| Objectives1 Randomized Controlled trials were adopted to study clinical curative effect of Simo decoction on Qi-induced constipation syndrome of constipation-predominant irritable bowel syndrome (IBS-C).2 Gastrointestinal motility disorder rat model of liver and spleen Qi stagnation syndrome was established to explore functional mechanism of Simo decoction on gastric bowel movement dysfunction.Methods1 Clinical research60 cases of IBS-C patients were chosen according to inclusion criteria. They were divided into treatment group 30 cases and control group 30 cases by random number method, and treatment group were given Simo decoction and control group were given mosapride for two weeks, with symptom scored before and after treatment and clinical curative effect observed.2 Experimental research60 SD rats in SPF grade, weighing from 180g to 220g, were chosen and given normal diet for one week as adaptive feeding. Then they were randomly divided into normal group, model group, mosapride group, low dose of Simo decoction group, moderate dose of Simo decoction group and high dose of Simo decoction group. Each group had 10 rats in half respectively male and female. Normal group was given regular food and water supply, and the other groups were used to make models by gastric perfusion of thick licorice liquid combined with tail-clipped irritation method. Model group was given gastric perfusionof saline 2ml per times,1 time per day, and low dose, moderate dose and high dose of Simo decoction group were separately given 1 time,2 times, four times as much dosage (6ml/kg,12ml/kg,24ml/kg) as that in clinic for 7 days. After administration, each group was given gastric emptying and small intestine ropulsion experiment. Radio immuno-assay was used to detect content of plasma SP, VIP in blood plasma, immunehisto-chemical method was used to detect expression level of SP, VIP,5-HT, AChE in colon intermuscular nervous plexus, and transmission electron microscope was used to watch the ultrastructural changes of Cajal interstitial cells.Results1 Clinical researchTotal effective rate of Simo decoction on TCM syndromes of IBS-C (Qi-induced constipation syndrome) was 100%, and that in control group was 86.67%. Total effective rate, cure rate, markedly effective rate and effective rate in treatment group were greater than those in control group. There was no significant difference in grade of symptoms between the two groups before treatment(P>0.05).The symptom scores after treatment decreased significantly compared with those before treatment, and there was significant difference (P<0.05). Except frequency grade of abdominal distension, there were significant differences in other symptoms between the two groups after treatment(P<0.05).2 Experimental research2.1 Particle and moisture content of feces in model group were significantly lower than normal group(P<0.01). Compared with normal group, high, medium and low dose of Simo decoction group and model group, particle and moisture content of feces were significantly different(P<0.01), and Mosapride group and model group were significantly different(P<0.01).2.2 Compared with normal group, gastric residual rate of model group was significantly higher and there were significantly different(P<0.01) by Simotang after treatment compared with the model residual was significantly reduced, There was a significant difference(P<0.01). Compared with the normal group, model group significantly reduced rate of small intestine(P<0.01). Compared with model group, high, medium and low-dose of Simo decoction group and mosapride group were significantly difference(P<0.01), and compared with low dose group, high dose of Simo decoction group was significantly difference (P<0.05).2.3 There were no significant differences in expression level of SP in rat plasma between each group(F=1.188, P=0.328). But judging from the trend, expression level of SP in model group decreased than that of normal group, while that of high, medium and low-dose of Simo decoction group and mosapride group increased than model group.2.4 There were no significant differences in expression level of VIP in rat plasma between each group(F=1.766, P=0.136). But judging from the trend, expression level of VIP in model group increased than that of normal group, while that of high, medium and low-dose of Simo decoction group and mosapride group decreased than model group.2.5 Expression level of SP in colonic intermuscular nervous plexus of model group were significantly lower than that of normal group(P<0.01). Compared with mosapride group, positive expression of SP in colonic intermuscular nervous plexus of high dose of Simo decoction group increased(P<0.05, P<0.05), while there was no statistical difference between low, mediun dose of Simo decoction group and model group(P>0.05, P>0.05), but there is an increasing trend.2.6 Expression level of VIP in colonic intermuscular nervous plexus of model group were significantly higher than that of normal group(P<0.01). Compared with mosapride group, positive expression of VIP in colonic intermuscular nervous plexus of high dose of Simo decoction group significantly increased(P<0.01, P<0.01), and there was statistical difference between low, mediun dose of Simo decoction group and model group(P<0.05, P<0.05).2.7 Expression level of 5-HT in colonic intermuscular nervous plexus of model group were significantly lower than that of normal group(P<0.01). Compared with mosapride group, positive expression of 5-HT in colonic intermuscular nervous plexus of high dose of Simo decoction group increased and there was statistical difference(P<0.05, P<0.05), while there was no statistical difference between low, mediun dose of Simo decoction group and model group(P>0.05, P>0.05), but there is an increasing trend.2.8 Expression level of AChE in colonic intermuscular nervous plexus of model group were significantly lower than that of normal group(P<0.01). Compared with mosapride group, positive expression of AChE in colonic intermuscular nervous plexus of high dose of Simo decoction group increased and there was significant statistical difference(P<0.01, P<0.01), and there was statistical difference between low, mediun dose of Simo decoction group and model group(P<0.05, P<0.05).2.9 ICC in model group:abnormal shape, reduction in number, smaller size, significant reduction in gap junctions with other cells, structural damage, loose connections, organelle degeneration and reduction, mitochondrial swelling, increased electron density or even vacuoles, perinuclear space widened. After treatment, ultrastructure of Chinese Medicines group and mosapride group had different degrees of improvement.Conclusion1 Curative effect of Simo decoction on IBS-C is certain. It is easy to use and worthy of being popularized.2 Simo decoction has obvious gastrointestinal promoting function on rat model of liver and spleen Qi stagnation syndrome.whose functional mechanism may be related to regulation of gastrointestinal hormones.
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