Therapeutic Effect Of Tongfu Jiangzhuo Decoction On Constipation-type Irritable Bowel Syndrome And Its Effect On Brain-gut Peptide Level

Objective:To observe the clinical efficacy and quality of life of patients with constipation predominant irritable bowel syndrome(IBS-C)treated with Tongfu Jiangzhuo decoction under the guidance of turbidity theory.By detecting changes in plasma VIP,SP,and serum 5-HT levels,the regulation of brain-gut interaction by brain-gut peptides explores the possible mechanism of treatment of IBS-C with Tongfu Jiangzhuo decoction,and provides a scientific treatment of IBS-C for clinical application.Methods:Seventy patients with IBS-C(turbidity and internal syndrome)who met the inclusion standard were randomly separated into two groups(35cases each).The treatment group was given the traditional Chinese medicine for relieving turbidity and the cisapride tablets in the control group for 4weeks.The quality of life scores and clinical symptom scores of the 2 groups before treatment?after treatment and 3 months of follow-up were recorded,The serum 5-HT,plasma SP and VIP were measured before and after treatment.Results:1.The scores of the treatment group after treatment and follow-up were compared with those before treatment,P<0.05,and the difference was tatistically significant.After treatment,the scores of the symptoms in the control group were compared with those before the treatment,P<0.05,the difference was statistically significant.At the time of follow-up,except for dry mouth,no drink,and phlegm and helium hiccup were compared with before treatment,P<0.05,the difference was statistically significant.After treatment,the treatment group was better than the control group,P<0.05;After the follow-up,the treatment group was better than the control group except for eating less or early,and drowsiness,P<0.05,the difference was statistically significant.2.Clinical efficacy The total effective rate of the treatment group was87.9%,and the total effective rate of the control group was 62.5%.The treatment group was significantly better than the control group,P<0.05,and the difference was statistically significant.3.IBS-QOL scores The treatment group in the anxiety,health concerns,interpersonal relationsh and other dimensions after treatment,follow-up improved(P<0.05),the difference was significant;The control group after treatment,except for sexual behavior(Q7)scores were increased(P<0.05),except for physical will,sexual behavior(Q3 and Q7),all dimensions were improved after follow-up(P<0.05);and the two groups were better than the control group after treatment and follow-up(P<0.05),the difference was statistically significant.4.The levels of serum 5-HT,plasma VIP and SP in the two groups were significantly lower than those before treatment(P<0.05),and the treatment group was significantly better than the control group(P<0.05),the difference was statistically significant.Conclusion:1.Tongfu Jiangzhu decoction can not only relieve the clinical symptoms of IBS-C patients,but also has a good clinical cure rate,and the short-term and long-term effects are stable,which is one of the effective methods for the treatment of IBS-C.2.Tongfu Jiangzhu decoction can reduce intestinal hypersensitivity,enhance intestinal smooth muscle contractility,and promote intestinal emptying by regulating the expression of brain-gut peptide 5-HT,SP,VIP,etc.which is the one of the possible mechanisms of treatment of IBS-C.