Study On The Mechanism Of Tongxieyaofang And Its Chaifang Relieving Visceral Hypersensitivity In IBS-D Based On MAPK-ERK Signaling Pathway

Objective: To study the effect of Tongxieyaofang and Chaifang ease irritable bowel syndrome mechanism of visceral hypersensitivity in patients with diarrhea predominant.From the molecular level and gene level of modern medicine to explain the scientific connotation of Tongxieyaofang "anti wood earth".Methods:90 cases of irritable bowel syndrome(IBS-D)patients were randomly assigned‘and divided into three groups,yimu group(i.e.baishao?fangfeng Group);peitu group(i.e.Chenpi?Baizhu group);whole group(i.e.Tongxieyaofang group)and normal control group;At the same time set normal control group.Each group of patients were taken according to the composition of the proportion of Tongxieyaofang made from fried particles.After 4 weeks of continuous medication,From the clinical level,To observe the changes of clinical symptom scores of each group before and after taking medicine;From the molecular level,The changes of VIP and CGRP in plasma of each group before and after treatment were compared by ELISA method;From the level of gene expression,The expression of MAPK-ERK signal pathway ERK1 m RNA,ERK2 m RNA and c-fosm RNA before and after treatmentwere detected by fluorescence quantitative RT-PCR.And according to the statistical requirements of the relevant data analysis,From the above three aspects of Tongxieyaofang and its disassembled prescriptions relief mechanism of IBS-D patients with visceral hypersensitivity.Results:1.clinical level(1)Gender,age,duration of disease:There was no significant difference between the ‘three groups in gender,age and duration of disease(P > 0.05).(2)Comparison of the scores of self rating Anxiety Scale(SAS)andself rating Depre ssion Scale(SDS):Baishaofangfeng group,chenpibaizhu group and Tongxieyaofang group before and after treatment anxiety scale(SAS),depression scale(SDS)score,the difference was statistically‘ significant(P < 0.05),Comparison between the two groups after treatment,Baishaofangfeng group compared with chenpibaizhu group,the difference was ‘statistically significant(P < 0.05).(3)Abdominal pain / abdominal discomfort symptoms integral comparison: Baishaofangfeng group,chenpibaizhu group and Tongxieyaofang group after the treatment of IBS-D patients with abdominal pain or discomfort symptoms were obviously improved,the difference was‘ statistically significant(P < 0.05)after treatment,comparison between groups,Baishaofangfeng group compared with chenpibaizhu group,the difference ‘was statistically significant(P < 0.05).(4)Comparison of the duration of normal defecation:The normal defecation time before and after treatment with Baishaofangfeng,group,chenpibaizhu,groupand,Tongxieyaofang and group had statistical difference(P < 0.05).After treatment,the scores between the two groups were compared,The difference was statistically significant between Baishaofangfeng‘group‘and chenpibaizhu‘group(P < 0.05).2.molecular level: comparison of plasma levels of VIP and CGRP in brain gut peptide(1)Comparison of changes of plasma ghrelin levels and the content of VIP in baishaofangfeng group before and after treatment,the difference was‘statistically significant(P < 0.05);compare the changes of plasma brain gut peptide content of VIP in chenpibaizhu group before and‘after treatment,there was no statistically significant‘difference(P > 0.05);comparison of changes of plasma ghrelin levels and the content of VIP in Tongxieyaofang group before and after‘treatment,the difference was‘statistically‘significant(P < 0.05).(2)Baishaofangfeng group,chenpibaizhu group and Tongxieyaofang group before and after treatment of plasma levels of CGRP in the brain,the difference was not statistically‘significant(P > 0.05).3.gene level: comparison of ERK1 m RNA,ERK2 m RNA and c-fosm RNA expression in MAPK-ERK signaling pathwayCompared with the normal control group,the expression of baishaofangfeng group and chenpibaizhu group,Tongxieyaofang group,ERK1 m RNA ERK2 m RNA,c-fosm RNA were higher,the difference‘was‘statistically‘significant(P < 0.05);after each drug intervention groups compared with expression of ERK1 m RNA,ERK2 m RNA,c-fosm RNA,baishaofangfeng comparison group before and after treatment decreased significantly,there are‘statistically‘significant‘difference(P < 0.05);the expression of ERK1 m RNA,ERK2 m RNA and c-fosm RNA before and after treatment in group chenpibaizhu decreased significantly,the ‘ difference‘was ‘ statistically significant(P < 0.05);the expression of ERK1 m RNA,ERK2 m RNA and c-fosm RNA before and after treatment in group Tongxieyaofang decreased significantly,the‘difference was statistically‘significant(P < 0.05);the treatment in the three groups after comparing the expression of ERK1 m RNA and ERK2 m RNA,the amount of c-fosm RNA was not different,the difference was‘not statistically‘significant(P > 0.05).Conclusion:(1)Tongxieyaofang can significantly improve the clinical symptoms of anxiety,depression,abdominal pain and diarrhea in patients with IBS-D,Compared with chenpibaizhu group,the curative effect of baishaofangfeng group was better than that of the control group.(2)the contents of VIP and CGRP in plasma of patients with cerebral infarction can be used as a reference index to reflect the severity of IBS-D.(3)Tongxieyaofang may reduce the level of VIP and CGRP in plasma of patients with IBS-D,which can relieve the visceral hypersensitivity of IBS-D.(4)MAPK-ERK signaling pathway may be one of the mechanisms of visceral hypersensitivity of IBS-D.(5)Tongxieyaofang may regulate the MAPK-ERK signaling pathway to relieve the visceral hypersensitivity of IBS-D,so as to improve the clinical symptoms of abdominal pain,diarrhea and other symptoms of IBS-D.