Clinical And Experimental Study On Functional Diarrhea Treated By Spleen

clinical research Purpose To discuss the curative effect and improvement on quality of life by Treating Functional diarrhea from the spleen.Material and method: 60 patients with functional diarrhea were divided into treatment and control groups 。the number of diarrhea,the score of Bristol Stool Scale,the overall impression of the scale,Hospital Anxiety and Depression Scale(HAD),TCM symptom table and SF-36 quality of life questionnaire of patients in the two groups were compared before and after treatment.Results:1、The number of diarrhea:compared with the symptom before treatment, the observation group were significant differences after 2 weeks of treatment, after 4 weeks of treatment, 4weeks after discontinuation(P <0.01); the control group was no significant difference(P>0.05) after 2 weeks of treatment. after 4 weeks of treatment, 4 weeks after discontinuation,the symptom were significantly different(P <0.05). after 2 weeks, 4 weeks, 4 weeks discontinuation,Observation group and control group were significantly different(P <0.05).2、The score of Bristol Stool Scale,compared with the symptom efore treatment, the observation group were significant differences(P <0.05) after2 weeks and 4 weeks of treatments.there was a significant difference(P<0.01) after 4 weeks of discontinuation; the control group had no significant difference(P> 0.05). the observation and treatment group was not a significant difference(P> 0.05) after 2 weeks of treatment on Bristol stool scale score.after 4 weeks of treatment, 4 weeks discontinuation there were significant differences(P<0.05).3、TCM symptom table :compared with the symptom before treatment, after 4 weeks of treatment in the observation group there were significant differences in epigastric fullness,shortness of breath, chills(P <0.05). there was a significant difference extremely in the symptoms: poor appetite, vomit clear saliva, limbs fatigue, body weight difficulties loose stool(P <0.01). After 4 weeks of treatment in the control group, there was a significant difference in epigastric fullness, body weight difficulties loose stool(P <0.05).After 4 weeks of treatmentthere was a significant difference in epigastric fullness, shortness of breath, chills,loss of appetite, vomit clear saliva, limb weakness, body weight difficulties, loose stool integral aspect(P < 0.05) between the observation and control group.4、The clinical symptoms total score:4 weeks after treatment and before treatment observation group and treatment group could reduce the clinical symptoms total score, there was a signifycant difference(P <0.05) were observed before group therapy compared with no significant difference between the control group and treatment( P> 0.05). Some observers compare the treatment group and treatment group after 4 weeks significantly different(P <0.05).5、The overall impression scale score: compared with the score before treatment, after 4weeks of treatment the observation group and the control group overall impression scale score has increased, there was a significant difference(P <0.01).the score of the observation group was significant difference(P <0.05). the score of the control group was no significant difference(P> 0.05). Comparative there was a significant difference(P <0.01) between the two groups after 4 weeks treatment.6、Hospital Anxiety and Depression Scale(HAD):compared with the score before treatment,after 4 weeks of treatment, the observation and treatment group could drop points anxiety,depression score, HADA / HADD points. HADD integration within the group, between the two groups before and after treatment showed no significant difference(P> 0.05). HADA integral of observation group, there were significant differences(P <0.05) before treatment and group therapy. After 4 weeks of treatment the observation group showed significant differences(P <0.05).7、The SF-36 quality of life questionnaire :compared with the previous treatment, role emotional(RE), general health(GH), mental health(MH) social function(SF), energy(VT)five dimensions have significant difference after 4 weeks of treatment group(P <0.05). In the control group the five dimensions of integration has improved, but only in comparison with the previous treatment of the emotional functions(RE), mental health(MH) both have significant differences(P <0.05), no other significant differences(P> 0.05). There was a significant difference(P <0.05) after 4 weeks of treatment in both groups of patients general health(GH), mental health(MH) social function(SF), energy(VT) in four dimensions score improvement. compared with the control there were significantly different in the psychologycal dimension, the total quality of life scores group After treatment for 4 weeks(P <0.05).Conclusion:1、Chinese medicine from spleen can reduce the number of diarrhea patients with functional diarrhea, and the lasting effect. compared with the control group there was a significant difference(P <0.05).2、Chinese medicine from spleen can reduce bristol stool scale score of patients with functional diarrhea and improve stool with lasting effect. compared with the control group there was a significant difference(P <0.05).3、Chinese medicine from spleen can improve function in patients with epigastric fullness diarrhea, shortness of breath, chills, loss of appetite, vomit clear saliva, limb weakness, body weight difficulties, loose stool. the total score of clinical symptoms in patients with diarrhea can be reduced. Placebo only improved significantly in epigastric fullness, body weight difficulties, loose stool three symptoms(P <0.05). Comparatively there were significant differences(P <0.05).4、Chinese medicine from spleen and placebo could increase the overall impression scale score and increase the confidence of patients to overcome the disease. Chinese herb group and between groups were statistically significant differences(P <0.05), better than the placebo group.5、Chinese medicine from spleen and placebo can reduce anxiety, depression points. especiallly anxiety score(P <0.05). the effect of traditional Chinese medicine group is superior.6、compared with the control group, Chinese medicine from spleen in patients with functional diarrhea can improved SF-36 score(P <0.05). it was better than the control group In the psychological dimension, total quality of life scores(P <0.05).7、course, anxiety, symptoms can affect mental health and quality of life in patients with functional diarrhea.and led to anxiety affect. While women, duration of more than five years,anxiety, symptom scores can affect physical health, which influenced the course.experiment research Purpose:Based on tight junction protein and cytokine of intestinal mucosa in rats with diarrhea,To discuss the pathogenesisand and effect mechanism of Treating Functional diarrhea from the spleen and to provide experimental basis for it.Material and method:The functional diarrhea spleen deficiency syndrome model in rats were established by using high lactose + small platform stations legislation。During the experiment, rats observed stool every day, general condition, appetite and body weight, based on the modeling for 14 days to evaluate changes in established animal models.the rats were divided into normal group, model group, Pinaverium Bromide group,SHEN LING BAI SHU particle high, medium and low dose group。The TNF-α、IFN-γ、SIg A 、IL-4、 IL-10 were detected by ELISA method;The ZO-1, Claudin-1, Occludin m RNA and protein expression levels were detected by rt-PCR Westernand Immunohistochemistry method.Results:1、General state observation:Normal rats full free stool changes, a good mental state. While the model group rats began to appear the next day, the pond stool soft, moisture content increases until watery stools, accompanied by listlessness. Medication for 14 days, in addition to the low dose group rats in each group were improved, pinaverium bromide and high-dose group recovery had better mental state, rat stool into a dark brown granular; middle dose group were slightly poor mental state,with acceptable stool dark brown, relatively forming individual slightly soft. Various aspects of low-dose group had no significant recovery with still loose stools.2、food intake of rats in each group comparison:Food intake of model rats significantly reduced.After medication for 14 days compared with model group each group were improved in addition to the low-dose group(P <0.05).3、Comparison of body weight of rats:After modeling compared with normal group the rats body weight were significantly reduced(P <0.01). After Medication for 14 days the body weight of rats in each group were increased.compared with model group, pinaverium ammonium group, SHENLINGBAISHU high-dose group(P<0.05); Also, body weight of SHENLINGBAISHU particle medium and low dose group increased, but there was no significant difference(P> 0.05). The Model group is lighter than the normal group(P<0.01).4、The average rate of diarrhea and fecal Points:During the modeling diarrhea was l OO%.After modeling compared with the normal group, the rats stool points of each group were significantly different(P <0.01). After Medication for 14 days the points of SHENLINGBAISHU particle high and medium dose group、Pinaverium Bromide group were reduceed and showed no significant difference with the normal group(P> 0.05). while the low dose and modle group are still significant differences with the normal group( P <0.05).5、HE staining of colon tissue morphology structure:Normal mucosal epithelial cells arranged in neat rows, a large number of absorptive cells and goblet cells, submucosal visible small arteries, veins and lymphatic vessels, muscle uniform thickness no abnormal changes. About Model group,the infiltrating inflammatory is visible in colonic mucosa layer cells, goblet cells disappeared, mucosal edema, epithelial shedding, submucosal small arteries, veins and lymphatic atrophy, muscle uneven shape, structure is destroyed. In Pinaverium ammonium and SHENLINGBAISHU particle High 、middle dose group, The colon tissue morphology structure has been restored,colonic mucosa mucosal layer of simple columnar epithelial cells, goblet cells, a small amount of submucosal inflammatory cell infiltration visible.The muscularis mucosa is still somewhat uneven and arranged in disorder in middle dose group.It had no significant recovery in Low-dose group.6、The serum content of DAO:Compared with the normal group, the model group was significantly higher(P <0.01); Compared with the model group, pinaverium ammonium and the SHENLINGBAISHU high dose group is significantly lower; the middle dose and low-dose group were not reduced.7、ZO-1, Claudin-1, Occludin m RNA expression in colon tissue of rats in each group :The ZO-1, Claudin-1, Occludin m RNA expression can be detected in Colon tissue of normal rats.Compared with the normal group, ZO-1, Claudin-1, Occludin m RNA expression was significantly reduced in colon tissue of rats in model group(P <0.01); After medication for 14 days, compared with the model group, the ZO-1, Claudin-1, Occludin m RNA expression in pinaverium ammonium and SHENLINGBAISHU particle high dose group were significantly upregulated.(P<0.01); the ZO-1, Occludinm RNA expression in SHENLINGBAISHU particle middle and low-dose group could increase, but not statistically significant(P> 0.05).8、ZO-1, Occludin Claudin-1 protein expression in colon tissue of rats by western blot:The ZO-1, Claudin-1, Occludin protein expression in Colon tissue in normal rats was detected.Compared with the normal group, the ZO-1, Occludin expression in the colon tissue of rats in the model group was significantly reduced(P <0.05); the Claudin-1 tended to decrease, but not statistically significant; compared with the model group, the ZO-1 protein expression of pinaverium ammonium and SHENLINGBAISHU particle high 、middle dose group can significantly increase(P<0.05); the Occludin protein expression in pinaverium ammonium group is significantly increased(P<0.05), SHENLINGBAISHU particle high-dose group tended to increase, but no statistically significant.9、ZO-1, Occludin protein expression was detected by immunohistochemistry colon tissue of rats:By light microscope the ZO-1, Occludin protein uniformly distributed in the continuous edge of intestinal epithelial cells in Normal group. At each time point, the ZO-1, Occludin protein expression in Model group was significantly reduced or missing. Compared with the normal group,the ZO-1, Occludin positive rat in model groupe were significantly different(<0.05). Compared with model group,the pinaverium ammonium and SHENLINGBAISHU high dose groupcan increase the ZO-1 expression(P <0.05). the Occludin expression was increased in all of the groups(P <0.05).10、The TNF-α, IFN-γ, SIg A, IL-4, IL-10 expression in colonic mucosa of rats by ELLSA :TNF-α, IFN-γ, SIg A, IL-4, IL-10 expression is detectable in Normal rat intestinal.(1)Compared with the normal group, the intestinal mucosa TNF-α were significantly increased in model group(P <0.01); Compared with the model group, pinaverium ammonium 、SHENLINGBAISHU particle high middle dose group significantly decreased(P < 0.05);SHENLINGBAISHU low-dose group tended to decrease, but there was no significant difference(P> 0.05)(2 compared with the normal group, the intestinal mucosa IFN-γ were significantly increased in the model group(P <0.05); compared with the model group,pinaverium ammonium group, SHENLINGBAISHU particle high middle dose group significantly decreased(P <0.05), SHENLINGBAISHU particles of low-dose group tended to decrease, but there was no significant difference(P> 0.05)(3) compared with the normal group, the intestinal mucosa IL-4 in model groupwere significantly declined(P<0.05);compared with the model group, pinaverium ammonium group, SHENLINGBAISHU particle high dose group increased significantly(P<0.01), SHENLINGBAISHU particle middle 、low-dose group tended to increase, but there was no significant difference(P> 0.05)(4)compared with the normal group, the intestinal mucosa IL-10 in model group decreased significantly(P<0.05); compared with the model group, all of the treatment group could significantly increase(P <0.05)(5) compared with the normal group, the intestinal mucosal SIg A in model group decreased significantly(P <0.05); compared with the model group,the pinaverium ammonium 、SHENLINGBAISHU particle high、middle dose group significantly increased(P <0.05), SHENLINGBAISHU low-dose group tended to increase, but there was no significant difference(P> 0.05).Conclusion:1、High Lactose + small standing platform can successfully replicate rat model of functional diarrhea spleen deficiency syndrome, Chinese medicine from spleen may be effective in treating the disease, and the efficacy was consistent with the Western medicine.2 、in the normal rat intestinal,There are the m RNA and protein expression of the ZO-1,Claudin-1, Occludin.Also there are SIg A, TNF-α, IFN-γ, IL-4, IL-10 expression. From spleen can treat functional diarrhea by regulating intestinal mucosal TJ and cytokine expression.3、In Colon tissue,the ZO-1, Claudin-1, Occludin m RNA expression was significantly reduced and the ZO-1, Occludin protein expression also reduced; The colonic tissue TNF-α, IFN-γexpression was significantly increased, the SIg A, IL-4, IL-10 expression was significantly reduced.TJ and cytokine may be one of the pathogenesis of functional diarrhea spleen deficiency.4、Chinese medicine from spleen can Dampness and Improve spleen, which could treat functional diarrhea. The mechanism may be regulating the expression of proteins and cytokines in colonic mucosa. Increasing the ZO-1, Claudin-1, Occludin m RNA expression in colonic tissue. regulating expression of ZO-1 protein; reducing TNF-α, IFN-γ expression in colon tissue; increasing SIg A 、IL-4、IL-10 expression.