Clinical Study Of Dispersing The Depressed Liver, Invigorating The Spleen And Calm The Nerves And Stomach In Treating Irritable Bowel Syndrome Of The Type Of Diarrhea

Irritable bowel syndrome is a common functional gastroenteropathy which is the characteristics of abdominal pain/abdominal discomfort and bowel evacuation habit,is short of change of morphology and biochemics.Its pathogenesis isnot clear so far.Now generally agreed that a lot of factors play an important role in clausing smooth muscle dyskinesia and visceral paresthesia,specifically mentality,psyche,society and circumstances,ect.This article reviews the onset,pathopoiesis,diagnosis and treatment of IBS,and relatted to gut hormones and MC to IBS.This clinical study proves Kangtai Fang can improve clinical symptoms by regulating MC and SP,VIP,iNOS,HO-1,ect gut hormones of neuroendocrine-immunization regulating network.Objective:1.By identifying the expression of iNOS,VIP,SP,HO-1,HO-1mRNA,iNOSmRNA and the quantity and degranulation of Mast Cells(MC),to explore the pathogenesis and correlation of irritable bowel syndrome(IBS) with stagnation of liver-QI with deficiency of the spleen and diarrhea.2.By identifying the effectiveness of TCM-Kang Tai Fang to influence the expression of iNOS,VIP,SP,HO-1,HO-1mRNA,iNOSmRNA and the quantity and degranulation of MC of IBS patients with stagnation of liver-QI with deficiency of the spleen and diarrhea,to explore the possible treatment mechanism of Kang Tai Fang.Methods: 1.Screening 15 healthy volunteers as the Control,and 63 qualified irritable bowel syndrome patients with stagnation of liver-QI with deficiency of the spleen and diarrhea randomly grouped as Kang Tai Fang Treatment Group and Dicetel Contrast Group,which are administrated with Kang Tai Fang and Dicetel for 8 weeks,respectively.Record the assessment result of medication effectiveness before and after treatment,obtain and preserve the specimen of colon mucosa of both Kang Tai Fang Treatment Group and Dicetel Contrast Group before and after medication administration.2.Identify the quantity and degranulation of MC and iNOS,VIP,SP,HO-1 expression of the Control,Kang Tai Fang Treatment Group and Dicetel Contrast Group through immunohistochemistry before and after medication administration.3.Identify HO-1mRNA,iNOSmRNA expression of the Control,Kang Tai Fang Treatment Group and Dicetel Contrast Group through RT-PCR before and after medication administration.Results:1.The total effective rate of TCM-Kang Tai Fang is 100%.The total effective rate,cure rate and apparent rate of Kang Tai Fang Treatment Group is significantly higher than Dicetel Contrast Group.TCM-Kang Tai Fang can actively improve the main clinical symptoms of IBS patients,and for Dicetel Contrast Group patients,stomachache,abdominal distension and loose stool can be improved by Dicetel,but others have no obvious improvement.2.Compared to the Control,the IBS patients' MC density and MC degranulation density,as well as the expression of VIP,SP,HO-1 are significantly increased, iNOS expression is significantly decreased.According to multi-reasons analysis,the positive correlation between IBS patients' indications and symptoms,such as stomachache,abdominal distention,and loose stool,and the MC density,MC degranulation density,the expression of VIP,SP,HO-1,iNOS is found.For Dicetel Contrast Group patients,the correlation between these aspects is still proved.3.Compared with the Control,the expression of iNOS and HO1mRNA of Kang Tai Fang Treatment Group patients and Dicetel Contrast Group patients is significantly different before and after medication treatment,which is related to the expression of iNOS and HO-1.Conclusions: 1.TCM-Kang Tai Fang can significantly improve IBS patients' main clinical symptoms without any obvious adverse reaction and its curative effect of improving upset and insomnia,loose stool,debilitation,poor appetite,etc is better than Dicetel.2.For Kang Tai Fang Treatment Group patients,the MC density and MC degranulation density,as well as the expression of VIP,SP,HO-1 are significantly increased,and iNOS expression is significantly decreased.The correlation is positive.In addition,Dicetel can actively play arole on IBS patients' symptoms and indications,MC density,MC degranulation density,and the expression of VIP,SP,HO-1 and iNOS.