Study On The Relationship Between Constipation And Depression In Parkinson’s Disease Based On The Theory Of "Brain-gut Axis" Theory

Objective:Based on the theory of "brain-gut axis",to study the incidence of constipation in patients with Parkinson’s disease depression disorder and the related mechanism;By using anorectal pressure detector,search for Parkinson’s disease constipation of the differences between different syndrome type in patients with anorectal dynamics.Methods:A total of 70 patients with Parkinson ’s disease constipation were enrolled in the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from February,2015 to May,2016,as the control group 35 patients with Parkinson’ s disease and non-constipation.On two groups of subjects were unified Parkinson disease rating scale(UPDRS),Hoehn-Yahr stage,Hamilton depression rating scale(HAMD)and serum ghrelin level are measured,statistical analysis software was used to analyze the data.70 cases of constipation group were classified according to syndrome differentiation,the distribution of TCM syndromes of Parkinson ’s disease constipation patients and the depressive disorder of TCM syndromes were statistically analyzed,and the differences of HAMD score of each syndromes were compared.According to the distribution of syndrome type,the patients with Parkinson’s disease constipation and depression were divided into virtual secret group and secret group,and set up a normal bowel movement as the control group.The anorectal pressure and sensory function were measured in each group,and the differences between the three groups were investigated.Results:Parkinson’s disease constipation group UPDRS-I score was(5.90±2.57)higher than that of non Parkinson’s disease constipation group(2.62±1.25),the difference was statistically significant(P<0.01);Parkinson disease constipation group HAMD score was(11.24±6.30)higher than that of non Parkinson’s disease constipation group(7.47±3.58),the difference was statistically significant(P<0.01);Parkinson’s disease constipation group depression rate of 55.7%,the incidence of Parkinson’s disease non constipation group depression rate was 20%,the difference was statistically significant(P<0.01).Parkinson’s disease patients with depressive disorder constipation group with constipation serotonin(1.45±0.47)for Parkinson’s disease is lower than the constipation patients serotonin(1.66±0.19),the difference was statistically significant(P<0.05);Parkinson’s disease patients with constipation group motilin(186.27±38.37)is lower than that of non Parkinson’s disease patients with constipation group motilin(274.23±12.18),the difference was statistically significant(P<0.01).3.70 cases of Parkinson’s disease with constipation in patients with TCM Syndrome Type: stomach heat retention syndrome in 18 cases(25.7%),25 cases of qi stagnation syndrome(35.7%),spleen qi deficiency syndrome 10 cases(14.3%),Yang deficiency of spleen and kidney in 7 cases(10%),10 cases of intestinal dryness due to yin deficiency(accounted for 14.3%).Parkinson’s disease patients with constipation pathogenesis qi stagnation syndrome type of depressive disorder was significantly higher than other syndromes,between the other four syndromes of depression incidence rate comparison,the difference was not statistically significant(P>0.05).Each type of syndrome,qi activity stasis syndrome HAMD scores mean compared with product of intestines and stomach heat syndromes,P values were 0.011,the difference was statistically significant(P<0.05);Qi activity stasis syndrome HAMD scores mean compared with Yin deficiency bowel dryness syndrome in patients with constipation,P values were 0.043,the difference was statistically significant(P< 0.05).Parkinson’s patients with depressive disorder real secret group with constipation anal maximal contraction pressure(19.12±3.33)less than Parkinson’s disease patients with depression disorder virtual secret group(21.60±3.11),difference was statistically significant(P<0.05);Anal resting pressure(11.26±2.65)is lower than Parkinson’s disease patients with depression disorder virtual secret group(13.27±1.81),the difference was statistically significant(P<0.05);Two groups of patients with anus contraction reflex,anal reflex diastolic pressure,the longest contraction time of the anal canal,rectal systolic blood pressure there was no statistical difference(P>0.05);Two groups of patients with anus contraction reflex,anal reflex diastolic pressure,the longest contraction time of the anal canal,anus maximum contraction pressure,anal canal resting pressure,anal resting pressure compared with normal control group,the difference was statistically significant(P<0.05).Parkinson’s disease patients with depression disorder virtual secret group of maximal tolerable rectal volum(194.04±26.05)higher than the normal control group(133.33±11.39),the difference was statistically significant(P<0.05),and the rectal sensory capacity threshold(19.53±5.41)were higher than in normal control group(13.51±2.12),the difference was statistically significant(P<0.05);Parkinson’s disease patients with depression disorder virtual secret group of maximal tolerable rectal volum(194.04±26.05)higher than Parkinson’s patients with depressive disorder real secret group(142.36±16.78),the difference was statistically significant(P<0.05),and the rectal sensory capacity threshold(19.53±5.41)were higher than Parkinson’s patients with depressive disorder real secret group(15.16±2.69),the difference was statistically significant(P<0.05).Conclusion:Parkinson’s disease constipation group the probability of occurrence of depression,the degree of Parkinson’s disease were significantly higher than the non-constipation group,and brain-gut peptide levels lower than Parkinson’s disease non-constipation group.In the Parkinson ’s disease type of constipation syndrome,the syndrome of qi stagnation is more,and the tendency of depressive disorder of qi stagnation syndrome is higher than other syndromes.Compared with the normal group,Parkinson’s disease patients with constipation and depression have anal rectal pressure,rectal sensory dysfunction and other indicators of the problem.Patients with Parkinson’s disease and depressive disorder were mainly characterized by changes in anorectal pressure,while patients with Parkinson’s disease and depressive disorder with virtual depression had the change of sensation threshold of anorectal rectum as the main feature.