D-IBS Overlapping FD Stagnation Of Liver-qi And Deficiency Of Spleen-qi Associated With Psychology And Gastrointestinal Hormones

Iritable bowel syndrome (IBS) and functional dyspepsia (FD) are two kinds of common Functional Gastrointestinal Disorders (FGIDs).They are very easy to overlap, research shows that about1/3to2/3IBS patients have the symptoms of FD, and the mechanisms of IBS overlapping FD have not been clarified yet. It is generally accepted that they have the same pathological and physiol-ogical basis,like abnormal psychological status and brain-gut axis dysfunction. Meanwhile,Traditional Chinese Medicine holds that the basic pathogenesis of IBS, Especially diarrhea type irritable bowel syndrome(D-IBS)and FD is closely related to Deficiency-weakness of spleen-Qi and liver-Qi stagnation, the only difference is disease position.At present, few researches of TCM and integrated traditional Chinese and western medicine involve the relationship between psychophysiologic disorders and gut hormones, our previous TCM study found that about60%IBS-FD patients are liver-depression and spleen-deficiency syndrome,spleen-deficiency syndrome or liver-depression sy-ndrome. So this This section takes syndrome of liver depression and spleen deficiency with overlapped D-IBS and FD as key point, to investigate the psychological status and levels change of six brain-gut peptides and cytokines in patients of syndrome of liver depression and spleen deficiency with overlapped D-IBS and FD.Taking Patients with D-IBS overlapping FD typed liver stagnation and spleen deficiency as research object, compared with healthy persons,pure D-IBS and FD patients. All subjects completed a questionnaire based on the Symptom Checklist(SCL-90) and general condition.Measuring Plasma levels of5-HT,SS,VIP,ET,IL-10and IL-12by ELISA instrument.The main results are showed as below:1.symptoms of patients with D-IBS overlapping FD typed liver stagnation and spleen deficiency. is related to course of disease.the proportion of patients with course>5years is highest in D-IBS-FD patients, at44.8%.There were significant difference among3researching groups (P<0.05).2.Patients with D-IBS overlapping FD typed liver stagnation and spleen deficiency have more severe clinical symptoms. The FD and IBS symptom index scores of D-IBS-FD patients was more significant than that of control (P<0.05).3.The abnormal psychological factor may play a key role in the mechanism of D-IBS overlapping FD typed liver stagnation and spleen deficiency. Of270patients,49cases (25.7%) were accompanied by abnormal psychological status.the fractions of depression and anxiety of3 researching groups were higher than that of control (P<0.05).4.4kinds ofbrain-gut peptides and2kinds of cytokines of patients with D-IBS overlapping FD typed liver stagnation and spleen deficiency are abnormal. The levels of plasma VIP and plasma IL-10were significant lower than that of control group (P<0.01respectively)..the plasma5-HT、 SS、VIP、ET and IL-10F value of the three groups was5.542.4.691,6.966,9.917and7.876, P<0.05.5.Compared with control group, the plasma VIP and SS level of the subjects complicated with anxiety or depression was decreased significantly(P<0.05respectively), the plasma VIP level was lower than those in patients with normal psychology too(P<0.01),. the plasma SS and VIP F value of the three groups was11.625、9.374, P<0.05respectively.6.Plasma ET level in patients whose course were greater than5years was significantly higher than those in patients whose course were less than1years or1-5years (P=0.01and0.001) and the IL-10level in patients whose course were greater than5years was significantly lower than those in patients whose course were less than1years(P<0.01),the plasma ET and IL-10F value of the three groups was7.159and4.803, P<0.05respectively.7. Compared with control group,the plasma5-HT levels of three types increased significantly,and the VIP and IL-10of three types decreased significantly(P<0.05), patients of type III were show higher levels of the plasma5-HT than type II and lower levels of the plasma VIP than type I.Conclusions:D-IBS-FD overlap patients are in the sub-healthy state of psychology. The overlapping symptoms may be related to the duration of disease, abnormal psychological factors, the increased level of5-HT and the decreased level of IL-10, and the D-IBS symptoms may be closely related to decreased levels of VIP,SS and increased level of ET.