粪便称量其干重、湿重。2周后提取标本,用放射免疫法(RIA)检测组织、血浆GLP-1、SS、SP、MTL水平。用RT-PCR法检测组织GLP-1、SSR1mRNA表达。
结果：1.痛泻要方各治疗组除1／6超微组外,粪便含水量均明显减少(P<0.01),腹肌收缩次数均明显减少(P<0.01)；且超微痛泻要方疗效优于传统痛泻要方(P<0.05),但1／3超微组与等剂量超微组差异不明显(P>0.05)。2.超微组组织、血浆GLP-1、SS、SP、MTL水平均低于传统痛泻要方组(P<0.01)；3.超微组、传统组、1／3超微组组织、血浆GLP-1、SS、SP、MTL均低于模型组(P<0.01)；1／6超微组与模型组相比,各指标含量略低,但差异无统计学意义(P>0.05)；4.组间比较,超微组组织、血浆各指标低于传统组(P<0.01),1／3超微组与传统组比较,差异无显著意义(P>0.05)。
结论：1.超微痛泻要方对肠易激综合征大鼠有治疗作用。2.超微痛泻要方对肠易激综合征大鼠胃肠激素有明显调节作用,抑制大鼠GLP-1的分泌,抑制SS、SP、MTL的分泌；且GLP-1与肠易激综合征关系密切,可能是其发病机理之一。3.超微痛泻要方对肠易激综合征大鼠结肠黏膜GLP-1、SSR1mRNA表达有抑制作用。4.超微痛泻要方疗效优于传统痛泻要方疗效。
Part I Clinic research on D-IBS by Tongxieyaofang ultramicro-drug.
Objective:To evaluate the clinical effect of Tongxieyaofang(TXYF) ultramicro-drug(UMD) on diarrhea-Irritable bowel syndrome (D-IBS), and the gastrointestinal hormone changes.
Method:60 patients with D-IBS were divided randomly into two groups,treated with one dose traditional TXYF(TTXYF) and one third dose TXYFUMD(1/3TXYFUMD) respectively, two weeks for one period of treatment, the glucagon-like peptide-1 (GLP-1), Somatostatin (SS) and motilin (MTL) were selected as evaluating items.
Results:1. The total effect rate of TTXYF and 1/3TXYFUMD were 96.7% and96.7% respectively and the Chinic efficiency were equal, The effectiue rate of 1/3 TXYFUMD was higher than that of TTXYF (p<0.05). 2. Two groups could reduce GLP-1, SS and MTL, and there were no significant difference between them.
Conclusion:TXYF could improve the symptom of D-IBS, the efficienly between them are equal. TXYF may inhibit the secretion of GLP-1, SS and MTL.
Part II The effect of TXYF UMD on D-IBS rats GLP-1, SS and MTL.
Objective:To explor the effect of TTXYF and TXYF UMD on GLP-1, SS and MTL content in tissue and serum of normal rats and D-IBS rats.
Method:60 SD rats were randomly divided into normal contrast group, D-IBS group, traditional TXYF group, divided into normal contrast group, D-IBS group, traditional TXYF group, TXYF UMD group,1/3 TXYF UMD group,1/6 TXYF UMD group. D-IBS groups were induced by drugs and bunch, the mormal contrast group were given high pressure disinfection water. To have a experiment of deliver of bowel and costringency experiment of abdominal muscles after 3 days. To collect the excrement of rats and measure its dry weight and wet weight. Withdraw specimen after 2 weeks.measure the level of GLP-1, SS and MTL of tissue and serum with the method of radioimmunoassay way (RIA).
Results:1. the tissue and serum GLP-1, SS,SP, MTL in the TXYF UMD group were lower than those in TTXYF group (p<0.01).2. The tissue and serum GLP-1, SS,SP and MTL in the TXYF UMD group,TTXYF group, and 1/3 TXYF UMD group were all lower than those in D-IBS group (p<0.01). but there were no significant difference between 1/6 TXYFUMD and D-IBS group. 3. The tissue and serum GLP-1,SS,SP and MTL in the D-IBS group were higher than those in other group (p< 0.01), and there were no significant difference between the 1/6 TXYFUMD group and D-IBS group (p>0.05).4.The tissue and serum GLP-1,SS,SP and MTL in the TXYFUMD group were all lower than those in TTXYF group (p< 0.01), and there were no significant difference between the 1/3 TXYFUMD group and TTXYF group (p>0.05)
Conclusion:1.TXYF has the function to regulate the gastrointestinal hormone for rats.2.1t may reduce the secretion of GLP-1, SS,SP and MTL.3. The TXYFUMD may reduce the secretion of GLP-1mRNA and SSR1RNA of D-IBS rats.4. The function of TXYFUMD may be more superior to function of TTXYF.
目的：评价超微痛泻要方治疗肠易激综合征的临床疗效,观察其对胃肠激素的影响。
方法：采用随机对照实验方法对60例辩证为肝气乘脾型肠易激综合症患者分为2组,分别给予传统痛泻要方,1／3剂量超微痛泻要方治疗,以15天为一观察疗程,观察各组治疗前后临床症状变化及血浆GLP-1,SS,MTL水平的变化。
结果：1.传统痛泻要方治疗组总有效率为96.7%,1／3超微组为96.7%,两者临床疗效基本一致,显效率超微组为63%,传统组为47%,超微组较传统组为优(P<0.05)。
2.与治疗前相比,痛泻要方传统组,1／3超微组均能降低GLP-1,SS及MTL水平,组间比较差异无统计学意义。
结论：痛泻要方能明显改善肠易激综合征患者临床症状,1／3剂量超微组与传统组疗效基本相当；痛泻要方能明显调节肠易激综合征患者胃肠激素水平,使之趋于正常；GLP-1与肠易激综合征关系密切,可能是其发病机理之一。
第二部分：超微痛泻要方对肠易激综合征大鼠胃肠激素的影响
目的：观察传统痛泻要方与超微痛泻要方对肠易激综合征大鼠模型组织和血浆GLP-1、SS、SP、MTL含量的影响。观察传统痛泻要方与超微痛泻要方对肠易激综合征大鼠模型组织GLP-1、SSR1mRNA表达的影响,探讨其调节相关胃肠激素水平的分子机制。
方法：取SD大鼠60只,随机分为空白对照组、模型组、传统痛泻要方组、超微痛泻要方组,1／3超微痛泻要方组。1／6超微痛泻要方组,用番泻叶及束缚方法造成肠易激综合征模型,空白组灌胃高压消毒水,其余各组灌胃番泻叶及束缚应激,3天后称量粪便干湿重及腹肌收缩试验,每天收集粪便称量其干重、湿重。2周后提取标本,用放射免疫法(RIA)检测组织、血浆GLP-1、SS、SP、MTL水平。用RT-PCR法检测组织GLP-1、SSR1mRNA表达。
结果：1.痛泻要方各治疗组除1／6超微组外,粪便含水量均明显减少(P<0.01),腹肌收缩次数均明显减少(P<0.01)；且超微痛泻要方疗效优于传统痛泻要方(P<0.05),但1／3超微组与等剂量超微组差异不明显(P>0.05)。2.超微组组织、血浆GLP-1、SS、SP、MTL水平均低于传统痛泻要方组(P<0.01)；3.超微组、传统组、1／3超微组组织、血浆GLP-1、SS、SP、MTL均低于模型组(P<0.01)；1／6超微组与模型组相比,各指标含量略低,但差异无统计学意义(P>0.05)；4.组间比较,超微组组织、血浆各指标低于传统组(P<0.01),1／3超微组与传统组比较,差异无显著意义(P>0.05)。
结论：1.超微痛泻要方对肠易激综合征大鼠有治疗作用。2.超微痛泻要方对肠易激综合征大鼠胃肠激素有明显调节作用,抑制大鼠GLP-1的分泌,抑制SS、SP、MTL的分泌；且GLP-1与肠易激综合征关系密切,可能是其发病机理之一。3.超微痛泻要方对肠易激综合征大鼠结肠黏膜GLP-1、SSR1mRNA表达有抑制作用。4.超微痛泻要方疗效优于传统痛泻要方疗效。
Part I Clinic research on D-IBS by Tongxieyaofang ultramicro-drug.
Objective:To evaluate the clinical effect of Tongxieyaofang(TXYF) ultramicro-drug(UMD) on diarrhea-Irritable bowel syndrome (D-IBS), and the gastrointestinal hormone changes.
Method:60 patients with D-IBS were divided randomly into two groups,treated with one dose traditional TXYF(TTXYF) and one third dose TXYFUMD(1/3TXYFUMD) respectively, two weeks for one period of treatment, the glucagon-like peptide-1 (GLP-1), Somatostatin (SS) and motilin (MTL) were selected as evaluating items.
Results:1. The total effect rate of TTXYF and 1/3TXYFUMD were 96.7% and96.7% respectively and the Chinic efficiency were equal, The effectiue rate of 1/3 TXYFUMD was higher than that of TTXYF (p<0.05). 2. Two groups could reduce GLP-1, SS and MTL, and there were no significant difference between them.
Conclusion:TXYF could improve the symptom of D-IBS, the efficienly between them are equal. TXYF may inhibit the secretion of GLP-1, SS and MTL.
Part II The effect of TXYF UMD on D-IBS rats GLP-1, SS and MTL.
Objective:To explor the effect of TTXYF and TXYF UMD on GLP-1, SS and MTL content in tissue and serum of normal rats and D-IBS rats.
Method:60 SD rats were randomly divided into normal contrast group, D-IBS group, traditional TXYF group, divided into normal contrast group, D-IBS group, traditional TXYF group, TXYF UMD group,1/3 TXYF UMD group,1/6 TXYF UMD group. D-IBS groups were induced by drugs and bunch, the mormal contrast group were given high pressure disinfection water. To have a experiment of deliver of bowel and costringency experiment of abdominal muscles after 3 days. To collect the excrement of rats and measure its dry weight and wet weight. Withdraw specimen after 2 weeks.measure the level of GLP-1, SS and MTL of tissue and serum with the method of radioimmunoassay way (RIA).
Results:1. the tissue and serum GLP-1, SS,SP, MTL in the TXYF UMD group were lower than those in TTXYF group (p<0.01).2. The tissue and serum GLP-1, SS,SP and MTL in the TXYF UMD group,TTXYF group, and 1/3 TXYF UMD group were all lower than those in D-IBS group (p<0.01). but there were no significant difference between 1/6 TXYFUMD and D-IBS group. 3. The tissue and serum GLP-1,SS,SP and MTL in the D-IBS group were higher than those in other group (p< 0.01), and there were no significant difference between the 1/6 TXYFUMD group and D-IBS group (p>0.05).4.The tissue and serum GLP-1,SS,SP and MTL in the TXYFUMD group were all lower than those in TTXYF group (p< 0.01), and there were no significant difference between the 1/3 TXYFUMD group and TTXYF group (p>0.05)
Conclusion:1.TXYF has the function to regulate the gastrointestinal hormone for rats.2.1t may reduce the secretion of GLP-1, SS,SP and MTL.3. The TXYFUMD may reduce the secretion of GLP-1mRNA and SSR1RNA of D-IBS rats.4. The function of TXYFUMD may be more superior to function of TTXYF.
引文
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