ABSTRACT
Objective To compare the effects of different spleen-strengthening recipes on water-electrolyte metabolism and water transport in rat model of spleen-deficiency syndrome. Methods The male Wistar rats were randomly assigned into the normal group and spleen-deficiency model group. The rat model of spleen-deficiency was established by overstrain plus disordered diet method. On the 15th modeling day, the model rats were randomly assigned into model group , Buzhong Yiqi Tang(BYT) group, Si Junzi Tang(SJT) group, Shenling Baizhu San(SBS) group, and the rats except for the model group were treated with gastric gavage of the corresponding medicine in the dosage of 4.05 g·kg-1·d-1. Rats of normal group and model group were given equal volume of normal saline. The medication lasted for 14 days. On the 29th experimental day, we detected serum Na+ and K+, plasma antidiuretic hormone(ADH) and aldosterone(ALD), aquaporin 3(AQP3) in the small intestine and colon, and renal AQP2. Results Compared with the normal group, plasma ADH and ALD levels, serum Na+ level, renal AQP2 content in the model rats were increased significantly, serum K+ and AQP3 content of small intestine and colon mucosa was decreased significantly(P<0.01). Compared with the model group, plasma ADH and ALD levels, serum Na+ level, renal AQP2 content in the three medication groups were decreased significantly, serum K+level and AQP3 in the small intestine and descending colon mucosa was increased significantly(P<0.05 or P<0.01). Of the three medication groups, SBS group had lower ADH, ALD, Na+levels, and higher serum K+level and AQP3 in the small intestine and descending colon mucosa than BYT group and SJT group(P<0.01); SBS group and BYT group had lower renal AQP2 than SJT group(P<0.05 or P<0.01). Conclusion Rat model with spleen-deficiency syndrome has disordered water-electrolyte metabolism and abnormal water transport. The spleen-strengthening recipes, which have the actions of strengthening spleen, strengthening spleen to drain dampness, strengthening spleen to elevate yang, can improve the disorder of water metabolism to some degrees, and SBS has the best effect.
ABSTRACT
La anorexia nerviosa es un padecimiento cuya incidencia y prevalencia van en aumento. Actualmente, las edades de presentación son cada vez más tempranas, por lo que es un tema de mucha importancia para la práctica pediátrica general. El manejo debe ser multidisciplinario. Es importante involucrar a la familia en el tratamiento por medio de terapia familiar. La primera tarea en el abordaje clínico es detectar criterios de hospitalización. Una vez iniciada la terapia se debe vigilar el surgimiento del síndrome de realimentación, caracterizado por trastornos hidroelectrolíticos que ponen en riesgo la vida (arritmias cardiacas). La nutrición por vía oral es la primera elección. La nutrición enteral continua por sonda, cuando es requerida, puede ser diurna y/o nocturna. Las alteraciones gastrointestinales asociadas a la anorexia nerviosa pueden requerir de manejo farmacológico. Los criterios diagnósticos y de hospitalización son mencionados en esta revisión, así como las modalidades de tratamiento médico y nutricional ambulatorio y hospitalario.
Prevalence and incidence of anorexia nervosa are both increasing. A younger age of onset is currently being observed, making this disease an important issue for general practice in pediatrics. Treatment must include a multidisciplinary team. Family participation in rehabilitation is currently encouraged. Detection of hospitalization criteria is the first task to accomplish during clinical evaluation. Once treatment is established, occurrence of refeeding syndrome consisting of lifethreatening disorders of water and electrolyte metabolism (cardiac arrhythmias) must be ruled out. Oral route is the first choice for refeeding. Continuous tube feeding, when required, may be diurnal and/or nocturnal. Gastrointestinal disorders associated with anorexia nervosa may require drug therapy. Diagnosis and hospitalization criteria are discussed in this review as well as medical and dietary treatment options in hospitalized and ambulatory settings.