Progress of Research on Application of Antispasmodics in Digestive Endoscopy / 胃肠病学

Reasonable use of antispasmodics to attenuate gastrointestinal peristalsis during digestive endoscopy is an effective clinical strategy to improve the clarity of endoscopic images and diagnostic accuracy. The commonly used antispasmodics in gastroenteroscopy mainly include systemic antispasmodics and local antispasmodics at present. Systemic antispasmodics have some limitations, such as inconvenience in usage, many contraindications and adverse reactions. Local antispasmodics can act directly on the digestive tract mucosa by oral administration or spraying, which can quickly and effectively inhibit peristalsis, and is convenient for clinical use with fewer adverse reactions. This review summarizes the mechanism of action, efficacy and application of systemic antispasmodics and local antispasmodics in digestive endoscopy, in order to provide strategies for the selection of antispasmodics in digestive endoscopy.

Improving comprehensive retention rate of peppermint oil in freeze-dried preparation based on cyclodextrin inclusion technology / 中国中药杂志

The freeze-drying technique, characterized by low-temperature processing, is especially suitable for sensitive volatile oils with thermal instability. However, there are few studies focusing on the retention of volatile oils in the processing of freeze-dried preparations. This study evaluated the effects of different addition methods(adsorption, emulsification, solid dispersion, and inclusion) on the retention rate of the main components in peppermint oil, aiming to explore the application feasibility of freeze-dried preparations of volatile oils. Firstly, the addition method was determined based on the retention rates of menthol in four freeze-dried preparations. Secondly, an orthogonal test was designed to optimize the preparation process based on the characteristics of the preferred addition method. The results showed that the most suitable preparation form of peppermint oil was inclusion with beta-cyclodextrin(β-CD), and the retention rate of menthol in freeze-drying was 86.36%. According to the two-step preparation process of inclusion and freeze-drying, we introduced the product of inclusion rate and retention rate, i.e., comprehensive retention rate, to determine the optimum processing parameters. The results showed that β-CD/oil ratio of 7∶1, inclusion temperature of 40 ℃, and inclusion time of 2 h were the optimum processing parameters. The product prepared with these parameter had the comprehensive retention rate of 68.41%, retention rate of 92.53%, and inclusion rate of 73.93%. The inclusion compound was white powder with significantly increased solubility. The pre-paration process based on cyclodextrin inclusion in this study is stable and reliable and provides a new idea for ensuring the efficacy and stability of volatile components in freeze-dried preparations.

Establishing a rabbit model of yang deficiency and cold coagulation with peppermint oil and climate chamber / 中国组织工程研究

BACKGROUND: Our preliminary studies have established a rabbit model of knee osteoarthritis using gypsum wire fixation, but the model of traditional Chinese medicine (TCM) syndrome of knee osteoarthritis has not been prepared. OBJECTIVE: To assess the feasibility of establishing a rabbit model of yang deficiency and cold coagulation using peppermint oil and climate chamber, to lay the foundation for future research. METHODS: Thirty-two experimental animals were randomly divided into normal group, model group, yang deficiency group and yang deficiency-cold coagulation group. Except for the normal group, the rabbit knee joints were fixed with plaster fixator brake method for 8 weeks. The yang deficiency group was given daily perfusion of peppermint oil for 2 weeks at the beginning of the 7th week of fixation. In the yang deficiency-cold coagulation group, the rabbits were placed in a climate chamber at 4 °C for 1.5 hours every day, and given daily perfusion of peppermint oil after 6 weeks of braking. After 7 and 14 days of intragastric administration, the serum level of thyrotropin (T4) was detected by ELISA. After 8 weeks of modeling, the articular cartilage, meniscus and synovium were taken for histological scoring. Animal behaviors were observed, and body surface temperature was detected using an infrared thermal imager. The experimental protocol was approved by the Animal Ethics Committee of the First Affiliated Hospital of Xinjiang Medical University (approval No. IACUC-20170222026). RESULTS AND CONCLUSION: For behavior observation, the symptoms of yang deficiency-cold coagulation appeared in the yang deficiency-cold coagulation group. The plantar temperature of the yang deficiency-cold coagulation was lower than that of the normal and model groups (P < 0.05). The serum T4 level was lower in the yang deficiency group and yang deficiency-cold coagulation group than the normal group (P < 0.05). The Mankin scores of the knee joints in two yang deficiency groups were both higher than that in the normal group (P < 0.05) but lower than that in the model group (P < 0.05). Hematoxylin-eosin staining of the meniscus and synovial membrane indicated the yang deficiency group and the yang deficiency-cold coagulation group had no significant difference from the model group. Histomorphological findings elucidated that the peppermint oil with climate box contributes to simulating the disease state to a certain extent, which can provide a reference for establishing the rabbit knee osteoarthritis model of yang deficiency-cold coagulation type.

Preparation of Peppermint Oil Moisturizing Microemulsion for Nasal Mucosa and Study on Its Mucosal Adhesion and Cilia Toxicity / 中国药房

OBJECTIVE： To prepare the Peppermint oil moisturizing microemulsion for nasal mucosa and survey its mucosal adhesion and cilia toxicity. METHODS： The polyoxyethylene hydrogenated castor oil was used as emulsifier to prepare the Peppermint oil moisturizing microemulsion for nasal mucosa， and the preparation technology was optimized on the basis of comprehensive score by orthogonal design. The microemulsion was characterized and the menthol content was determined by GC. The mucosal adhesion was evaluated by measuring the transport rate by cilia in vivo， and the cilia toxicity of microemulsion was evaluated by measuring the sustained movement time of cilia in vitro. RESULTS： The optimal preparation technology of self-made microemulsion was to firstly disperse the peppermint oil and the emulsifier， then add anhydrous ethanol， edible glycerin and distilled water， and stir at 1 200 r/min for 2 h. The average contents of menthol in the three batches of the microemulsion were 2.682， 2.507 and 2.496 mg/mL （RSD＝2.89％，n＝3）， respectively. The cilia transport rates in vivo were （0.65±0.01）， （0.78±0.03）and （0.92±0.04） cm/min in high-dose， medium-dose， and low-dose groups of self-made microemulsion （2.561， 0.256， 0.128 mg/mL of menthol） respectively， which were significantly lower than normal saline group and compound menthol nasal droups （P＜0.05）. The cilia movement time in vitro were（206.7±4.9）， （226.0±13.5）， （269.3±12.9）min， which were significantly longer than sodium deoxycholate group （P＜0.05）. CONCLUSIONS： The preparation technology of self-made microemulsion is easy-to-handle and controllable in quality. The prepared microemulsion shows good mucosal adhesion without cilia toxicity．

Study on Quality Standard of Compound Lavandula angustifolia Ointment / 中国药房

OBJECTIVE:To establish the quality standard for Compound Lavandula angustifolia ointment. METHODS:TLC was used for the qualitative identification of ethanol extract from Scutellaria baicalensis and volatile oil of L. angustifolia. GC method was used for qualitative identification of dementholized peppermint oil. GC method was used to determine the content of menthol. The determination was performed on Agilent DB-WAX capillary column,with temperature programming. The injector temperature was 250℃,and the temperature of detector was 250℃.The injection volume was 1 μL and the split ratio was 5:1 by split sampling. RESULTS:TLC spots of ethanol extract of S. baicalensis and volatile oil of L. angustifolia were clear and well-repeated without interference from negative control. The chromatographic peaks in TLC of test samples of dementholized peppermint oil had same retention time as that of substance control.The linear range of menthol injection amount was 0.113 4-1.133 5μg (r=0.999 4). RSDs of precision,intra-day precision,stability and reproducibility tests were not higher than 2.0%. The recoveries were 95.40%-99.82%(RSD=1.61%,n=6). CONCLUSIONS:Established quality standard can be used for the quality control of Compound L.angustifolia ointment.

Optimization of inclusion process of mixed volatile oil of forsythia oil and peppermint oil by colloid mill method / 中草药

Objective: To optimize the preparation of β-cyclodextrin (β-CD) inclusion compound of forsythia oil and peppermint oil using the colloid mill method. Methods: With recovery ratio and inclusion rate of volatile oil-β-CD as evaluation indexes, the single factor test combining Box-Behnken response surface methodology was used to study the effects of β-CD-pure water ratio, β-CD-volatile oil ratio, and inclusion time on the inclusion process of volatile oil. Using TLC, IR spectrum, and microscopic image, the inclusion complexes were confirmed. Results: The optimum preparation conditions of inclusion compound were as follows: β-CD-pure water ratio was 1:3, mixture of forsythia oil and peppermint oil-β-CD ratio was 1:9, and the inclusion time was 25 min. The formation of inclusion complex was preliminary proved by TLC, IR spectrum, and microscopic image. Conclusion: The method is reasonable and feasible.

Clinical efficacy of peppermint oil capsules combined with Domperidone in the treatment of bile reflux gastri-tis after gastric surgery / 中国基层医药

Objective To observe the clinical efficacy of peppermint oil capsules combined with domperi-done in the treatment of bile reflux gastritis(BRG)after gastric surgery.Methods Totally 47 patients with BRG after gastric surgery were treated with peppermint oil capsule (0.9g,tid)and domperidone(10mg,tid).Each patient's gas-troscopic manifestations and histopathology were rechecked after 4 weeks.The efficacy was observed on the improve-ment of symptoms and gastric mucosal injury,and on the reduction of bile reflux.Results 42 patients attained satis-factory therapeutic effect with the total efficiency rate of 89.4%.No adverse effects during the treatment period. Conclusion Peppermint oil capsules combined with domperidone shows better efficacy in treatment of BRG after gastric surgery.

Análise da eficácia do óleo de hortelã pimenta (Mentha piperita L) na síndrome do intestino irritável: revisão baseada em evidência / Analysis of the efficacy of the peppermint oil (Mentha piperita L) on irritable bowel syndrome: an evidence-based review / Análisis de la eficacia del aceite de menta (Mentha piperita L) sobre el síndrome del intestino irritable: revisión basada en evidencia

Objetivo: Avaliar a eficácia do óleo de hortelã-pimenta (Mentha piperita L) no tratamento de indivíduos com síndrome do intestino irritável (SII), analisando a melhora dos sintomas e da qualidade de vida. Métodos: Foram realizadas pesquisas nas bases de dados Trip database, National Guideline Clearinghouse, Guidelines finder, Cochrane Library, Dare, Bandolier e Medline utilizando os termos MeSH Irritable bowel syndrome e peppermint oil. Foram incluídas normas de orientação clínica (NOC), revisões sistemáticas e metanálises e ensaios clínicos aleatorizados e controlados (ECAC) que avaliassem a eficácia do óleo de hortelã-pimenta (OHP) no alívio sintomático ou melhoria da qualidade de vida de indivíduos com SII, quando comparado com placebo ou outra terapêutica validada. Resultados e Discussão: Foram selecionados 8 artigos (5 NOC, 3 revisões sistemáticas/metanálises). A evidência sugere que o OHP é eficaz no alívio sintomático global da SII, especialmente quando existe dor abdominal, verificando-se a sua superioridade em relação ao placebo na maioria dos estudos avaliados ­ com odds ratio favorecendo o óleo de hortelã-pimenta atingindo 2,7 (IC de 95% de 1,6 a 4,8) e NNT de 3. Existe também evidência de melhoria da qualidade de vida com o OHP, em comparação com o placebo (p<0,001). Conclusão: A evidência demonstra eficácia do OHP na SII, especialmente quando existe um componente de dor abdominal, quando comparado com o placebo (força de recomendação B). São necessários mais estudos com qualidade metodológica que avaliem eficácia e segurança a longo prazo do OHP no alívio sintomático da SII.

Objective: To evaluate the efficacy of peppermint oil (Mentha piperita L.) on individuals diagnosed with irritable bowel syndrome (IBS) regarding symptom improvement and quality of life enhancement. Methods: Literature search was conducted according to evidence based on methodology review at Trip database, National Guideline Clearinghouse, Guidelines finder, Cochrane Library, Dare, Bandolier and Medline, as well as using the MeSH index terms "Irritable bowel syndrome" and "peppermint oil". We selected practice guidelines, systematic reviews, meta-analysis and randomized controlled trials that evaluated peppermint oil (PO) efficacy in improving symptoms and/or quality of life when compared to placebo or other approved therapy for IBS. Results and Discussion: A total of eight articles were selected including five practice guidelines and three systematic reviews/ meta-analysis. Existing evidence suggests that there are enough data to support the use of peppermint oil in IBS for overall symptomatic relief, especially when abdominal pain is the dominant symptom, when compared to placebo (with an odds ratio of 2.7; CI 95%, 1.6 to 4.8 and NNT of 3). There is also evidence regarding overall quality of life improvement when using PO compared to placebo (p<0.001). Conclusion: So far, evidence suggests that PO should be considered for IBS patients, especially in the presence of abdominal pain (Strength of recommendation B). However, more high methodological quality studies that evaluate long-term efficacy and security of PO are needed.

Objetivo: Evaluar la eficacia del aceite de menta (Mentha piperita L.) en el tratamiento de pacientes con síndrome del intestino irritable (SII) y analizar el alivio de sus síntomas y la mejora en su calidad de vida. Métodos: Se realizaron búsquedas en las bases de datos Trip database, National Guideline Clearinghouse, Guidelines finder, Cochrane Library, Dare, Bandolier y Medline usando los términos MeSH "Irritable bowel syndrome" y "peppermint oil". Se incluyeron las normas de orientación clínica (NOC), revisiones sistemáticas y meta-análisis y ensayos clínicos controlados aleatorizados (ECAC) para evaluar la eficacia del aceite de menta (AM) en el alivio sintomático y mejora de la calidad de vida de las personas con SII en comparación con el placebo u otra terapia validada. Resultados y Discusión: Se seleccionaron ocho estudios (cinco NOC y tres revisiones sistemáticas/meta-análisis). La evidencia sugiere que el AM es eficaz en el alivio de los síntomas generales del SII, en particular si había dolor abdominal, verificandose su superioridad sobre el placebo en la mayoría de los estudios evaluados (odds ratio de 2,7; IC 95% de 1,6 a 4,8 y NNT de 3). Hubo también evidencia de mejora en la calidad de vida en los pacientes tratados con AM, en comparación con el placebo (p <0,001). Conclusión: Las pruebas demuestran la eficacia del AM en el SII, especialmente en presencia de dolor abdominal, en comparación con el placebo (fuerza de recomendación B). Se necesitan más estudios con buena calidad metodológica que evalúen la eficacia y la seguridad a largo plazo del AM en el alivio de los síntomas del SII.

Comparative evaluation in the efficacy of peppermint (Mentha piperita) oil with standards antibiotics against selected bacterial pathogens

Objective: To find the efficacy of peppermint oil against selected bacterial pathogens and compare with their susceptibility towards antibiotics. Methods:Peppermint oil was evaluated for activity against Bacillus cereus, Bacillus subtilis, Escherichia coli, Staphylococcus aureus (S. aureus), Klebsiella pneumoniae and Pseudomonas aeruginosa. The antibacterial assay was evaluated using agar well diffusion method and the viability of the organisms (MIC and MBC) was determined at different concentrations using broth dilution method. Results: Peppermint oil was found to be effective against all the gram positive and gram negative organisms tested. A progressive effect of antibacterial activity with increase in concentration of oil was observed. The test organisms were found to be inhibited by peppermint oil at lower concentration in broth dilution method as compared with agar diffusion method. When comparing the assessment of the inhibitory effect of peppermint oil, broth dilution was found to be more effective as compared with agar diffusion method. Except S. aureus, the remaining organisms tested in the present study were found to possess multiple drug resistance. However, peppermint oil was found to be effective against these bacterial strains studied. Conclusions:Hence, with such broad spectrum activity of peppermint oil, it can be further recommended in the treatment of the infections caused by these multi-drug resistant bacteria.

Preparation and characterization of peppermint oil-β-cyclodextrin polymer microsphere inclusion compound / 中草药

Objective: To optimize the including preparation for peppermint oil-β-cyclodextrin polymer (β-CDP) microsphere inclusion compound. Methods: Peppermint oil-β-CDP microsphere inclusion compound was prepared by using co-precipitation. The preparation process was optimized through the L9(34) orthogonal test design and regression analysis. Peppermint oil-β-CDP microsphere inclusion compound was characterized by infrared (IR) spectroscopy, thermogravimetric analysis (TGA), and X-ray diffraction (XRD). Results: The best technological condition was A 2B2C1D3, and the order of the influence factors was the proportion of β-CDP microsphere and water > the percentage of peppermint oil in β-CDP microsphere > inclusion temperature > inclusion time. The formation of peppermint oil β-CDP microspheres inclusion compound was proved by the results of IR, XRD, TGA analyses. Conclusion The method is reasonable and feasible.

The Effect of Peppermint Oil on Peristalsis during Gastroscopy / 대한소화기내시경학회지

BACKGROUND/AIMS: Gastrointestinal peristalsis may hinder inspection of the gastrointestinal track or its treatment during endoscopy. Antispasmodic agents such as hyoscine-N-butylbromide are commonly administered before endoscopy for alleviating peristalsis, although it causes unwanted complications. Peppermint oil (PMO) has a spasmolytic effect on viscera and it has been used as an adjunctive remedy for some disorders. We evaluated the antispasmodic effect of PMO solution during gastroscopy, and we determined if there are any adverse effects. METHODS: 1.6% PMO solution was sprayed on the antrum of the examinees (n=40) during gastroscopy. Observation was performed 5 cm ahead of the pyloric ring to count the peristaltic waves for 3 minutes before and after spraying PMO. The intensity of peristalsis was graded from 0 (none) to 4 (severe), and the pulse rate of all the examinees was recorded every minute. RESULTS: The number of peristaltic contractions decreased after PMO spraying from 7.02+/-2.25 to 3.17+/-2.57 times/3 minutes (p<0.01). The peristaltic intensity also decreased from 3.15+/-1.18 to 1.34+/- \0.95 (p<0.01) with a difference of 1.80+/-1.29. On observing the examinees' pulse rates, using PMO did not induce tachycardia. No adverse effect during and after the investigation with PMO solution was reported. CONCLUSIONS: PMO showed a significant antispasmodic effect, and it reduced the number of peristaltic contractions and the intensity of gastric peristalsis. It also did not have any significant side effects. PMO solution may be used as an effective antispasmodic agent during gastroscopy.

Effect of peppermint oil on GSH and ATPase in rat liver-tissues and primary cultured rat hepatocyte / 中成药

AIM: To study the effect of peppermint oil on GSH、ATPase in rat liver-tissues and primary cultured rat hepatocyte. METHODS: The rat liver tissues were obtained to detect content of GSH and level of Na~+-K~+-ATPase、Ca~(2+)-Mg~(2+)-ATPase after being administered peppermint oil orally at 24 % concentration of peppermint oil in 36 and 48 hours.Primary rat hepatocyte was separated and cultured,then peppermint oil and the serum containing that were respectively added level of LDH,ALT,AST in the supernatant fluid was respectively determined after incubating for 12,24 and 48 hours. RESULTS: The content of GSH and level of Na~+-K~+-ATPase and Ca~(2+)-Mg~(2+)ATPase in liver tissues was low remarkably(P

Evaluation of uncertainty measurement in the assay of Danshu Capsule / 中成药

AIM: To establish a method for evaluating uncertainty of Danshu Capsule(peppermint oil). METHODS: The uncertainty originated from menthol in Danshu Capsule was analyzed by GC.The influencing factors on the uncertainty were evaluated, including solution strength of reference substance,sample weight,solution volume of sample,peak area of chemical reference substance,peak area of sample,average weight of capsule,etc. RESULTS: The expanded uncertainty U_95 was 1 mg(P=95%,k=2). CONCLUSION: It can be used for evaluation of uncertainty measurement by GC.