益气养血温阳法治疗便秘的实验和临床研究
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摘要
目的：通过泻药性便秘大鼠模型研究益气养血温阳法中方药对泻药性便秘的作用机理；通过益气养血温阳法中方药治疗老年性便秘临床观察,评价该方药疗效及安全性
方法：试验研究：建立泻药性便秘大鼠模型后分为6组,模型组、空白对照组、阳性对照组、益气养血温阳法低剂量组、中剂量组、高剂量组。阳性对照组予以聚乙二醇4000散灌胃；益气养血温阳法低、中、高剂量分别予以该方成人剂量5倍、10倍、20倍灌胃；组模型组、空白对照组予以生理盐水灌胃；均治疗2周。治疗后观察大鼠小肠碳末推进率,用免疫组化法检测大鼠结肠VIP、NOS、SP表达情况,采用RT-PCR方法检测大鼠结肠Cajal间质细胞表达情况。临床研究：临床研究：共收集50例患者,随机分成2组,治疗组30例,对照组20例,分别予以益气养血温阳法方药、聚乙二醇4000散口服。疗程2周,观察治疗前后症状积分变化。实验所得数据均采用χ±s表示,所得结果采用SPSS11.5统计软件包进行分析。
结果：实验研究：益气养血温阳法可以明显改善泻药性便秘模型大鼠小肠碳末推进率,与模型组相比较有显著差异。益气养血温阳法能提高泻药性便秘模型大鼠结肠SP含量,其中高剂量组大鼠结肠SP表达与模型组大鼠结肠SP表达比较有显著差异(P<0.05)。高剂量组大鼠结肠VIP表达与模型组大鼠结肠V1P表达比较有显著差异(P<0.05)。益气养血温阳法治疗后,便秘大鼠结肠一氧化氮氧合酶表达明显降低,高、中、低剂量组与模型组比较,结肠一氧化氮氧合酶表达都有显著差异(P<0.05)。益气养血温阳法治疗后大鼠结肠ICC数量明显升高,尤其是中、高剂量组升高明显,与模型组比较有显著差异(P<0.05)临床研究：两组药物在治疗后比较总体疗效和便秘评分上没有统计学差异(P>0.05)。而两组药物在大便性状积分和中医症状积分改善方面有统计学差异,说明益气养血温阳法在大便性状和中医症状改善方面明显优于聚乙二醇4000散。而且没有腹痛、腹泻不良反应。
结论：益气养血温阳法能够促进泻药性便秘大鼠模型小肠蠕动作用。益气养血温阳法可以使泻药性便秘模型大鼠结肠SP水平、ICC数量提高,降低VIP、NOS表达,从而调节胃肠运动,改善便秘症状。同时在临床上应用也是安全有效的。
Objectives:Study the mechanism of the herbs of Yi qi yang xue wen yang(YQYXWY) treatment on constipation lead by laxatives. To observe therapeutic effect of herbs of Yi qi yang xue wen yang treatment on constipation of the aged; and to evaluate its side effect and its safety
Methods:empirical study：After constipation lead by laxatives rat model was established,they are divided into6groups:model group, normal group,PPEG4000group(control group),the high dose of YQYXWY(YQYXWY-H), the medium dose of YQYXWY group(YQYXWY-M) and low dose of YQYXWY(YQYXWY-L) group.The control group rats took medicine of PPEG4000,model group and normal group took medicine of physiological saline. The other three groups took medicine of herbs YQYXWY at high dose, medium dose, low dose. They were treated by2weeks. Then the rats were sacrificed, the colonic transit fuction were measured by ink propulsion test. We excised rats'colon specimen.We applied with immunohistochemical technology to analyze the expression of VIP, NOS, SP. The expression of interstitial cells of Cajal in colon was analyzed by RT-PCR. Clinical trial:50old patients with chronic constipation were divided randomizedly to the study group30and the control group20. The study group take medicine of herbs of Yi qi yang xue wen yang, the control group take medicine of PPEG4000(Poly (ethylene glycol)4000). The course of treatment is2weeks. We recorded the change of symptom scores.All counted data was expressed in the form of χ±s, and dealed by SPSS11.5statistics software.
Results:empirical study:The intestinal propusion rate in YQYXWY groups was significantly increased than that in model group (P<0.05).The herbs of YQYXWY can increased the expression of SP in colon of rat, that in YQYXWY-H group is higher than model group (p<0.05). VIP in YQYXWY-H group is lower than model group (p<0.05). The herbs of YQYXWY can degrade the level of NOS in colon tissue. The expression of NOS in the YQYXWY-H group, YQYXWY-M group and YQYXWY-L group is lower than that in model group (p<0.05). The herbs of YQYXWY can increase expression of interstitial cells of Cajal in the colon of rat; the expression of interstitial cells of Cajal in the YQYXWY-H group, YQYXWY-M group is higher than that in model group (p<0.05). Clinical study:There were no differences in the overall effect and constipation integral between the two groups (p>0.05). Great differences were found in the stool property integral and TCM symptoms integral between the two groups. No side effects such as abdominal pain, diarrhea were found in the study group.
Conclusions:The herbs of YQYXWY can increase the intestinal propusion rate in the rat model constipation led by laxative. It also can increase expression of interstitial cells of Cajal, SP and degrade expression of VIP, NOS in the colon of rat model constipation led by laxative. The herbs of Yi qi yang xue wen yang is effective and safe in treatment of constipation of the age.
方法：试验研究：建立泻药性便秘大鼠模型后分为6组,模型组、空白对照组、阳性对照组、益气养血温阳法低剂量组、中剂量组、高剂量组。阳性对照组予以聚乙二醇4000散灌胃；益气养血温阳法低、中、高剂量分别予以该方成人剂量5倍、10倍、20倍灌胃；组模型组、空白对照组予以生理盐水灌胃；均治疗2周。治疗后观察大鼠小肠碳末推进率,用免疫组化法检测大鼠结肠VIP、NOS、SP表达情况,采用RT-PCR方法检测大鼠结肠Cajal间质细胞表达情况。临床研究：临床研究：共收集50例患者,随机分成2组,治疗组30例,对照组20例,分别予以益气养血温阳法方药、聚乙二醇4000散口服。疗程2周,观察治疗前后症状积分变化。实验所得数据均采用χ±s表示,所得结果采用SPSS11.5统计软件包进行分析。
结果：实验研究：益气养血温阳法可以明显改善泻药性便秘模型大鼠小肠碳末推进率,与模型组相比较有显著差异。益气养血温阳法能提高泻药性便秘模型大鼠结肠SP含量,其中高剂量组大鼠结肠SP表达与模型组大鼠结肠SP表达比较有显著差异(P<0.05)。高剂量组大鼠结肠VIP表达与模型组大鼠结肠V1P表达比较有显著差异(P<0.05)。益气养血温阳法治疗后,便秘大鼠结肠一氧化氮氧合酶表达明显降低,高、中、低剂量组与模型组比较,结肠一氧化氮氧合酶表达都有显著差异(P<0.05)。益气养血温阳法治疗后大鼠结肠ICC数量明显升高,尤其是中、高剂量组升高明显,与模型组比较有显著差异(P<0.05)临床研究：两组药物在治疗后比较总体疗效和便秘评分上没有统计学差异(P>0.05)。而两组药物在大便性状积分和中医症状积分改善方面有统计学差异,说明益气养血温阳法在大便性状和中医症状改善方面明显优于聚乙二醇4000散。而且没有腹痛、腹泻不良反应。
结论：益气养血温阳法能够促进泻药性便秘大鼠模型小肠蠕动作用。益气养血温阳法可以使泻药性便秘模型大鼠结肠SP水平、ICC数量提高,降低VIP、NOS表达,从而调节胃肠运动,改善便秘症状。同时在临床上应用也是安全有效的。
Objectives:Study the mechanism of the herbs of Yi qi yang xue wen yang(YQYXWY) treatment on constipation lead by laxatives. To observe therapeutic effect of herbs of Yi qi yang xue wen yang treatment on constipation of the aged; and to evaluate its side effect and its safety
Methods:empirical study：After constipation lead by laxatives rat model was established,they are divided into6groups:model group, normal group,PPEG4000group(control group),the high dose of YQYXWY(YQYXWY-H), the medium dose of YQYXWY group(YQYXWY-M) and low dose of YQYXWY(YQYXWY-L) group.The control group rats took medicine of PPEG4000,model group and normal group took medicine of physiological saline. The other three groups took medicine of herbs YQYXWY at high dose, medium dose, low dose. They were treated by2weeks. Then the rats were sacrificed, the colonic transit fuction were measured by ink propulsion test. We excised rats'colon specimen.We applied with immunohistochemical technology to analyze the expression of VIP, NOS, SP. The expression of interstitial cells of Cajal in colon was analyzed by RT-PCR. Clinical trial:50old patients with chronic constipation were divided randomizedly to the study group30and the control group20. The study group take medicine of herbs of Yi qi yang xue wen yang, the control group take medicine of PPEG4000(Poly (ethylene glycol)4000). The course of treatment is2weeks. We recorded the change of symptom scores.All counted data was expressed in the form of χ±s, and dealed by SPSS11.5statistics software.
Results:empirical study:The intestinal propusion rate in YQYXWY groups was significantly increased than that in model group (P<0.05).The herbs of YQYXWY can increased the expression of SP in colon of rat, that in YQYXWY-H group is higher than model group (p<0.05). VIP in YQYXWY-H group is lower than model group (p<0.05). The herbs of YQYXWY can degrade the level of NOS in colon tissue. The expression of NOS in the YQYXWY-H group, YQYXWY-M group and YQYXWY-L group is lower than that in model group (p<0.05). The herbs of YQYXWY can increase expression of interstitial cells of Cajal in the colon of rat; the expression of interstitial cells of Cajal in the YQYXWY-H group, YQYXWY-M group is higher than that in model group (p<0.05). Clinical study:There were no differences in the overall effect and constipation integral between the two groups (p>0.05). Great differences were found in the stool property integral and TCM symptoms integral between the two groups. No side effects such as abdominal pain, diarrhea were found in the study group.
Conclusions:The herbs of YQYXWY can increase the intestinal propusion rate in the rat model constipation led by laxative. It also can increase expression of interstitial cells of Cajal, SP and degrade expression of VIP, NOS in the colon of rat model constipation led by laxative. The herbs of Yi qi yang xue wen yang is effective and safe in treatment of constipation of the age.
引文
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