ABSTRACT
Objective:This study aims to investigate the clinical efficacy of Modified Xiangsha Liu Junzitang in the treatment of diabetic gastroparesis （DGP） and its influence on gastrointestinal hormones and oxidative stress. Method:In this study， 128 patients were randomly divided into control group （64 cases） and observation group （64 cases） . Patients in two groups took domperidone tablets orally 30 minutes before meals， 10 mg/time， 3 times/day. Patients in control group took Shenling Baizhusan San， 6 g/time， twice a day. Patients in observation group were prescribed addition and subtraction therapy of Modified Xiangsha Liu Junzitang， 1 dose/day. The course of treatment for both groups was 4 weeks. Before and after treatment， scores of gastroparesis cardinal symptom index （GCSI）， and gastric emptying test and electrogastrogram were noted. Before the treatment， scores of traditional Chinese medicine （TCM） syndrome and health survey summary were graded（SF-36）. The levels of gastrin （GAS）， motilin （MTL）， vasoactive intestinal peptide （VIP）， somatostatin （SS）， superoxide dismutase （SOD）， reactive oxygen species （ROS） and malondialdehyde （MDA） were measured before and after treatment. And adverse reactions during treatment were recorded. Result:The scores of postprandial abdominal distension/early satiety， nausea and vomiting， abdominal distention and the total scores of GCSI in the observation group were lower than those in control group （<italic>P</italic><0.01）. The gastric emptying rate in observation group was higher than that in control group （<italic>P</italic><0.01）， and the score of TCM syndromes was lower than that of control group （<italic>P</italic><0.01）. The scores of SF-36 in observation group were higher than those in control group （<italic>P</italic><0.01）. The frequency of gastric electricity and gastric electric vibration before and after the meal in observation group were higher than that in control group （<italic>P</italic><0.01）. The levels of GAS， MTL， VIP， ROS and MDA in observation group were lower than those in control group （<italic>P</italic><0.01）， while the levels of SS and SOD were higher than that of control group （<italic>P</italic><0.01）. The total effective rate in observation group was 93.75% （60/64）， which was higher than 79.69% （51/64） （<italic>χ</italic><sup>2</sup>=5.494， <italic>P</italic><0.05） in control group （<italic>P</italic><0.01）. And no adverse reactions were found in the clinical observation. Conclusion:Modified Xiangsha Liu Junzitang combined with prokinetic drugs in the treatment of DGP patients can reduce the clinical symptoms of DGP， enhance gastrointestinal motility， improve the gastric emptying rate， improve the quality of life， regulate the level of gastrointestinal hormones， and reduce the damage of autonomic nerve caused by oxidative stress， with good comprehensive clinical effect and safety in application.
ABSTRACT
Objective: To observe the effects of the Banxia Xiexin Decoction (BXD) on the intestinal flora and inflammatory factors of diabetic gastroparesis (DGP) rats. Methods: The high fat and sugar feeding combined with intraperitoneal injection of STZ were used for the preparation of DGP rats model, which were randomly divided into model group, the metformin (1.80 g/kg) group, the low (2.55 g/kg), medium (5.10 g/kg), and high (10.20 g/kg) dose group of BXD, and the blank group with 10 rats in each group. Four weeks of continuous ig administration of fasting blood glucose (FBG), gastric residual rate, intestinal propulsion rate, serum D-xylose level, intestinal flora, serum endotoxin, immunoglobulin A, and inflammatory factors were detected. Results: Compared with the blank group, the body weight, intestinal propulsion rate, flora (bacteroides, bifidobacterium, enterococcus, and lactobacilli) amount, IgA, and IL-10 in DGP model were significantly reduced (P < 0.01); FBG, gastric residual rate, serum D-xylose, enterobacter number, endotoxin, and TNF-α were significantly increased (P < 0.01); Compared with model group, high dose BD group of body weight, intestinal propulsion rate, flora (bacteroides, bifidobacterium, enterococcus, and lactobacilli) amount, IgA, and IL-10 level in the low, medium, and high dose group of Banxia Xiexin decoction were increased significantly (P < 0.05, 0.01), FBG, gastric residual rate, serum D-xylose, enterobacter number, endotoxin and TNF-α were significantly decreased (P < 0.05, 0.01). The FBG, intestinal propulsion rate, bacteroides number, and IgA level in the low-dose group were less affected. Conclusion: BXD can effectively adjust the various indexes of DGP model rats, including improving the intestinal flora proportion, reducing endotoxin, inhibiting inflammation factors, and improving the intestinal barrier function, and the potential mechanism may be related to regulation of intestinal bacteria and inflammation factors.
ABSTRACT
[ ABSTRACT] AIM: To discuss the relevance between the pathogenesis of diabetic gastroparesis and the large-conductance calcium-activated potassium channels ( BKCa ) in gastric smooth muscle cells.METHODS:The SD rats were randomly divided into control group and model group.The gastric smooth muscle cells of the SD rats were enzymatically iso-lated in a low calcium solution containing papain.The current was recorded by patch clamp single channel recording tech-nique.The expression of KCNMA and KCNMB1 were observed by the method of immunohistochemistry.RESULTS:The value of BKCa single channel conductance was (220.10 ±10.90) pS;the channels had distinct voltage dependent and cal-cium dependent characteristics.In outside-out patch (Vm =+30 mV), the activation of BKCa was blocked by 200 nmol/L IbTX completely.Compared with control group, the open probability and amplitude of current in model group significant-ly increased, while the mean open time and mean close time significantly decreased.Compared with control group, the ex-pression of KCNMB1 in model group was significantly increased.CONCLUSION: Up-regulation of β1-subunit and in-crease in BKCa functional activities may be associated with diabetes gastroparesis in rats.