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SUMMARY OBJECTIVE: Functional constipation is the most common form of constipation, and its exact aetiology is still unclear. However, it is known that deficiencies in hormonal factors cause constipation by changing physiological mechanisms. Motilin, ghrelin, serotonin acetylcholine, nitric oxide, and vasoactive intestinal polypeptide are factors that play a role in colon motility. There are a limited number of studies in the literature where hormone levels and gene polymorphisms of serotonin and motilin are examined. Our study aimed to investigate the role of motilin, ghrelin, and serotonin gene/receptor/transporter polymorphisms in constipation pathogenesis in patients diagnosed with functional constipation according to the Rome 4 criteria. METHODS: Sociodemographic data, symptom duration, accompanying findings, the presence of constipation in the family, Rome 4 criteria, and clinical findings according to Bristol scale of 200 cases (100 constipated patients and 100 healthy control) who applied to Istanbul Haseki Training and Research Hospital, Pediatric Gastroenterology Outpatient Clinic, between March and September 2019 (6-month period) were recorded. Polymorphisms of motilin-MLN (rs2281820), serotonin receptor-HTR3A (rs1062613), serotonin transporter-5-HTT (rs1042173), ghrelin-GHRL (rs27647), and ghrelin receptor-GHSR (rs572169) were detected by real-time PCR. RESULTS: There was no difference between the two groups in terms of sociodemographic characteristics. Notably, 40% of the constipated group had a family history of constipation. The number of patients who started to have constipation under 24 months was 78, and the number of patients who started to have constipation after 24 months was 22. There was no significant difference between constipation and control groups in terms of genotype and allele frequencies in MLN, HTR3A, 5-HTT, GHRL, and GHSR polymorphisms (p<0.05). Considering only the constipated group, the rates of gene polymorphism were similar among those with/without a positive family history of constipation, constipation onset age, those with/without fissures, those with/without skin tag, and those with type 1/type 2 stool types according to the Bristol stool scale. CONCLUSION: Our study results showed that gene polymorphisms of these three hormones may not be related to constipation in children.
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Objective:To investigate the curative effects of omeprazole combined with amoxicillin on chronic gastritis and patients' quality of life.Methods:A total of 350 patients with chronic gastritis who received treatment in Jinan Seventh People's Hospital from May 2018 to August 2020 were included in this study. They were randomly divided into control and observation groups ( n = 175/group). The control group was treated with omeprazole, and the observation group was treated with omeprazole combined with amoxicillin. Curative effects, inflammatory factor levels, gastric motility, quality of life score, and the incidence of adverse reactions were compared between the two groups. Results:The response rate in the observation group was significantly higher than that in the control group [95.43% (167/175) vs. 86.86% (155/175), χ2 = 5.59, P = 0.018). Before treatment, there were no significant differences in C-reactive protein, interleukin-6, and tumor necrosis factor-α levels between the two groups (all P > 0.05). After treatment, C-reactive protein, interleukin-6, and tumor necrosis factor-α levels in the observation group were (47.97 ± 8.59) mg/L, (38.82 ± 6.29) μg/L, and (38.77 ± 5.92) μg/L, respectively, which were significantly lower than (51.34 ± 9.77) mg/L, (41.20 ± 7.53) μg/L, (41.09 ± 6.85) μg/L in the control group ( t = 3.42, 3.20, 3.39, all P < 0.05). Before treatment, there were no significant differences in serum gastrin-17 and motilin levels between the two groups (both P > 0.05). After treatment, serum gastrin-17 and motilin levels in the observation group were (380.49 ± 61.27) ng/L and (514.42 ± 68.73) ng/L, respectively, which were significantly higher than (362.25 ± 50.16) ng/L and (495.43 ± 61.36) ng/L in the control group ( t = 3.04, 2.72, both P < 0.05). After treatment, the quality of life score in the observation group was significantly higher than that in the control group ( P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Omeprazole combined with amoxicillin is highly effective on chronic gastritis. The combined therapy can reduce inflammatory responses, improve gastric motility, improve patients' quality of life, and is highly safe.
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ObjectiveTo explore the clinical efficacy of Huanglian Jiedutang as an adjunctive treatment for acute cerebral infarction complicated with gastric motility disorder. MethodSixty patients with acute cerebral infarction complicated with gastric motility disorder with fire toxin syndrome were randomly divided into a western medicine control group （control group） and a traditional Chinese medicine （TCM） combined treatment group （observation group）， with 30 cases in each group. The control group received basic treatment for cerebral infarction and relevant western medical symptomatic treatment based on the patients' gastrointestinal symptoms. The observation group received Huanglian Jiedutang in addition to the treatment provided to the control group. The treatment course was 7 days. Neurological deficit scores and gastrointestinal dysfunction scores were assessed in both groups before treatment and on the 4th and 7th days of treatment. Gastrointestinal electrographic parameters， serum citrulline （CIT）， and motilin （MTL） levels were measured in both groups before treatment and on the 7th day of treatment. Clinical efficacy was compared between the two groups. ResultCompared with the baseline in both groups， the neurological deficit scores and gastrointestinal dysfunction scores were significantly reduced on the 4th and 7th days of treatment （P<0.05）. The reductions in these scores were more significant on the 7th day compared with those on the 4th day of treatment （P<0.05）. On the 4th and 7th days of treatment， the observation group showed a significantly greater reduction in neurological deficit scores and gastrointestinal dysfunction scores compared with the control group （P<0.05）. On the 7th day of treatment， compared with the baseline， both groups showed a significant increase in gastric antral and gastric body electric wave amplitudes as well as serum CIT and MTL levels （P<0.05）， and there were no statistically significant differences in the frequency of gastric antral and gastric body electric waves. On the 7th day of treatment， compared with the control group， the observation group had a significant increase in gastric antral and gastric body electric wave amplitudes as well as serum CIT and MTL levels （P<0.05）， and there were no statistically significant differences in the frequency of gastric antral and gastric body electric waves. After 7 days of treatment， the total effective rate in the observation group was 90.00% （27/30）， higher than 76.67% （23/30） in the control group， but the difference was not statistically significant. ConclusionAdjunctive treatment with Huanglian Jiedutang can effectively improve the symptoms of neurological function impairment and gastrointestinal dysfunction in patients with acute cerebral infarction complicated with gastric motility disorder， increase gastric antral and gastric body electric wave amplitudes， improve gastric motility disorder， and increase serum CIT and MTL levels， thereby improving the imbalanced secretion function of the gastrointestinal tract.
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Objective:To investigate the clinical efficacy of quadruple therapy combined with probiotics for helicobacter pylori-positive erosive gastritis.Methods:A total of 350 patients with helicobacter pylori-positive erosive gastritis who received treatment in Jinan Seventh People's Hospital from January 2020 to January 2021 were included in this study. They were randomly assigned to receive a quadruple therapy (clarithromycin, ribavirin, amoxicillin and rabeprazole) alone (control group, n = 175) or in combination with probiotics (observation group, n = 175) for 2 weeks. Clinical efficacy was compared between the two groups. Results:Total response rate was 90.86% (150/175) in the observation group, which was significantly higher than that in the control group [72.57% (127/175), χ 2 = 19.58, P < 0.001]. After treatment, gastrointestinal microbiota were improved in both groups, but the improvements were greater in the observation group than in the control group ( t = 15.14, 14.30, 17.37, all P < 0.001). At 3 and 6 months after treatment, conversion rates from helicobacter pylori-positive to helicobacter pylori-negative in the observation group were 72.57% (127/175) and 95.43% (167/175) respectively, which were significantly higher than 50.29% (88/175) and 79.43% (139/175) in the control group (χ 2 = 18.34, 20.38, both P < 0.001). After treatment, the amplitude of decrease in serum level of gastrin, motilin, tumor necrosis factor-α and interleukin-6 in the observation group were greater than those in the control group ( t = 35.15, 44.91, 16.76, 5.73, all P < 0.001). Conclusion:Quadruple therapy combined with probiotics is highly effective on helicobacter pylori-positive erosive gastritis. The combined therapy can increase conversion rate from helicobacter pylori-positive to helicobacter pylori-negative, improve gastrointestinal function, and greatly inhibit inflammatory reaction.
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Objective:To investigate the efficacy of mosapride versus domperidone in the treatment of functional dyspepsia and its effects on gastric motility indexes and gastrointestinal hormone levels. Methods:Ninety-four patients with functional dyspepsia who received treatment in Huzhou Linghu People's Hospital between May 2019 and May 2021 were included in this study. They were randomly assigned to undergo treatment with either domperidone (control group, n = 47) or mosapride (study group, n = 47). Efficacy was compared between the two groups. Results:Total response rate in the study group was significantly higher than that in the control group ( χ2 = 5.04, P = 0.025). After medication, motilin, plasma leptin and corticotropin-releasing hormone in the study group were (184.22 ± 25.36) μg/mL, (18.57 ± 2.44) μg/L, (7.21 ± 1.14) pg/mL, respectively, which were superior to those in the control group [(111.25 ± 21.00) μg/mL, (15.41 ± 2.28) μg/L, (9.02 ± 1.32) μg/mL, t = 15.19, 6.48, 16.23, P < 0.001, < 0.001, < 0.001]. After medication, cholecystokinin, somatostatin, vasoactive intestinal peptide and gastrin levels in the study group were (45.36 ± 5.12) ng/L, (5.48 ± 1.25) ng/L, (86.35 ± 12.11) pg/mL, and (105.24 ± 12.05) ng/L, respectively, which were significantly superior to those in the control group [(50.21 ± 6.18) ng/L, (7.01 ± 0.98) ng/L, (98.75 ± 14.18) pg/mL and (97.35 ± 11.48) ng/L, t = 4.14, 6.60, 4.55, 3.25, P < 0.001, < 0.001, < 0.001, < 0.002]. The recurrence rate in the study group was significantly lower than that in the control group (2.13% vs. 27.66%, χ2 = 4.66, P = 0.031). The incidence of adverse reactions in the study group was significantly lower than that in the control group (14.89% vs. 34.04%, χ2 = 10.80; P = 0.001). Conclusion:Mosapride has a better therapeutic effect on functional dyspepsia, exhibits a greater effect on improving gastric motility indexes and gastrointestinal hormone levels, and leads to a lower incidence of recurred functional dyspepsia than domperidone. Therefore, mosapride for treatment of functional dyspepsia deserves clinical promotion.
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Objective:To explore the regulatory effects of cow milk with the addition of breast milk equivalent dose of somatostatin (SST) and motilin (MTL) on food allergy and food intolerance.Methods:Young Brown Norway (BN) rats were divided into 5 groups and fed with pure breast milk(breast milk group), cow milk(cow milk group), cow milk added with SST(SST group), cow milk added with MTL(MTL group) and cow milk added with both SST+ MTL(SST+ MTL group). Allergic irritation was enhanced with skin smear at the same time.Clinical damages were quantified weekly.Levels of serous total Immunoglobulin E (IgE) and fecal calprotectin (FC) were detected by the enzyme-linked immunosorbent assay (ELISA). Gastric emptying ratio and intestinal propulsion ratio were measured by method of dextran blue.Results:In breast milk group, cow milk group, SST group, MTL group and SST + MTL group, the levels of IgE were (45.75±5.05) μg/L, (580.42±45.24) μg/L, (290.38±22.88) μg/L, (424.26±22.17) μg/L, (209.49±17.59) μg/L, respectively; FC level were (149.07±24.78) μg/g, (458.85±33.81) μg/g, (343.63±34.97) μg/g, (407.79±29.62) μg/g, (296.83±28.77) μg/g, respectively; the total score of clinical damage were (0.50±0.61) scores, (9.37±1.04) scores, (6.83±1.49) scores, (7.00±1.14) scores, (5.37±1.19) scores, respectively.The cow milk group had the highest scores of clinical damages.Compared with the cow milk group, the clinical damage score, IgE and FC of the SST, MTL and SST+ MTL groups had significantly lower levels, and there was significant difference among them (all P<0.01). The general status of the SST + MTL group was most similar to the breast milk group.The gastric emptying rate of MTL group was the closest to that of breast milk group [(92.52±6.27)% vs.(100.00±9.70)%, P<0.05]. There were obvious diarrhea and fast small intestinal propulsion in cow milk group, the small intestinal propulsion ratio in breast milk group was (39.32±2.61)%, and (71.96±4.43) % in cow milk group, the difference was statistically significant between the 2 groups ( P<0.01). The intestinal motility of SST+ MTL group was decreased, but it just prevented diarrhea caused by milk allergy, the small intestine propulsion ratio in SST+ MTL group was (38.90±2.65)% vs.breast milk group (39.32±2.61)%( P>0.05). Conclusions:The cow milk added with SST and MTL decreased allergic reaction and increased food tolerance in gastrointestinal tract, which was more similar to breast milk.SST was beneficial to relieving allergic immune reaction, MTL contributed to improving the gastrointestinal tolerance of cow milk.The combination of SST and MTL may achieve an antagonistic and balanced mechanism on gastrointestinal regulation, which could synergistically improve the gastrointestinal tolerance of cow milk.
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Objective:To explore the mechanism of Dahuangfuzi decoction on intestinal motility disorder by observing its effect on serum motilin, Cajal interstitial cells and motilin receptor in rats with severe acute pancreatitis (SAP).Methods:Eighteen clean male Sprague-Dawley rats were randomly divided into the control group, SAP group and Dahuangfuzi group ( n=6 each group). The SAP rat model was prepared by retrogradely injected 4% sodium taurocholate into cholangiopancreatic duct. The rats in the SAP group were given 2 mL normal saline (37℃) enema at 12 and 24 h after operation. The rats in the Dahuangfuzi group was given 2 mL Dahuangfuzi decoction (37℃) enema at 12 and 24 h respectively. For the control group, the pancreas was exposed in the same way and then the abdomen was closed. Forty-eight h after operation, the abdominal aorta blood samples were taken for determination of serum endotoxin and amylase, and for detection of serum motilin by enzyme-linked immunosorbent assay (ELISA); the pathological changes of pancreas and ileum were observed by hematoxylin-eosin (HE) staining. The expression of c-kit and motilin receptor protein in ICC in ileum tissue was detected by immunohistochemistry. Results:Compared with the control group, the levels of serum endotoxin and amylase in the SAP group were significantly higher [(504.98±88.81) pg/mL vs. (17.76±5.01) pg/mL; (532.28±66.53) vs. (69.45±3.61) U/L, P<0.05], while the levels of serum motilin were significantly lower [(195.4±6.7) ng/L vs. (301±8.10) ng/L, P<0.05], and the scores of c-kit and motilin receptor protein were decreased ( P<0.05); compared with the SAP group, the levels of serum endotoxin and amylase in the Dahuangfuzi group were significantly reduced [(189.9±38.23) pg/mL vs. (504.98±88.81) pg/mL; (294.23±25.66) vs. (532.28±66.53) U/L, P<0.05], while the levels of serum motilin were significantly increased [(264.2±8.3) ng/L vs. (195.4±6.7) ng/L, P<0.05], and the scores of c-kit and motilin receptor protein were increased ( P<0.05). Conclusions:Dahuangfuzi decoction can improve the intestinal motility of SAP rats by promoting the secretion of motilin, increasing the activity of ICC cells and the expression of motilin receptor.
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Objective:To evaluate the clinical efficacy of modified Liqi-Hewei Decoction combined with conventional western medicine therapy in the treatment of Hp-positive chronic superficial gastritis (CSG). Methods:A total of 96 patients with Hp-positive CSG in the First People’s Hospital of Lianyungang and Changshu No.1 People’s Hospital who met the inclusion criteria between January 2017 and January 2019 were divided into two groups according to the random number table method, with 48 in each group. The control group was treated with conventional western medicine, and study group was additionally given modified Liqi-Hewei Decoction on the basis of control group. Both groups were treated for 8 weeks and followed up for 12 weeks. The TCM symptom score, gastric mucosa and pathological grading were scored before and after treatment. Levels of motilin, gastrin and somatostatin were detected by immunoturbidimetry, and levels of CD3 +, CD4 + and CD8 + were detected by automatic flow cytometry and the ratio of CD4 +/CD8 + was calculated. The Hp negative conversion rate was observed, the adverse reactions were recorded, the clinical efficacy was evaluated and the recurrence rate was statistically analyzed. Results:The Hp negative conversion rate was 89.6% (43/48) in study group and was 72.9% (35/48) in control group, where the difference was statistically significant ( χ2=4.376, P=0.036). The total effective rate was 95.8% (46/48) in study group and was 83.3% (40/48) in control group ( χ2=5.031, P=0.025). After treatment, the scores of epigastric pain, upper abdominal fullness, acid reflux, belching and poor appetite in the study group were significantly lower than those in control group ( t=8.919, 3.971, 7.949, 8.171, 9.865, all Ps<0.01). The scores of gastric mucosa and pathological grading were significantly lower than those in control group ( t=13.705, 15.495, all Ps<0.001). After treatment, the levels of gastrin [(126.15 ± 14.36) ng/L vs. (152.38 ± 17.51) ng/L, t=8.025], motilin [(93.59 ± 11.87) ng/L vs. (102.48 ± 14.68) ng/L, t=3.263] and somatostatin [(36.76 ± 8.97) ng/L vs. (40.84 ± 10.68) ng/L, t=2.027] in the study group were significantly lower than those in the control group ( P<0.01 or P<0.05). The levels of CD3 +, CD4 + and CD4 +/CD8 + were significantly higher than those in the control group ( t=6.883, 6.720, 4.306, all Ps<0.001). The recurrence rate was 4.3% (2/46) in the study group and was 17.5% (7/40) in the control group ( χ2=3.950, P=0.046). During treatment, the incidence rate of adverse reactions was 8.3% (4/48) in the study group and was 12.5% (6/48) in the control group ( χ2=0.446, P=0.504). Conclusion:Modified Liqi-Hewei Decoction combined with conventional western medicine therapy can effectively improve the levels of gastrointestinal hormones and clinical symptoms, enhance the immunity and Hp negative conversion rate, and reduce the recurrence rate of patients with Hp-positive CSG.
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Objective:To investigate the curative efficacy of modified Qilang prescription on drug-dependent constipation with Qi and Yin deficiency and the effects on serum vasoactive intestinal peptide （VIP）， motilin （MTL）， 5-hydroxytryptamine （5-HT）， and 5-hydroxytryptamine 4 receptor （5-HT4R）. Method:A total of 160 patients diagnosed with drug-dependent constipation were randomly divided into a treatment group （<italic>n</italic>=80， Qilang prescription） and a control group （<italic>n</italic>=80， lactulose oral solution）. The treatment lasted for eight weeks. Changes in clinical symptoms， traditional Chinese medicine （TCM） syndrome， and serum VIP， MTL， 5-HT， and 5-HT4R before and after treatment were observed. The clinical efficacies of the two groups were compared. An eight-week follow-up was carried out for the observation of recurrent rate and TCM syndrome. Result:The overall response rate of the treatment group （90.91%） was higher than that （75.00%） of the control group<italic> </italic>（<italic>Z</italic>=-6.514，<italic>P</italic><0.05）. There was no significant difference in serum VIP， MTL， 5-HT， and 5-HT4R between the two groups before treatment. After treatment for eight weeks， both groups showed reduced serum VIP level as compared with those before treatment， and the treatment group was inferior to the control group （<italic>P</italic><0.05）. The serum MTL levels of the two groups were both higher than those before treatment （<italic>P</italic><0.05）， and the treatment group was superior to the control group （<italic>P</italic><0.05）. After treatment， the level of 5-HT in the treatment group was higher than that in the control group （<italic>P</italic><0.05）. The post-treatment 5-HT4R level in the treatment group slightly increased （<italic>P</italic><0.05）， but no significant difference in 5-HT4R levels between the two groups after treatment was observed. During the eight-week follow-up， the recurrence rate in the treatment group was significantly lower than that in the control group at the 2nd and 4th weeks （<italic>P</italic><0.05）. There was no significant difference in the recurrence rate between the treatment group ［57.14% （40/70）］ and the control group ［64.81% （35/54）］ after eight weeks. Conclusion:Modified Qilang prescription was superior to lactulose in the short- and mid-term efficacy on drug-dependent constipation with Qi and Yin deficiency. No significant difference in the long-term efficacy was observed. The underlying therapeutic mechanism might be related to the regulation of serum VIP， MTL， 5-HT， and 5-HT4R levels.
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OBJECTIVE@#To explore the clinical therapeutic effect of herb-partitioned moxibustion at point in patients of diabetic gastroparesis differentiated as spleen and stomach deficiency and retention of turbid dampness as well as its effect mechanism.@*METHODS@#A total of 134 patients with diabetic gastroparesis were randomized into an observation group and a control group, 67 cases in each one. In the observation group, herb-partitioned moxibustion at point was adopted, 40 min each time, once a day for 5 times a week. In the control group, itopride hydrochloride tablets were prescribed for oral administration, 50 mg each time, three times a day. A total of 6 weeks of treatment was required in the two groups. Before and after treatment, the gastroparesis cardinal symptom index (GCSI) scores, 4-hour gastric emptying rate, TCM symptom score, as well as the levels of plasma motilin and serum gastrin were observed in the patients of the two groups. Additionally, the clinical therapeutic effect was evaluated in the two groups.@*RESULTS@#After treatment, the score of every item of GCSI, TCM symptom scores and the levels of plasma motilin and serum gastrin were all reduced as compared with those before treatment in the patients of the two groups (<0.05), and those in the observation group were lower than the control group (<0.05). Regarding 4-hour gastric emptying rates, which were increased as compared with those before treatment in the two group (<0.05), and the rate in the observation group was higher remarkably than that in the control group (<0.05). The total effective rate was 92.5% (62/67) in the observation group, higher than 74.6% (50/67) in the control group (<0.05).@*CONCLUSION@#Herb-partitioned moxibustion at point relieves the clinical symptoms in the patients with diabetic gastroparesis and increases the gastric emptying rate, which is probably related to the regulation of the levels of plasma motilin and serum gastrin.
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Humans , Acupuncture Points , Diabetes Mellitus , Gastric Emptying , Gastrins , Blood , Gastroparesis , Therapeutics , Motilin , Blood , MoxibustionABSTRACT
OBJECTIVE: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) of different acupoint combinations on postoperative nausea and vomiting (PONV) and serum motilin (MTL) content in patients undergoing laparoscopic surgery, so as to provide evidence for clinical selection of suitable acupoint compatibility. METHODS: A total of 140 patients undergoing elective laparoscopic surgery were randomly divided into general anesthesia (GA) control, TG2 ［Neiguan (PC6) + Hegu (LI4)］, TG3 ［PC6 + LI4 + Zusanli (ST36)］, and TG4 ［PC6 + LI4 + ST36 + Sanyinjiao (SP6)］ groups, with 35 cases in each group. Patients of the TG2, TG3 and TG4 groups received TEAS (2 Hz/100 Hz, 3-8 mA) of the above mentioned acupoint (bilateral) groups for 30 min before the induction of anesthesia until the end of the operation. Patients of the GA control group received intravenous injection of Midazolam, Sufentanil, Propofol, Rocuronium Bromide, etc. The blood sample (4 mL) from the right median cubital vein was collected at the time of patient's entry, 12 and 24 h after surgery, respectively, for measuring MTL concentration by enzyme-linked immunosorbent assay. The incidence of early and late PONV and changes of PONV degree within 24 h after surgery were recorded. RESULTS: The serum MTL concentrations were significantly decreased at 12 h after surgery in all the 4 groups (P<0.05), and decreased at 24 h after surgery in GA and TG2 groups vs their own pre-surgery (P < 0.05), and considerably higher at both 12 and 24 h after surgery in the TG2, TG3 and TG4 groups than in the GA control group (P<0.05), and also evidently higher in the TG3 and TG4 groups than in the TG2 group (P<0.05). The incidence of PONV was significantly lower in the TG2, TG3 and TG4 groups than in the GA control group in the early and late periods (except TG2 group) of surgery (P<0.05). The number of patients with PONV grade Ⅰ was significantly larger in the TG2, TG3 and TG4 groups than in the GA control group at 24 h after surgery (P<0.05), suggesting a mild PONV in more patients undergoing TEAS. CONCLUSION: TEAS has a preventive effect on PONV in patients undergoing laparoscopic surgery, which may be related to its effect in reducing serum MTL concentration. The preventive effect of TEAS of PC6 + LI4 + ST36 and PC6 +LI4 + ST36 + SP6 is similar and better than TG2 (two acupoints) group.
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Objective Increased pneumoperitoneum and intra-abdominal pressure during laparoscopic surgery may cause postoperative nausea and vomiting (PONV), avoiding the occurrence of which can accelerate postoperative recovery of the patients. In this study, we observed the effects of dexmedetomidine (DEX) on plasma motilin (MTL) and PONV in patients undergoing gynecologic laparoscopic surgery. Methods Eighty female patients underwent gynecological laparoscopic surgery under elective general anesthesia in our hospital from June 2017 to June 2018. We randomly assigned the patients to a control and a DEX group of equal number, the former injected intravenously with isotonic saline for 10 minutes at 40 minutes before the completion of surgery and the latter with DEX 0.5 μg/kg at 40 minutes before the end of and DEX 2.5 μg/kg + sufentanil 2.5 μg/kg after surgery. We compared the cough and sedation agitation scores (SAS) of the patients before and after extubation, the MTL concentration before and at 2, 24 and 48 hours after surgery, and the incidence and severity of PONV at 2, 24 and 48 hours postoperatively between the two groups. Results Compared with the controls, the patients of the DEX group showed significantly decreased cough and SAS scores before and after extubation (P < 0.05), MTL concentration at 2 hours ([478.81 ± 42.94] vs [391.39 ± 54.49] pg/mL, P < 0.05) and 24 hours after surgery ([385.64 ± 38.03] vs [321.96 ± 36.50] pg/mL, P < 0.05), and incidence rate of severe PONV at 2 hours (25.0% vs 5.0%, P < 0.05) and 24 hours postoperatively (20.0% vs 2.5%, P < 0.05). Intravenous pump injection of DEX at 0.5 µg/kg before the end of surgery can inhibit the postoperative release of MTL, effectively reduce the incidence and severity of PONV, and contribute to early recovery of the patients undergoing gynecologic laparoscopic surgery. Conclusion In gynecological laparoscopic surgery,0.5 µg/kg DEX used before the end of the surgery and low-dose maintenance of PCIA can inhibit the release of MTL after operation, effectively reduce the incidence and severity of PONV and improve the recovery quality of patients during anesthesia recovery period at the same time.
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Objective To observe clinical effect of Huxiang-Yangwei powder combined with conventional western medicine on gastric motility and gastrointestinal hormones in patients with chronic atrophic gastritis. Methods A total of 100 patients with chronic atrophic gastritis according to the inclusion criteria were randomly divided into the observation group and the control group, with 50 cases in each group. The control group was given routine symptomatic treatment. Based on the treatment of control group, the observation group was given Huxiang-Yangwei powder therapy. After 1 month, the gastroscope score, pathological tissue score, gastric motility index (gastric motility rhythm, gastroelectric rhythm and gastric antrum motility), and the improvement of plasma gastrointestinal hormone (MTL, GAS, SS) were compared. Results The total effective rate of the observation group was 92.0% (42/50), and the total effective rate of the control group was 78.0% (39/50), with statistically significant (Z=-2.978, P=0.003). After treatment, the under gastroscope score (0.59 ± 0.06 vs. 1.23 ± 0.17, t=4.877) and the pathological organization score (0.65 ± 0.08 vs. 1.33 ± 0.19, t=5.096) of the observation group were significantly lower than those of the control group (P<0.05). After treatment, the gastric motility rhythm (76.15% ± 8.77% vs. 62.35% ± 7.31%, t=5.301), gastroelectric rhythm (81.02% ± 9.23% vs. 73.02% ± 8.43%, t=5.286), gastric antral motility (0.012 ± 0.002? vs. 0.008 ± 0.001 ?, t=4.160) of the observation group were significantly higher than those of the control group (P<0.05). After treatment, the plasma MTL (246.73 ± 31.82 pg/ml vs. 203.86 ± 27.91 pg/ml, t=5.832), GAS (49.55 ± 6.25 pg/ml vs. 35.81 ± 4.63 pg/ml, t=5.126), SS (17.35 ± 2.76 pg/ml vs. 15.01 ± 2.60 pg/ml, t=4.970) of the observation group were significantly higher than those of the control group (P<0.05). Conclusions The application of Huxiang-Yangwei powder in the treatment of chronic atrophic gastritis patients can repair gastric mucosa, regulate gastrointestinal hormone levels and increase gastric motility.
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Objective To observe the effect of acupuncture plus Chinese medication on the therapeutic efficacy and digestive function in treating patients with functional dyspepsia (FD). Method A retrospective analysis was carried out by targeting 68 FD patients admitted during August 2015 and August 2017. According to the treatment protocol the patients received, they were divided into an observation group and a control group. The control group (33 cases) received Chinese medication, and the observation group (35 cases) was intervened by acupuncture plus Chinese medication. The two groups were compared in terms of clinical efficacy, and post-treatment changes in dyspepsia symptom score, gastric emptying, and the levels of motilin and neuropeptide in serum. Result The total effective rate in the observation group (85.7％) was higher than that in the control group (63.6％), and the difference was statistically significant (P<0.05); before treatment, there were no significant differences between the two groups in the scores of bloating discomfort, early satiation, upper abdominal pain, and upper abdominal burning sensation (P>0.05), while the scores of the dyspepsia symptoms mentioned above were significantly lower in the observation group than in the control group after treatment (P<0.05); there was no significant difference in gastric emptying between the two groups before treatment (P>0.05), while the gastric emptying evaluation was better in the observation group than in the control group after treatment (P<0.05); the between-group differences in the serum levels of motilin and neuropeptide were statistically insignificant before treatment (P>0.05), while the levels of motilin and neuropeptide in serum of the observation group were significantly higher than those in the control group after treatment (P<0.05). Conclusion Acupuncture plus Chinese medication can effectively increase the levels of motilin and neuropeptide in serum, boost gastric emptying, and improve dyspepsia symptoms and gastrointestinal motility in treating FD.
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Books on Chinese herbal medicines have shown that Dendrobium has the effect of nourishing Yin and reinforcing Yin,usually used for constipation induced by spleen Yin deficiency in clinical application. D. huoshanense,as an independent species among many species of Dendrobium,has no experimental studies about its effects on spleen Yin deficiency-type constipation. The purpose of this experiment was to illustrate the therapeutic effect of D. huoshanense on the constipation of spleen Yin deficiency type in rats,investigate its preliminary mechanism,and compare it with the D. officinale and D. nobile contained in the Chinese Pharmacopoeia to clarify its characteristics. The spleen Yin deficiency model was replicated in 70 rats by the composite factor method,and then the model rats were randomly divided into 7 groups: model group,Liuwei Dihuang Pills group( LWDHP),D. huoshanense high( DHS-H),medium( DHS-M),low( DHS-L) dose groups,D. nobile group( DNS),and D. officinale group( DOS),and another 10 rats were used as normal group( Normal). After 7 continuous days of administration,the fecal water content and intestine propulsion rate of each group were detected. HE staining was used to observe the pathological damage of ileum and colon in each group. Immunohistochemistry and Western blot were used to detect aquaporin 3( AQP3) expressions,while the expression levels of the somatostatin( SS) and motilin( MTL) in the ileum of each group were detected by enzyme-linked immunosorbent assay. The results showed that as compared with the model group,the rats in each drug-administered group had increased number of fecal pellets,increased fecal water content,and the increased intestinal propulsion rate( P<0. 01),while the pathological damage of the ileum and colon was significantly reduced; the expression of AQP3 protein was significantly decreased( P<0. 01); the level of MTL was significantly increased and the level of SS was decreased( P<0. 01). All DHS groups showed a good dose-effect relationship,and the same dose treatment effect was equivalent to that of DOS,but it was superior to DNS. Therefore,DHS has a significant therapeutic effect on constipation of spleen Yin deficiency type,and its mechanism may be related to intestinal motility and water-liquid metabolism,with a good therapeutic effect.
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Animals , Rats , Constipation , Drug Therapy , Dendrobium , Chemistry , Drugs, Chinese Herbal , Pharmacology , Intestines , Plants, Medicinal , Chemistry , Random Allocation , Spleen , Yin Deficiency , Drug TherapyABSTRACT
Objective To compare the effects of prepared Rehmanniae Radix Praparata (RRP) on gastrointestinal motility in rats with purgation with bitter cold and excessive fatigue type spleen deficiency. Methods A total of 80 SD rats were randomly divided into eight groups according to their body weights, which named as control group, model group, nine steamed nine sunned RRP group (RRP ), nine steamed nine sunned (without yellow wine) RRP group (RRP Ⅱ group), nine steamed nine sunned (without Amomi Fructus) RRP group (RRP III group), nine steamed nine sunned (without yellow wine and Amomi Fructus) RRP group (RRP IV group), steamed RRP group (RRP V group), and wine stewed RRP group (VI group). By filling the rats with Rhei Radix et Rhizoma decoction and swimming 2 to 5 min at the same time, with its body sinking as degree, once daily, after obtaining the model of purgation with bitter cold and excessive fatigue type spleen deficiency of the RRP groups I-VI, the spleen deficiency rats’ general physical signs were observed, and the serum D-xylose, GAS, and MTL of the spleen asthenia rats were measured. The effects of different processed products of RRP on gastrointestinal digestion and absorption and intestinal propulsion in rats with spleen deficiency were observed. Results The weight, food intake, and influent amount of model rats were significantly increased after nine steamed and nine sunned RRP treatment (P < 0.01), while the weight, food intake, and water intake of the rats in RRP V and VI groups after administration were decreased compared with the model rats (P < 0.05). By measuring the intestinal propulsion rate, D-xylose, GAS, and MTL content in the serum, the intestinal propulsive rate, the serum D-xylose, GAS, and MTL content of the rats in RRP III, IV, V, and groups were lower than those of the control group (P < 0.01). The intestinal propulsive rate and the content of serum D-xylose in the RRP V group and RRP VI group were lower than that in the RRP group (P < 0.01). The intestinal propulsive rate and the serum D-xylose content in rats of RRP IV group were lower than those in the RRP group (P < 0.05). The serum GAS and MTL content in rats of RRP IV group were lower than those in the RRP group (P < 0.01). Conclusion Nine steamed nine sunned processing method can effectively alleviate the disadvantages of RRP because of its strong flavor and rich spleen.
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Objective To explore the effects of Chinese herbal compound Qinghuayin on the pathological changes of gastric mucosa and interleukin-10 (IL-10) ,nitric oxide (NO) ,gasmn (GAS) and motilin (MTL) in the serum in the animal model of chronic atrophic gastritis (CAG ) in rats .Methods We divided 53 Wistar rats randomly into blank control group (n=8) and CAG model group (n=45) ,and the animal model of CAG in rats was replicated by combination of disease and syndrome .After confirming the sampled rat model was successful built , the other 40 CAG rats in CAG model group were divided into model group ,vitacoenzyme tablet group ,low-dosage TMC group ,medium-dosage TMC group ,and high-dosage TMC group (each group n=8) .With the corresponding drug intervention to different rats for 30 days , the rats were executed . Then their blood was drawn from the abdominal aorta and the gastric tissue was taken to analyze the changes of serum IL-10 ,NO ,GAS and MTL concentrations and gastric mucosa pathology . Results Compared with blank control group , model group had various degrees of gastric mucosa atrophy ; decreased concentrations of serum IL-10 and GAS ; increased NO and MTL ( P<0 .01 ) .Compared with model group,Qinghuayin could improve gastric mucosa pathology in different degrees and increase the concentrations of IL-10 and GAS . Decrease the concentrations of NO and MTL( P<0 .05 or P<0 .01 ) . What's more. The curative effect in high-dosage TMC group was better( P<0. 01 ). Conclusion Chinese herbal compound Qinghuayin can effectively regulate the lopsided expressions of serum IL-10 . NO .GAS and MTL and reverse the pathological and histological changes in the gastric mucosa of CAG rats .
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Objective To analysis the relationship between thyroid function with gastrointestinal motility and plasma motilin levels, and to provide the basis for clinical application.Me thods We selected 30 cases of patients with hyperthyroidism, 30 cases of hyperthyroidism group and hypothyroidism as hypothyroidism group, and 30 healthy volunteers as control group who were treated in our hospital from January 2013 to January 2016 in;The radioimmunoassay was used to test serum motilin levels, isotope single photon emission computed tomography was used to detected the gastric liquid technology half time, esophageal transit time.Re s ults The esophagus passage time of the subjects in the hypothyroidism group was significantly higher than that of the hyperthyroidism group and the control group, and the difference was statistically significant (P＜0.05);The level of motilin in serum of hyperthyroidism group was significantly higher than that of control group (P＜0.05), and the level of motilin in serum of hypothyroidism group was significantly lower than that of control group (P＜0.05);Hyperthyroidism was positively correlated with motilin level (r = 0.542, P＜0.05), and negatively correlated with the time of passage of the esophagus and gastric emptying time (r =-0.126 and r =-0.481, P＜0.05);Hypothyroidism was negatively correlated with motilin level (r =-0.617, P＜0.05), and positively correlated with esophageal transit time and gastric emptying time (r = 0.627 and r = 0.416, P ＜0.05).Conclus ions Hyperthyroidism can lead to the increase of gastrointestinal function and motilin level. Hypothyroidism can lead to the decrease of gastrointestinal function and motilin level.
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Objective To investigate the effects of different extracts of pericarpium citri reticulatae (PCR) and pogostemon cablin benth (PCB) on the contraction of gastrointestinal smooth muscle and the level of gastrointestinal hormones in rat model of gastrointestinal motility disorder. Methods Seventy Wistar rats were randomly divided into groups of control, model, water extractive of PCR, hesperidin, water extractive of PCB, water extractive of PCB plus volatile oil and patchouli alcohol, ten rats in each group. Except the control group, the rest groups were established gastrointestinal motor disorder model via limb ischemia-reperfusion (LIR). After modeling rats of groups were intervened with corresponding extracts. The effects of different extracts on contraction amplitude of corpora ventriculi and small intestine smooth muscle were observed. The levels of gastrointestinal hormones including motilin (MOT), gastrin (GAS), cholecystokinin (CCK) and somatostatin (SS) were detected by radioimmunoassay. Results The contraction amplitudes of corpora ventriculi and small intestine smooth muscle were decreased (P<0.05), the serum level of GAS and plasma level of MOT were also significantly decreased, while CCK and SS levels in the gastric antrum were significantly increased in model group than those of the control group (P < 0.05). Water extractive of PCR, hesperidin, water extractive of PCB and water extractive of PCB +patchouli oil can increase the contraction amplitudes of corpora ventriculi and small intestine smooth muscle, increase the serum level of GAS and reduce levels of CCK and SS in the gastric antrum (P<0.05), whereas showed no influence in the plasma level of MOT (P>0.05)]. Compared with model group, patchouli alcohol showed no influence in the contraction of gastrointestinal smooth muscle and levels of MOT, GAS, CCK and SS (P>0.05). In the aspect of regulating the contraction of gastrointestinal smooth muscle and the level of GAS, CCK and SS, the pharmacological effect of PCR water extract was better than that of hesperidin (P<0.05), while water extractive of PCB+volatile oil was better than that of water extractive of PCB (P < 0.05). Conclusion The active ingredients of PCR and PCB have variant regulative effects on the contraction of gastrointestinal smooth muscle and the serum level of GAS, CCK and SS in the gastric antrum in rat model of gastrointestinal motility disorder.
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Objective:To explore the effect of feeding via the transpyloric route on the gastrointestinal function in very low birth weight (VLBW) infants and find the best early enteral nutrition protocol.Methods:Sixty VLBW infants were randomly devided into transpyloric feeding group(TP group) (n =30) and intragastric feeding group(IG group) (n =30).The frequency of apnoea,weight gain,the time of birth weight regain,feed intolerance,time of reaching full enteral feeding,the incidence of extrauterus-growth retardation (EUGR),motilin,gastrin,the length of hospital stay,necrotizing enterocolitis and duodenal perforation were observed in two groups.Results:The intolerance and time of reaching full enteral feeding were reduced significantly during transpyloric feeding compared with intragastric feeding (P ＜ 0.05).The number of episodes of apnoea was decreased significantly during transpyloric feeding compared with intragastric feeding (P ＜ 0.01).Conclusion:Transpyloric feeding can be used in VLBW infants.