Effects Of Acupuncture On Irritable Bowel Syndrome Patients With Different TCM Syndromes In Electrocolonogram And Brain-gut Peptide

Background: Irritable bowel syndrome (IBS) is the most common functional disease of intestinal tract associated with dysfunction of bowel motility. As its cause and pathogenesis is still unknown, there is no specific remedy so far. New approach of classification of IBS is under exploration to illustrate its essential pathogenetic features and improve its treatment.Chinese medicine (includes Chinese herbs, acupuncture, etc.), which bases its diagnostic and treatment approach on the differentiation of the symptoms and signs in view of body as a whole, has more advantages and higher therapeutic effectiveness than western medicine does in the treatment of IBS.Objective: To provide bases for the categorization of the different syndromes of IBS in view of TCM and explore the therapeutic mechanism of acupuncture on Zusanli.Methods: According to the diagnostic principles of TCM, 40 cases of patients with IBS were categorized into two subtypes, spleen deficiency with dampness group and liver-intestine Qi stagnation group (20 cases in each group). Twenty patients with ulcerative colitis (UC, due to spleen deficiency with dampness) wereenrolled in UC contrast group, with another 20 normal subjects serving as control.?Recording of the electrocolonogram (ECOG) for 6' 40" was performed before -and after acupuncture on Zusanli with uniform reinforcing - reducing method for 20 min, and the average amplitude of peak (Ap), frequency of peak (Fp) and average zero-crossing frequency (Fz) were analyzed. ㏒amples of the vein blood were taken for the determination of the content of substance P (SP) and vasoactive intestinal polypeptide (VIP) with radioimmunoassay before and after acupuncture on Zusanli.3Two samples of sigmoid mucosa were taken for immunohistochemical assay of the cells positive of SP and VIP before acupuncture on Zusanli. Results and analyses:1. Normal controls: The mean values of ECOG of the sigmoid colon in the normal controls were (128?6.3) uV for Ap, (2.34?. 85)cpm for Fp, (3.77?0.84) cpm for Fz, which significantly increased after puncturing on Zusanli (P<0.05). The content of SP(excitatory substance) and VIP (inhibitory substance) was (17.91 ?.17)pg/ml and (27.69?.44)pg/ml respectively in the plasma, and SP level increased (P<0.05 ) while that of VIP decreased (/><0.01) after acupuncture. These results indicated that acupuncture on Zusanli can enhance the colon motility in normal controls, which may be associated with the increase of SP and the decrease of VTP in the plasma.2. Comparison between two different syndromes of the same disease (IBS): The spleen deficiency with dampness group had a slower Fp (basic frequency) of ECOG, lower level of SP content and higher level of VIP content in the plasma than normal controls (P<0.05 or P<0.01), showing weakened motility of the colon. In contrast, the liver-intestine Qi stagnation group had higher value of Fp, Ap, Fz of ECOG, higher level of SP content and lower level of VIP content in the plasma , more SP positive cells and less VIP positive cells in the sigmoid mucosa, showing an enhanced motility of colon. All the indexes in two IBS groups were improved and recovered the normal after Zusanli points were punctured, showing a bothway regulatory effect of acupuncture on IBS patients with different syndromes.3. Comparison between two groups of different diseases with the samesyndrome (IBS ;UC): These two groups of IBS or UC with spleen deficiency with dampness had the same abnormal tendency in all the indexes before acupuncture, and were all recovered by acupuncture on Zusanli. Conclusions:1.This paper suggests that the pathogenesis of IBS is mainly due to Qi disorder of spleen, liver and bowel, and the most frequent syndromes are spleen deficiency with dampness and liver-intestine Qi stagnation. The TCM categorization of the syndromes may be more helpful to the treatment of IBS than that only depending on symptoms by western medicine.2. This study demonstrates for the first time that there are differences between t...