A Study On Factors Related To Liver Lose Control Of Regulating In Irritable Bowel Syndrome Patients And Relationship Between TCM Syndromes And Blood Test Results

ObjectiveThere are three main purposes of this paper. First, try to find out some relevant factors to reflect liver lose control of regulating in Irritable Bowel Syndrome(IBS) patients. Second, discover the features of syndrome factors in Irritable Bowel Syndrome patients. Third, analyze relationship between TCM syndromes and blood test results in Irritable Bowel Syndrome patients. This study aims to provide the basis for further research in treating IBS by restoring normal function of liver, to provide new ideas for treatment and research on IBS, and eventually to find a more effective cure for IBS patients.Methods280patients who met all the diagnostic and inclusion criteria were enrolled from December2011to January2014at the First Affiliated Hospital of Guangzhou University of Chinese Medicine. Patients’ information were collected such as personal information, symptoms, diagnosis and TCM syndromes, etc. And each patient had to draw a5ml blood sample for testing.19items were tested:calcitonin gene related peptide (CGRP), angiotensin II (AT-Ⅱ), dobaamine (DA),5-hydroxytryptamine (5-HT), glucocorticoid (GC), NPY, endothelin (ET), homocysteine (HCY), acetylcholine (ACH), melatonin (MT), substance P (SP), estradiol or testosterone, tumor necrosis factor alpha (TNF-α), nitric oxide (NO), vasoactive intestinal peptide (VIP), somatostatin (SS),5-serotonin3receptor(5-HT3R) and adrenocorticotropin (ACTH).After the investigation was over, incomplete cases were excluded. Information were inputted into EpiData3.0and software SPSS17.0was used to do the data analysis. Symptoms with a frequency of less than15%were deleted. Frequency analysis method, single factor analysis and multiple factor analysis were used to find out relevant factors to reflect liver lose control of regulating in IBS patients.Before analyzing the features of syndrome factors in IBS patients, some symptoms were combined. These symptoms were analyzed by using clustering analysis and factor analysis. Then the results were classified into different syndrome factors according to ZHONG YI LIN CHUANG ZHEN LIAO SHU YU GUO JIA BIAO ZHUN (ZHENG HOU BU FEN), ZHONG YI ZHENG HOU JIAN BIE ZHEN DUAN XUE, XIN DE BIAN ZHENG ZHENG SU ZHENG ZHUANG PAN DUAN ZHI BIAO YAN JIU and expertise.Analysis of variance and t-test were used to analyze relationship between different TCM syndromes and blood test results in IBS patients.Results280patients were enrolled and one patient was excluded.39.8%of the patients are male and60.2%are female. There are4different syndromes in the patients, stagnation of liver Qi and spleen deficiency syndrome accounts for72.4%, stagnation of liver Qi syndrome accounts for4.7%, damp-heat in the spleen and the stomach syndrome accounts for14.0%and damp obstruction disease due to spleen deficiency syndrome accounts for25%. After analyzed the collected information using single factor analysis and multiple factor analysis,21useful factors were extracted and7factors were extracted in the end. The7factors are constipation, depression, abdominal pain, tinnitus, fatigue, AT-II and imbalanced diet, each with a score of0.358、1.256、1.137、-1.209、-0.296、0.643、0.153。All the selected symptoms were clustered into17groups by using clustering analysis and22common factors were extracted by using factor analysis. The common syndrome factors of location are liver, spleen, stomach, large intestine, small intestine and kidney. The common syndrome factors of feature are damp and heat. The common syndrome factors of tendency is stagnation of Qi.For calcitonin gene related peptide (CGRP), angiotensin Ⅱ (AT-Ⅱ), dobaamine (DA),5-hydroxytryptamine (5-HT), glucocorticoid (GC), NPY, endothelin (ET), homocysteine (HCY), melatonin (MT), substance P (SP), estradiol or testosterone, tumor necrosis factor alpha (TNF-α), nitric oxide (NO), vasoactive intestinal peptide (VIP), somatostatin (SS),5- serotonin3receptor(5-HT3R) and adrenocorticotropin (ACTH), there are no statistically significant difference among stagnation of liver Qi and spleen deficiency syndrome, stagnation of liver Qi syndrome, damp-heat in the spleen and the stomach syndrome and damp obstruction disease due to spleen deficiency syndrome. For acetylcholine (ACH), there is a statistically significant difference among the4syndromes.For calcitonin gene related peptide (CGRP), angiotensin Ⅱ (AT-Ⅱ), dobaamine (DA),5-hydroxytryptamine (5-HT), glucocorticoid (GC), NPY, endothelin (ET), melatonin (MT), estradiol or testosterone, tumor necrosis factor alpha (TNF-α), nitric oxide (NO), vasoactive intestinal peptide (VIP), somatostatin (SS),5-serotonin3receptor(5-HT3R) and adrenocorticotropin (ACTH), there are no statistically significant difference between stagnation of liver Qi group and non-stagnation of liver Qi group. For substance P (SP), homocysteine (HCY) and acetylcholine (ACH), there are statistically significant differences between stagnation of liver Qi group and non-stagnation of liver Qi group.For calcitonin gene related peptide (CGRP), angiotensin II (AT-Ⅱ), dobaamine (DA),5-hydroxytryptamine (5-HT), glucocorticoid (GC), NPY, endothelin (ET), homocysteine (HCY), acetylcholine (ACH), melatonin (MT), substance P (SP), estradiol or testosterone, tumor necrosis factor alpha (TNF-a), nitric oxide (NO), vasoactive intestinal peptide (VIP), somatostatin (SS),5-serotonin3receptor(5-HT3R) and adrenocorticotropin (ACTH), there are no statistically significant difference between spleen deficiency syndrome group and non-spleen deficiency syndrome group.For calcitonin gene related peptide (CGRP), angiotensin Ⅱ (AT-Ⅱ), dobaamine (DA),5-hydroxytryptamine (5-HT), glucocorticoid (GC), NPY, endothelin (ET), homocysteine (HCY), acetylcholine (ACH), melatonin (MT), substance P (SP), estradiol or testosterone, tumor necrosis factor alpha (TNF-α), nitric oxide (NO), vasoactive intestinal peptide (VIP), somatostatin (SS),5-serotonin3receptor(5-HT3R) and adrenocorticotropin (ACTH), there are no statistically significant difference between stagnation of liver Qi and spleen deficiency syndrome and stagnation of liver Qi syndrome.For calcitonin gene related peptide (CGRP), dobaamine (DA),5-hydroxytryptamine (5-HT), glucocorticoid (GC), NPY, endothelin (ET), homocysteine (HCY), melatonin (MT), substance P (SP), estradiol or testosterone, tumor necrosis factor alpha (TNF-α), nitric oxide (NO), vasoactive intestinal peptide (VIP), somatostatin (SS),5-serotonin3receptor(5-HT3R) and adrenocorticotropin (ACTH), there are no statistically significant difference between damp-heat in the spleen and the stomach syndrome and damp obstruction disease due to spleen deficiency syndrome. For angiotensin Ⅱ (AT-Ⅱ) and acetylcholine (ACH), there are statistically significant differences between damp-heat in the spleen and the stomach syndrome and damp obstruction disease due to spleen deficiency syndrome.ConclusionWomen, young people, well-educated people, people earn a medium or high income, people who live in towns and people with a low level of physical activity are more likely to have IBS. There are no evidence suggest that smoking and drinking are related to IBS. Relevant factors with IBS may include eating habit, lack of sleep, insufficient physical exercise, season, diet, cold, exhaustion and negative emotion. Common symptoms include abdominal pain, abdominal bloating, diarrhea and constipation. The most common syndrome is stagnation of liver Qi and spleen deficiency syndrome.There are16factors closely related to the4syndromes:stagnation of liver Qi and spleen deficiency syndrome, stagnation of liver Qi syndrome, damp-heat in the spleen and the stomach syndrome and damp obstruction disease due to spleen deficiency syndrome.7factors are closely related to liver lose control of regulating in IBS patients. They are constipation, depression, abdominal pain, tinnitus, fatigue, AT-Ⅱ and imbalanced diet.The common syndrome factors of location are liver, spleen, stomach, large intestine, small intestine and kidney. The common syndrome factors of feature are damp and heat. The common syndrome factors of tendency is stagnation of Qi.Calcitonin gene related peptide (CGRP), angiotensin Ⅱ (AT-Ⅱ), dobaamine (DA),5-hydroxytryptamine (5-HT), glucocorticoid (GC), NPY, endothelin (ET), homocysteine (HCY), melatonin (MT), substance P (SP), estradiol or testosterone, tumor necrosis factor alpha (TNF-α), nitric oxide (NO), vasoactive intestinal peptide (VIP), somatostatin (SS),5-serotonin3receptor(5-HT3R) and adrenocorticotropin (ACTH) can not be used to distinguish stagnation of liver Qi and spleen deficiency syndrome, stagnation of liver Qi syndrome, damp-heat in the spleen and the stomach syndrome and damp obstruction disease due to spleen deficiency syndrome. Acetylcholine (ACH) may be used to distinguish the4syndromes.Calcitonin gene related peptide (CGRP), angiotensin II (AT-II), dobaamine (DA),5-hydroxytryptamine (5-HT), glucocorticoid (GC), NPY, endothelin (ET), melatonin (MT), estradiol or testosterone, tumor necrosis factor alpha (TNF-α), nitric oxide (NO), vasoactive intestinal peptide (VIP), somatostatin (SS),5-serotonin3receptor(5-HT3R) and adrenocorticotropin (ACTH) can not be used to distinguish stagnation of liver Qi group and non-stagnation of liver Qi group. Substance P (SP), homocysteine (HCY) and acetylcholine (ACH) may be used to distinguish stagnation of liver Qi group and non-stagnation of liver Qi group.Calcitonin gene related peptide (CGRP), angiotensin II (AT-Ⅱ), dobaamine (DA),5-hydroxytryptamine (5-HT), glucocorticoid (GC), NPY, endothelin (ET), homocysteine (HCY), acetylcholine (ACH), melatonin (MT), substance P (SP), estradiol or testosterone, tumor necrosis factor alpha (TNF-α), nitric oxide (NO), vasoactive intestinal peptide (VIP), somatostatin (SS),5-serotonin3receptor(5-HT3R) and adrenocorticotropin (ACTH) can not be used to distinguish spleen deficiency syndrome group and non-spleen deficiency syndrome group.Calcitonin gene related peptide (CGRP), angiotensin Ⅱ (AT-Ⅱ), dobaamine (DA),5-hydroxytryptamine (5-HT), glucocorticoid (GC), NPY, endothelin (ET), homocysteine (HCY), acetylcholine (ACH), melatonin (MT), substance P (SP), estradiol or testosterone, tumor necrosis factor alpha (TNF-α), nitric oxide (NO), vasoactive intestinal peptide (VIP), somatostatin (SS),5-serotonin3receptor(5-HT3R) and adrenocorticotropin (ACTH) can not be used to distinguish stagnation of liver Qi and spleen deficiency syndrome and stagnation of liver Qi syndrome.Calcitonin gene related peptide (CGRP), angiotensin II (AT-II), dobaamine (DA),5-hydroxytryptamine (5-HT), glucocorticoid (GC), NPY, endothelin (ET), homocysteine (HCY), acetylcholine (ACH), melatonin (MT), substance P (SP), estradiol or testosterone, tumor necrosis factor alpha (TNF-a), nitric oxide (NO), vasoactive intestinal peptide (VIP), somatostatin (SS),5-serotonin3receptor(5-HT3R) and adrenocorticotropin (ACTH) can not be used to distinguish damp-heat in the spleen and the stomach syndrome and damp obstruction disease due to spleen deficiency syndrome. Angiotensin Ⅱ (AT-Ⅱ) and acetylcholine (ACH) may be used to distinguish damp-heat in the spleen and the stomach syndrome and damp obstruction disease due to spleen deficiency syndrome.