Study On The Effection Of The Traditional Chinese Medicine Chang-An-Jun-Tai Granule On The Bile Acid Metabolism Of Patients With Diarrhea-predominant Irritable Bowel Syndrome Of Liver Stagnation And Spleen Deficiency

Objective:To explore the difference of bile acid metabolism in the syndrome of IBS-D of liver stagnation and spleen deficiency,to study the influence of Chang-An-Jun-Tai Granules on the bile acid metabolism of IBS-D patients with liver spleen deficiency,and to analyze the effect of Chang-An-Jun-Tai Granules in treating IBS-D syndrome of stagnation of liver and deficiency of spleen from bile acid metabolism by combining with the clinical study of Chang-An-Jun-Tai Granules on the treatment of liver stagnation and spleen deficiency type IBS-D and the study on regulating intestinal flora.Methods:Patients meeting the diagnostic criteria of IBS-D syndrome of stagnation of liver and deficiency of spleen in the outpatient and inpatient departments of the First Affiliated Hospital of Guangzhou University of Chinese Medicine were recruited.After taking Chang-An-Jun-Tai Granules for 1 month,fresh feces from patients before and after treatment were collected and transported to Shanghai Biotree Company for targeted metabonomics of 41 kinds of quantitative detection of bile acids detection.After establishing 41 kinds of bile acid databases,paired t text,paired rank sum text was used to analyze of six main primary bile acids and four main secondary bile acids before and after the treatment.Multivariate analysis was used to analyze the types of bile acids with different metabolism before and after treatment,and the bile acids with significant differences were screened.Correlation analysis was conducted between differential bile acids and patients’ clinical scale scores(including scores of the IBS severity scale score,the Bristol Fecal Traits Scale,the IBS Quality of Life Scale,and the Hospital Anxiety and Depression Scale),combined with previous studies on the influence of Chang-An-Jun-Tai Granules on intestinal flora of the IBS-D syndrome of stagnation of liver and deficiency of spleen,so as to analyze the effect of Chang-An-Jun-Tai Granules on the IBS-D syndrome of stagnation of liver and deficiency of spleen.Results:1.The scores of the IBS Severity Scale,the Bristol fecal traits scale,the IBS quality of life scale,and the anxiety scale of hospital anxiety and depression scale of 14 patients with IBS-D with liver depression and spleen deficiency after treatment with Chang-An-Jun-Tai Granules were lower than those before treatment,and the difference was statistically significant(P<0.05).The score of depression scale was higher than that before treatment,and there was no statistical difference(P>0.05).2.The mean contents of 6 primary bile acids(Cholic acid,Chenodeoxycholic acid,Glycocholic acid,Glycochenodeoxycholic acid,Taurocholic acid,and Taurochenodeoxycholic acid)after treatment were higher than those before treatment.In addition,the mean values of the four secondary bile acids(Lithocholic acid,Deoxycholic acid,Glycodeoxycholic acid,and Taurochenodeoxycholic acid)were all higher after treatment than before treatment,and the difference was not statistically significant(P>0.05).3.Differential bile acids: A total of 12 bile acids were further screened out,and there were possible differences between them before and after treatment.Among them,the average values of Ursodeoxycholic acid and Allocholic acid were higher than those before treatment,with statistical differences(P<0.05),the average values of 7-Ketolithocholic acid,12-Dehydrocholic acid,Chenodeoxycholic acid,7,12-Diketolithocholic acid,7-Ketodeoxycholic acid,Hyocholic acid,3-Dehydrocholic acid,Ursocholic acid,β-Muricholic acid and Cholic acid were higher than those before treatment,with no statistical differences(P<0.05).4.Correlation analysis showed that there was a positive correlation between the difference of Ursodeoxycholic acid and Allocholic acid before and after treatment(P<0.05),a negative correlation between the difference of the depression scale before and after treatment(P<0.05),and a negative correlation between the difference of ursodeoxycholic acid and the anxiety score before and after treatment(P<0.05).5.The results of previous studies indicated that the abundance of the bacteria decreased after treatment with Chang-An-Jun-Tai Granules including Escherichia,Enterobacteriaceae,Enterobacteriaceae,Bacteroidetes,Bacteroidetes,etc.The abundance of Changanjingtai granules increased including Firmicutes,Clostridium,Clostridium,Rumen Bacteriaceae,Clostridium,etc.Conclusion:1.Chang-An-Jun-Tai Granules can increase the contents of Ursodeoxycholic acid and Allocholic acid in the intestinal tract of IBS-D patients with liver depression and spleen deficiency,and can regulate IBS-D bile acid and increase the excretion of bile acid in patients’ feces.2.The increase of Ursodeoxycholic acid and Allocholic acid may be related to the improvement of anxiety and depression in IBS-D patients with liver stagnation and spleen deficiency.3.The abundance of Clostridium related to the production of Ursodeoxycholic acid and Allocholic acid increased after the treatment with Chang-An-Jun-Tai Granules.4.The increase of bile acid excretion and the amount of Ursodeoxycholic acid and Allocholic acid by regulating intestinal flora may be one of the mechanisms of Chang-An-Jun-Tai Granules to relieve the liver and invigorate the spleen.