Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 712
Filter
1.
Rev. gastroenterol. Perú ; 41(3): 144-149, jul.-sep 2021. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1357338

ABSTRACT

RESUMEN El síndrome de intestino irritable es una enfermedad funcional intestinal frecuente a nivel mundial, pero con pocos estudios de prevalencia. Su diagnóstico es clínico y se basa en criterios acordados internacionalmente que han cambiado con el tiempo, actualmente regidos por el Consenso de Roma IV. Objetivo : Recabar y actualizar datos disponibles de prevalencia de América Latina para entender mejor el comportamiento regional de SII. Materiales y métodos : Se realizó una búsqueda de trabajos originales, autodefinidos de prevalencia, en las bases de datos Pubmed y Lilacs así como presentaciones en congresos de trabajos originales. Resultados : Se encontraron 27 estudios según los criterios de búsqueda establecidos. De ellos, 16 eran en población general. Dos trabajos incluyeron el estudio de prevalencia de más de una población constituyendo finalmente 22 referencias desarrolladas en 9 países. La prevalencia promedio total para América Latina fue 15,4%. La prevalencia promedio encontrada por criterios de Roma II fue 23,5%; por Roma III 11,8% y por Roma IV 6,98%. Conclusión : Esta es la primera revisión en reunir datos de prevalencia de síndrome de intestino irritable en población general de nueve países de América Latina. La prevalencia promedio encontrada fue 15%. La variabilidad fue amplia y los criterios diagnósticos utilizados hicieron la mayor diferencia.


ABSTRACT Although irritable bowel syndrome is a common functional bowel disease worldwide, few prevalence studies have been published. Diagnosis is clinical and based on internationally agreed criteria that have changed over time. Currently the Rome IV Consensus is used as the international reference. Objective : Collect and update available prevalence data from Latin America to better understand the regional behavior of irritable bowel syndrome. Materials and methods : A search was carried out for original works, self-defined on prevalence, in the Pubmed and Lilacs databases. Presentations or posters at congresses of original works were also considered. Results : According to the established search criteria, 27 studies were found. Of these, 16 were in the general population. Two studies included the study of the prevalence of more than one population, for which reason 22 prevalence data were obtained from 9 countries. The total average prevalence for Latin America was 15.4%. The average prevalence found by the Rome II criteria was 23.5%; by Rome III 11.8% and by Rome IV 6.98%. Conclusion : This is the first review to collect data on the prevalence of irritable bowel syndrome in the general population from nine Latin American countries. The average prevalence found was 15%. The variability was wide and the diagnostic criteria used made the biggest difference.

2.
J. pediatr. (Rio J.) ; 97(2): 197-203, Mar.-Apr. 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1287031

ABSTRACT

Abstract Objective: Irritable bowel syndrome is a frequent functional gastrointestinal disorder. The aims of this study were to investigate its epidemiology, focusing on the role of intestinal mucosal integrity and to evaluate the impact on the quality of life. Methods: A community-based survey applying a comparative cross sectional approach was conducted in six high schools in Palembang. Subjects were recruited using multistage random sampling divided in two groups. Rome III criteria were used to establish a diagnosis of IBS in combination with a questionnaire to determine risk factors. Determination of fecal alpha-1-antitrypsin and calprotectin levels was performed to determine impaired intestinal mucosal integrity. A questionnaire was used to evaluate how quality of life was affected by irritable bowel syndrome. Results: The survey was performed in 454 14−18 years old adolescents, of whom 30.2% fulfilled the Rome III criteria for IBS, with the following subtypes: 36.5% diarrhea, 18.9% constipation, 21.9% mixed, and 22.6% unclassified. Major risk factors were female gender, bullying, age 14-16 years, history of constipation and diarrhea, eating nuts, and drinking coffee, tea, and soft drinks. There was a significant association with intestinal inflammation (p = 0.013). A significantly impaired quality of life was found (p = 0.001). Conclusions: The prevalence of irritable bowel syndrome in adolescents was high, with bullying, female gender, age 14-16 years, constipation and diarrhea, and dietary consumption of soft drinks, coffee, and tea as risk factors. A significant association with intestinal inflammation was found.

3.
Arq. gastroenterol ; 58(1): 120-126, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1248995

ABSTRACT

ABSTRACT BACKGROUND: Irritable bowel syndrome (IBS) is a complex gastrointestinal disorder, whose understanding is relatively uncertain, and the treatment guidance decision still represents a challenge. OBJECTIVE: To identify and critically appraise systematic reviews (SRs) published in the Cochrane Database of SRs (CDSR) on the effects of interventions (pharmacological and non-pharmacological) for the treatment of IBS. METHODS: The search was conducted at the Cochrane Library in May 2020. The methodological quality of the SRs was evaluated by the AMSTAR-2 tool. RESULTS: Eight SRs with moderate to high quality were included, which addressed the treatments: (a) pharmacological: volume agents, antispasmodics, antidepressants and tegaserod; and (b) non-pharmacological: homeopathy, acupuncture, phytotherapy, biofeedback, psychological interventions and hypnotherapy. The results were favorable to antispasmodic drugs and antidepressants regarding the improvement of clinical symptoms. There was no difference between volume agents or tegaserod when compared to placebo. Acupuncture and homeopathy showed a little improvement in symptoms compared to placebo, but the certainty of this evidence was considered low to very low. Psychological interventions seem to improve the overall assessment of the patient and relief symptoms such as abdominal pain. However, there was no long-term follow-up of these patients. The results of the other treatments were considered uncertain due to the high risk of bias. CONCLUSION: Considering the low quality of the studies included in the SRs, pharmacological treatment with antispasmodics and antidepressants seems to be beneficial for patients with IBS. Among non-pharmacological interventions, psychological interventions seem to be beneficial. However, further clinical trials are recommended with greater methodological rigor to prove these findings.


RESUMO CONTEXTO: A síndrome do intestino irritável (SII) é um distúrbio gastrointestinal complexo, cujo entendimento é relativamente incerto e a decisão de orientação do tratamento ainda representa um desafio. OBJETIVO: Identificar e avaliar criticamente as revisões sistemáticas (RSs) publicadas na base de dados de RSs Cochrane (CDSR) sobre os efeitos das intervenções (farmacológicas e não farmacológicas) para o tratamento da SII. MÉTODOS: A busca foi realizada na Biblioteca Cochrane em maio de 2020. A qualidade metodológica das RSs foi avaliada pela ferramenta AMSTAR-2. RESULTADOS: Foram incluídas oito RSs com qualidade moderada a alta, as quais abordaram os tratamentos: (a) farmacológico - agentes de volume, antiespasmódicos, antidepressivos e o tegaserod; e (b) não farmacológico - homeopatia, acupuntura, fitoterapia, biofeedback, intervenções psicológicas e hipnoterapia. Os resultados foram favoráveis aos medicamentos antiespasmódicos e antidepressivos em relação à melhora dos sintomas clínicos. Não houve diferença entre os agentes de volume ou tegaserod quando comparados ao placebo. Acupuntura e homeopatia apresentaram pequena melhora dos sintomas em comparação ao placebo, porém a qualidade da evidência foi considerada baixa a muito baixa. As intervenções psicológicas parecem melhorar a avaliação global do paciente e alívio de sintomas como dor abdominal. Contudo, não houve acompanhamento desses pacientes a longo prazo. Os resultados dos demais tratamentos foram considerados incertos devido ao alto risco de viés. CONCLUSÃO: Considerando a baixa qualidade dos estudos incluídos nas RSs, o tratamento farmacológico com antiespasmódicos e antidepressivos parece ser benéfico para os pacientes com SII. Entre os não-farmacológicos, as intervenções psicológicas parecem obter benefícios. Entretanto, novos ensaios clínicos são recomendados com maior rigor metodológico para comprovar estes achados.


Subject(s)
Humans , Irritable Bowel Syndrome/drug therapy , Abdominal Pain , Phytotherapy
4.
Article in Chinese | WPRIM | ID: wpr-906094

ABSTRACT

Objective:To explore the potential mechanism of Bianketong tablet (BKT) in the treatment of constipation-predominant irritable bowel syndrome (C-IBS) based on network pharmacology and bioinformatics. Method:The BKT-meridian network was constructed for analyzing the combined effect of the nine Chinese herbs in BKT. The active components and targets of BKT were collected from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and then screened according to the oral bioavailability (OB) and drug likeness (DL) criteria. Following the acquisition of C-IBS target set from GeneCards, Online Mendelian Inheritance in Man (OMIM), Drugbank and DisGeNet, the protein-protein interaction (PPI) network was constructed. Cytoscape 3.7.2 was utilized for network visualization. The screened key targets were subjected to gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis using DAVID platform. The C-IBS mouse model was established via intragastric administration of ice water, and the key targets of BKT against C-IBS were verified by enzyme linked immunosorbent assay (ELISA) and immunohistochemistry. Result:The large intestinal meridian was the main site where BKT acted. There were 70 potential active components in BKT, which acted on 227 intersection targets. Through T helper cell 17(Th17) differentiation, Toll-like receptor (TLR), tumor necrosis factor and other signaling pathways, BKT participated in inflammatory response, immune regulation, intestinal nerve regulation, hormonal regulation, and oxidative stress response, thus exerting the therapeutic effects against C-IBS. As reveled by <italic>in vivo</italic> experiments, BKT significantly improved the small intestinal propulsion rate, up-regulated the expression of vasoactive intestinal peptide (VIP) in serum and colon tissue of C-IBS mice, and down-regulated the expression of nuclear transcription factor-<italic>κ</italic>B (NF-<italic>κ</italic>B), interleukin(IL)-6, and TLR2 in serum and colon tissue, which confirmed the reliability of integration analysis. Conclusion:BKT inhibits C-IBS via multiple components, multiple targets, and multiple pathways. This study has provided ideas for further clinical research and experimental verification of BKT in the treatment of C-IBS.

5.
Article in Chinese | WPRIM | ID: wpr-905997

ABSTRACT

Objective:To establish an ultra-performance liquid chromatography-mass spectrometry (UPLC-MS/MS) for determining the plasma concentrations of 10 active ingredients in Wujiwan at different time points after oral administration, and to compare the pharmacokinetic characteristics between normal rats and rats with chronic visceral hypersensitive irritable bowel syndrome (CVH-IBS). Method:CVH-IBS rat model was prepared by the neonatal rat colon percutaneous transluminal coronary angioplasty (PTCA) balloon stimulation method. After intragastric administration of Wujiwan (0.245 g·kg<sup>-1</sup>), blood was collected from the jugular vein at different time points, and the plasma concentrations of 10 active ingredients (berberine hydrochloride, palmatine hydrochloride, coptisine hydrochloride, jatrorrhizine hydrochloride, epiberberine, dihydroberberine, evodiamine, evodine, paeoniflorin, albiflorin) in Wujiwan was detected simultaneously by UPLC-MS/MS, the pharmacokinetic parameters of each component in normal rats and CVH-IBS rats were calculated. Result:The established UPLC-MS/MS could sensitively and accurately detect the plasma concentrations of 10 active ingredients of Wujiwan in rats. Compared with the normal group, the absorption rates of these 10 active ingredients of Wujiwan in the blood of CVH-IBS rats all decreased to a certain extent, and the peak time (<italic>t</italic><sub>max</sub>) was prolonged. Among them, the <italic>t</italic><sub>max</sub> of berberine hydrochloride and jatrorrhizine hydrochloride were significantly prolonged from 54 minute and 39 minute to 90 minute, respectively (<italic>P</italic><0.05, <italic>P</italic><0.01). Area under the plasma concentration-time curve (AUC<sub>0-</sub><italic><sub>t</sub></italic>) of each component increased, and evodiamine and paeoniflorin were significantly different (<italic>P</italic><0.05,<italic> P</italic><0.01). The clearance rates (CL/<italic>F</italic>) of these 10 active ingredients were all decreased, among which berberine hydrochloride, palmatine hydrochloride and evodiamine had significant differences (<italic>P</italic><0.05, <italic>P</italic><0.01). Conclusion:There are significant differences in the pharmacokinetic behavior of the active ingredients in Wujiwan between normal rats and CVH-IBS rats, which may be related to the destruction of microstructure of intestinal epithelial cells and the change of activity of liver enzymes under the pathological state of IBS.

6.
Article in Chinese | WPRIM | ID: wpr-877622

ABSTRACT

OBJECTIVE@#To compare the curative effect on diarrhea-predominant irritable bowel syndrome (IBS-D) between acupuncture for regulating @*METHODS@#A total of 231 patients with IBS-D were randomized into an acupuncture group (154 cases) and a western medication group (77 cases) at the ratio of 2 to 1. In the acupuncture group, acupuncture was applied to acupoint regimen for regulating @*RESULTS@#After treatment and in follow-up, the total scores of IBS-SSS in the patients of the two groups were all reduced as compared with those before treatment (@*CONCLUSION@#Acupuncture for regulating


Subject(s)
Acupuncture Therapy , Diarrhea/therapy , Humans , Irritable Bowel Syndrome/therapy , Quality of Life , Serotonin Plasma Membrane Transport Proteins/genetics , Spleen , Treatment Outcome
7.
Article in Chinese | WPRIM | ID: wpr-877561

ABSTRACT

OBJECTIVE@#To compare the therapeutic effect between long-snake moxibustion combined with western medication and simple medication on diarrhea type irritable bowel syndrome (IBS-D) of spleen and kidney @*METHODS@#A total of 60 patients with IBS-D of spleen and kidney @*RESULTS@#Compared before treatment, the symptom scores of abdominal pain, defecation frequency, mucous stool and appetite reduction were decreased (@*CONCLUSION@#Long-snake moxibustion combined with western medication can effectively treat the IBS-D of spleen and kidney


Subject(s)
Acupuncture Points , Animals , Diarrhea/drug therapy , Humans , Irritable Bowel Syndrome/drug therapy , Kidney , Moxibustion , Quality of Life , Snakes , Spleen , Yang Deficiency/drug therapy
8.
China Pharmacy ; (12): 314-319, 2021.
Article in Chinese | WPRIM | ID: wpr-872683

ABSTRACT

OBJECTIVE:To study the improvement effect of Shenling baizhu p owder on irritable bowel syndrome with diarrhea(IBS-D)model mice with anxiety ,and to elucidate its mechanism from the point of view of intestinal microecology. METHODS:C57 BL/6 mice were randomly divided into blank control group ,model group ,Shenling baizhu powder group (3.6 g/kg),with 8 mice in each group. Except for blank control group ,IBS-D model with anxiety was established in model group and Shenling baizhu powder group by giving corticosterone subcutaneously combined with intragastric administration of Folium Sennae decoction and chronic restraint treatment. After modeling , blank control group and model group were given intragastric administration of normal saline ,and Shenling baizhu powder group was given relevant medicine intragastrically ,for consecutive 4 weeks. After last medication ,loose stools rate ,diarrhea index ,body weight ,sugar water preference percentage ,the times of crosssing open field center area and minimum pain threshold as well as the levels of BDNF in hippocampal tissue and 5-HT in serum were detected in each group. The cecal contents of mice in each group were extracted for microbial DNA extraction and sequencing; the abundance and diversity of intestinal microorganisms were analyzed by Alpha and Beta diversity analysis. RESULTS : Compared with blank control group ,body weight ,sugar water preference percentage ,the times of crossing open field center area and minimum pain threshold as well as the levels of BDNF in hippocampal tissue ,relative abundance of Firmicutes phylum microorganism in intestine , relative abundance of Lachnospiraceae_NK4A136_group genus microorganism were decreased significantly (P<0.05);loose stools rate,diarrhea index ,serum level of 5-HT,relative abundance of Verrucomicrobia phylum microorganism and relative abundance of Ackermann phylum microorganism were increased significantly (P<0.05),and there were great differences in the types of intestinal microorganisms. Compared with model group ,body weight ,sugar water preference percentage ,the times of crossing open field center area ,minimum pain threshold ,BDNF level of hippocampus ,relative abundance of Firmicutes phylum microorganism,relative abundance of Lachnospiraceae_NK4A136_group genus microorganism were increased significantly (P< 0.05 or P<0.01);loose stools rate ,diarrhea index ,serum level of 5-HT,relative abundance of Verrucomicrobia phylum microorganism and relative abundance of Ackermann phylum microorganism were decreased significantly (P<0.05),and and there were great differences in the types of intestinal microorganisms. CONCLUSION :Shenling baizhu powder can improve the diarrhea and anxiety behavior of IBS-D model mice with anxiety ,increase the level of BDNF in hippocampus and decrease serum level of 5-HT. Its mechanism may be related to decreasing relative abundance of Verrucomicrobia phylum microorganism and Ackermann phylum microorganism ,increasing the relative abundance of Firmicutes phylum and Lachnospiraceae_NK4A136_group genus microorganism.

9.
Journal of Integrative Medicine ; (12): 274-281, 2021.
Article in English | WPRIM | ID: wpr-881021

ABSTRACT

OBJECTIVE@#The clinical symptoms of diarrhea-predominant irritable bowel syndrome (IBS-D) can be effectively improved by traditional Chinese medicine (TCM) treatment, based on the usage of specific therapies for different TCM syndromes. However, in the stage of diagnosis, the standard criteria for the classification of TCM syndrome were still deficient. Through serum metabolic profiling, this study aimed to explore potential biomarkers in IBS-D patients with different TCM syndromes, which can assist in diagnosis of the disease.@*METHODS@#Serum samples were collected from healthy controls (30 cases), IBS-D patients with Liver-Stagnation and Spleen-Deficiency syndrome (LSSD, 30 cases), Yang Deficiency of Spleen and Kidney syndrome (YDSK, 11 cases) and Damp Abundance due to Spleen-Deficiency syndrome (DASD, 22 cases). Serum metabolic profiling was conducted by ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. The potential biomarkers were screened by orthogonal partial least square-discriminate analysis, while metabolic pathways undergoing alterations were identified by pathway enrichment analysis in MetaboAnalyst 4.0.@*RESULTS@#Overall, 34 potential biomarkers were identified in LSSD group, 36 in YDSK group and 31 in DASD group. And the 13 metabolites shared by three groups were determined as the potential biomarkers of IBS-D. Glycerophospholipid metabolism was disturbed significantly in IBS-D patients, which may play a role in IBS-D through inflammation. What's more, three TCM syndromes have the specific potential biomarkers in glycerophospholipid metabolism.@*CONCLUSION@#The serum metabolomics revealed that different TCM syndrome types in IBS-D may have different metabolic patterns during disease progression and glycerophospholipid metabolism was one of the pathways, whose metabolism was disturbed differently among three TCM syndromes in IBS-D. Therefore, the specific potential biomarkers in glycerophospholipid metabolism of three TCM syndromes in IBS-D can serve as the objective indicators, which can facilitate the TCM-syndrome objective classification of IBS-D.

10.
Article in Chinese | WPRIM | ID: wpr-920997

ABSTRACT

OBJECTIVE@#To compare the clinical therapeutic effect on diarrhea-predominant irritable bowel syndrome (IBS-D) of spleen deficiency and damp excess among fire needling therapy with filiform needle combined with acupoint application therapy, simple acupoint application therapy and pinaverium bromide tablets, and explore the mechanism on the improvements in IBS-D.@*METHODS@#A total of 150 patients with IBS-D of spleen deficiency and damp excess were randomized into a combined treatment group (50 cases, 14 cases dropped off), an acupoint application group (50 cases, 16 cases dropped off ) and a western medication group (50 cases, 13 cases dropped off ). In the western medication group, pinaverium bromide tablets were prescribed for oral administration, 50 mg per time, three times a day. In the acupoint application group, the herbal plaster of @*RESULTS@#Except the score for abdominal pain in the acupoint application group and the scores for abdominal pain and abdominal distention in the western medication group after 7 days of treatment, the scores for abdominal pain, abdominal distention, defecation frequency, stool form and incomplete bowel movement after 7 and 28 days of treatment were all reduced as compared with those before treatment in each group separately (@*CONCLUSION@#The combined treatment with the fire needling therapy with filiform needle and the acupoint application therapy effectively relieves the clinical symptoms, improves the quality of life and strengthens the immunity in the patients with IBS-D. The therapeutic effect of this combined regimen is better than either simple acupoint application therapy or the oral medication of pinaverium bromide. The mechanism may be related to the regulation of the levels of T lymphocyte subsets and the modulation of the expressions of 5-HT3R and 5-HT4R mRNA in colon tissue.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Diarrhea/therapy , Humans , Irritable Bowel Syndrome/therapy , Quality of Life , Spleen , Treatment Outcome
11.
Article in Chinese | WPRIM | ID: wpr-887494

ABSTRACT

OBJECTIVE@#To explore the bidirectional regulation of acupuncture based on a subgroup analysis of multicenter randomized controlled trial of acupuncture with @*METHODS@#A total of 519 patients were included in the analysis, including 137 patients with constipation type irritable bowel syndrome (IBS-C) (92 cases in the acupuncture group and 45 cases in the polyethylene glycol [PEG] group), and 382 patients with diarrhea type irritable bowel syndrome (IBS-D) (252 cases in the acupuncture group and 130 cases in the pinaverium group). The patients in the acupuncture group were given acupuncture at Baihui (GV 20), Yintang (GV 29), Tianshu (ST 25), Shangjuxu (ST 37), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) once every other day, 3 times a week. The patients in the PEG group received polyethylene glycol 4000 powder orally, and the pinaverium group received pinaverium bromide tablets orally. All were treated for 6 weeks. The IBS symptom severity score (IBS-SSS) was assessed at baseline, treatment period (2, 4, 6 weeks of treatment) and 12 weeks of follow-up, and the IBS quality of life (IBS-QOL) score was evaluated at the baseline period, 6 weeks of treatment and 12 weeks of follow-up.@*RESULTS@#The total IBS-SSS scores of the two groups of IBS-C patients at 2, 4, 6 weeks of treatment and follow-up of 12 weeks were lower than those in the baseline period (@*CONCLUSION@#Acupuncture with


Subject(s)
Acupuncture Points , Acupuncture Therapy , Diarrhea , Humans , Irritable Bowel Syndrome/therapy , Quality of Life , Treatment Outcome
12.
Article in Chinese | WPRIM | ID: wpr-878894

ABSTRACT

The purpose of this study was to understand the pharmacodynamic effect of Valeriana jatamansi extract in diarrhea predominant irritable bowel syndrome(IBS-D) rat model induced by maternal separation combined with three kinds of stress, and observe the changes of endogenous metabolites in feces after intervention to find potential biomarkers and related metabolic pathways. The animal model of IBS-D was established by maternal separation combined with restraint, ice swimming and tail clamping. The therapeutic effect of each dose group of V. jatamansi extract was evaluated in terms of abdominal withdrawal reflex pressure threshold, fecal water content and immobility time of forced swimming test. In addition, rat feces were collected for detection of metabolic profiles of small molecular metabolites with UPLC-LTQ-Orbitrap MS platform, so as to find the biomarkers of differential metabolism with multivariate statistical analysis methods such as principal component analysis(PCA) and orthogon partial least squares discrimination analysis(OPLS-DA). The results showed that as compared with the normal group, the threshold of abdominal withdrawal reflex pressure was decreased, the fecal water content was increased, and the immobility time of forced swimming test was prolonged in the model group. The results of fecal metabonomics showed that the levels of 39 metabolites were down-regulated and those of 37 metabolites were up-re-gulated. Further analysis showed that these metabolites were related to bile acid metabolism, unsaturated fatty acid metabolism, amino acid metabolism, ceramide metabolism and other metabolic pathways. This study proved that the extract of V. jatamansi had definite pharmacodynamic effect on IBS-D model rats, and the mechanism was discussed from the perspective of fecal metabonomics.


Subject(s)
Animals , Chromatography, High Pressure Liquid , Chromatography, Liquid , Diarrhea , Feces , Irritable Bowel Syndrome/drug therapy , Maternal Deprivation , Metabolomics , Rats , Tandem Mass Spectrometry , Valerian
13.
Article in Chinese | WPRIM | ID: wpr-912863

ABSTRACT

Objective: To observe the therapeutic effect of mild moxibustion on irritable bowel syndrome (IBS) visceral hyperalgesiamodel rats and its regulatory effect on P2X3 receptors in the spinal cord, anterior cingutate cortex (ACC) and thalamic ventral posterolateral nucleus (VPL). Methods: Thirty 8-day-old newborn rats were randomly divided into a normal group (n=6) and a modeling group (n=24) according to the completely random number table method. Rats in the normal group were bred routinely, and those in the modeling group were subjected to preparing IBS chronic visceral hyperalgesia model using colorectal distention (CRD) in stimulation method. Rats successfully modelled were re-divided into a model group, a mild moxibustion group, a P2X3 receptor antagonist group, and a normal saline group according to the completely random number table method with 6 rats in each group. Rats in each group received corresponding interventions from the 37-day old, once a day for 7 consecutive days. Immunohistochemistry and Western blot assays were used to detect P2X3 protein expressions in the spinal cord, ACC and VPL of rats. Results: Under different intensities of CRD stimulation, the abdominal withdrawal reflex (AWR) scores of the model group were significantly increased versus the normal group (all P<0.05); the AWR scores of the mild moxibustion group and the P2X3 receptor antagonist group were significantly reduced versus the model group (all P<0.01). The P2X3 protein expressions in rat spinal cord, ACC and VPL tissues of the model group were significantly increased versus the normal group (all P<0.01); the P2X3 protein expressions in rat spinal cord, ACC and VPL tissues of the mild moxibustion group and the P2X3 receptor antagonist group were significantly reduced versus the model group (all P<0.01). Conclusion: Mild moxibustion can inhibit the P2X3 receptor expressions in the spinal cord, ACC, and VPL tissues of IBS visceral hyperalgesia model rats, which may be the mechanism of mild moxibustion in relieving the central sensitization of rats with IBS visceral hyperalgesia.

14.
Chinese Journal of Digestion ; (12): 522-527, 2021.
Article in Chinese | WPRIM | ID: wpr-912206

ABSTRACT

Objective:To investigate the overlapping prevalence and risk factors of gastroesophageal reflux disease (GERD), functional dyspepsia (FD) and irritable bowel syndrome (IBS) among rural adults in Shaanxi Province.Methods:From February 1 to October 31 in 2019, 12 villages in Shaanxi Province were randomly selected for household questionnaire survey through multistage stratified cluster sampling. A total of 2 423 subjects were enrolled, including 1 037 males and 1 386 females, with age of (45.3±16.9) years old. GERD was diagnosed according to the Montreal criteria, FD and IBS were diagnosed according to the Rome Ⅳ criteria. The overlapping prevalence of the three diseases were calculated. The risk factors for the overlapping of GERD, FD and IBS were analyzed. Multivariate logistic regression was used for statistical analysis.Results:Among the 2 423 subjects, 624 cases had GERD (302 cases), FD (377 cases) or IBS (167 cases), of which 30.77% (192/624) patients had overlap of ≥two diseases. The overlap rates of GERD and FD, GERD and IBS, FD and IBS, GERD, FD and IBS were 2.56% (62/2 423), 1.61% (39/2 423), 2.52% (61/2 423) and 1.24% (30/2 423), respectively. The results of Multivariate analysis showed that female and migraine without aura were positively correlated with the overlap of GERD and FD, FD and IBS, and GERD and IBS (odds ratio ( OR)=3.08, 2.68, 3.66, 7.37, 5.91 and 4.46, 95% confidence interval ( CI) 1.35 to 7.01, 1.35 to 5.30, 1.52 to 8.83, 3.97 to 13.69, 1.78 to 19.60 and 2.01 to 9.92; all P<0.05). Heavy drinking (alcohol intake≥50 g/d (male) or≥30 g/d (female)) was positively correlated with the overlap of FD and IBS, GERD and IBS, and GERD, FD and IBS ( OR=3.69, 4.20 and 4.91, 95% CI 1.19 to 11.48, 1.01 to 17.50 and 1.23 to 19.52; all P<0.05). Heavy smoking (smoking≥20 cigarettes per day) was positively correlated with the overlap of GERD and FD, FD and IBS, GERD and IBS, and GERD, FD and IBS ( OR=3.44, 6.25, 8.27 and 7.04, 95% CI 1.07 to 11.01, 1.60 to 24.44, 1.80 to 38.07 and 1.76 to 28.12; all P<0.05). The educational level of junior or senior high school and age≥60 years old were negatively correlated with the overlap of GERD and FD, FD and IBS, GERD and IBS, and GERD, FD and IBS ( OR=0.47, 0.29, 0.20, 0.05, 0.23, 0.10, 0.37 and 0.16, 95% CI 0.23 to 0.93, 0.09 to 0.95, 0.09 to 0.42, 0.01 to 0.19, 0.09 to 0.60, 0.02 to 0.65, 0.15 to 0.87 and 0.03 to 0.81; all P<0.05). Conclusions:The overlap of GERD, FD and IBS is common and affected by many factors. Female, age≥60 years old, heavy smoking, heavy drinking, low education level and history of migraine without aura are associated with multiple overlaps of GERD, FD and IBS.

15.
Article in Chinese | WPRIM | ID: wpr-907696

ABSTRACT

Objective:To evaluate the clinical efficacy of modified Sini Powder combined with acupoint application in the treatment of liver depression and spleen deficiency syndrome of diarrhea irritable bowel syndrome(IBS-D). Methods:A total of 104 IBS-D patients with liver depression and spleen deficiency syndrome in our hospital from October 2018 to December 2020 were randomly divided into two groups according to the random number table method, 52 in each group. Both groups took montmorillonite powder orally first. On this basis, the control group was treated with pivirium bromide tablets, and the study group was treated with Modified Sini Powder combined with acupoint application. Both groups were treated for 4 weeks. TCM symptom scores were performed before and after treatment. The levels of serum IL-6, IL-8 and TNF-α were detected by ELISA. The recovery time of stool characteristics, the disappearance time of abdominal pain and the recovery time of stool times were observed and recorded, and the clinical curative effect was evaluated. Results:The total effective rate was 92.3% (48/52) in the observation group and 75.0% (39/52) in the control group, there was significant difference between the two groups ( χ2=5.696, P=0.017). After treatment, the scores of abdominal pain, diarrhea, stool frequency, irritability, mental fatigue and hypochondriac pain in the observation group were significantly lower than those in the control group ( t values were 15.492, 16.827, 13.419, 10.831, 14.736,12.437, respectively, all Ps<0.001), and the levels of serum IL-6, IL-8 and TNF-α were significantly lower than those in the control group ( t values were 16.390, 21.528 and 18.734, respectively, all Ps<0.001). The recovery time of stool characteristics [(3.79 ± 0.63) d vs. (4.84 ± 0.79) d, t=7.493], the disappearance time of abdominal pain [(2.63 ± 0.32) d vs. (3.91 ± 0.37) d, t=18.869], and the recovery time of stool times [(3.26 ± 0.57) d vs. (4.19 ± 0.68) d, t=7.558] in the observation group were significantly shorter than those in the control group ( P<0.01). Conclusion:Modified Sini Powder combined with acupoint application can improve the clinical symptoms of IBS-D patients with liver depression and spleen deficiency syndrome, reduce the level of serum inflammatory cytokines and improve the curative effect.

16.
Article in Chinese | WPRIM | ID: wpr-907689

ABSTRACT

Objective:To explore the effect of Tongxie-Yaofang on visceral sensitivity in IBS-D and the possible mechanism. Methods:Divided 30 male SD rats (one-day old) into normal group (10 rats) and IBS-D model group (20 rats) randomly. IBS-D was induced by the method of neonatal maternal separation and restraint stress. After successful modeling, the IBS-D model group was randomly divided into model group and Tongxie-Yaofang group, with 10 rats in each group. Tongxie-Yaofang group was given Tongxie-Yaofang formula, 4.92 g/ml by gavage, while the normal and model groups were given the same amount of normal saline, rats were gavaged with 2 ml/100 g body weight once a day for 14 days. The electromyography of the exorectus muscle was used to meature colorectal distension and by using electronic constant pressure apparatus to evaluate visceral sensitivity. The morphology of colon by HE staining and Enzyme-linked immunosorbent assay (ELISA) were used to determine the level of colonic 5-hydroxytryptamine (5-HT), qPCR was used to detect the colonic mRNA expression of serotonin transporter (SERT) and Western blot was used to detect SERT expression in colon and hypothalamus. Results:Compared with the model group, at the expansion pressure of 60 mmHg and 80 mmHg, the electromyographic response [(179.51 ± 18.26)% vs. (226.42 ± 25.78)%; (242.13 ± 15.42)% vs. (306.02 ± 51.51)%] in Tongxie-Yaofang group was significantly decreased ( P<0.05 or P<0.01). The colonic content of 5-HT was significantly lower than that in the model group [(8.85 ± 0.53) ng/mg vs.(12.25 ± 1.95) ng/mg] ( P<0.01), the expression of SERT mRNA (0.85 ± 0.12 vs. 0.38 ± 0.02) and SERT protein (0.53 ± 0.11 vs. 0.36 ± 0.17) in the colon was significantly increased ( P<0.05 or P<0.01), the expression of SERT protein (0.88 ± 0.12 vs. 0.36 ± 0.13) in the hypothalamus was significantly increased ( P<0.05). Conclusion:Tongxie-Yaofang could relieve the visceral hypersensitivity, which may be achieved by regulating the 5-HT and SERT expression.

17.
Article in Chinese | WPRIM | ID: wpr-907680

ABSTRACT

Objective:To study the regulatory effect of Wumen-Yiji powder on 5-hydroxytryptamine (5-HT) signal transduction system in intestine and hypothalamus of diarrhea irritable bowel syndrome (IBS-D) model rats. Methods:Sixty male SD rats were randomly divided into blank group (10 rats) and diarrhea irritable bowel syndrome group (50 rats). The diarrhea irritable bowel syndrome group formed the diarrhea irritable bowel syndrome model after 2 weeks of senna leaf gavage and restraint stress. They were randomly divided into model group, deshute group (1.5 mg/kg), low, medium and high dose group of Wumen-Yiji San (6, 12, 24 g/kg), with 10 rats in each group. After continuous administration for 2 weeks, the contents of 5-HT in serum, colon and hypothalamus were detected by ELISA; HE staining was used to observe the pathological changes of colon in each group. The protein and mRNA levels of tryptophan hydroxylase 1 (TPH-1), serotonin receptor 3 (5-HT3R), serotonin receptor 4 (5-HT4R), serotonin transporter (SERT) in colon and hypothalamus were detected by Western blot and RT-PCR, respectively. Results:Compared with the model group, the pathological morphology of colon in each treatment group was improved. Compared with the model group, the level of 5-HT in serum and colon significantly decreased ( P<0.05), and the level of 5-HT in hypothalamus of rats in the low, medium, high dose group of Wumen-Yiji San significantly increased ( P<0.05). The expression of TPH-1, 5-HT3R and 5-HT4R protein significantly decreased ( P<0.05), and the expression of SERT protein in the medium, high dose group of Wumen-Yiji San significantly increased ( P<0.05). The expression of TPH-1, 5-HT3R and 5-HT4R protein in hypothalamus increased ( P<0.05), and the expression of SERT protein in the high dose group of Wumen-Yiji San significantly decreased ( P<0.05). The mRNA levels of TPH-1 (4.778 ± 0.604, 3.278 ± 0.668, 1.670 ± 0.361 vs. 6.877 ± 0.148), 5-HT3R (3.807 ± 0.463, 2.697 ± 0.455, 1.132 ± 0.136 vs. 6.322 ± 0.778), 5-HT4R (4.521 ± 0.234, 2.801 ± 0.351, 1.331 ± 0.142 vs. 6.741 ± 0.293) in colon tissue of low, medium and high dose groups of Wumen-Yiji San decreased ( P<0.05). The level of 5-HT4R mRNA (0.616 ± 0.208, 0.726 ± 0.226 vs. 0.521 ± 0.062) increased ( P<0.05), and the level of SERT mRNA (1.563 ± 1.023 vs. 2.612 ± 1.035) in medium, high dose group of Wumen-Yiji San decreased ( P<0.05). Conclusion:The result showed that Wumen-Yiji San could regulate the expression of 5-HT signaling system relating proteins and mRNA in the colon and hypothalamus of IBS-D rats within a certain dose range, so as to improve the symptoms of IBS-D.

18.
Article in Chinese | WPRIM | ID: wpr-906509

ABSTRACT

Objective:To investigate the effects of Da Jianzhongtang on substance P (SP), mast cells (MC), Toll like receptor 2 (TLR2), TLR4 on MC model and nuclear transcription factor (NF)-<italic>κ</italic>B p65 in visceral pain rats with irritable bowel syndrome (IBS), and explore its mechanism of action on IBS visceral pain. Method:Forty-eight 3-day-old SD rats were randomly divided into 6 groups: the control group (control), irritable bowel syndrome group (IBS), ketotifen group (Ketotifen,0.18 mg·kg<sup>-1</sup>), Da Jianzhongtang low, medium and high dose groups (DJZT-L, DJZT-M, DJZT-H,2.16,1.08,0.54 g·kg<sup>-1</sup>), with 8 rats in each group. Intragastric administration lasted for 2 weeks. Maternal separation method was used to establish the IBS visceral pain model in rats. The visceral sensitivity of rats was evaluated at 60, 40 and 20 mmHg (1 mmHg≈0.133 kPa) with Abdominal wall withdrawal response (AWR) scale. SP and NF-<italic>κ</italic>B p65 protein expression levels in colon tissue were detected with Western blotting technique. TLR2 and TLR4 proteins on mast cell membrane were detected by immunofluorescence staining. The degranulation rate of mast cells in colon tissue was detected by toluidine blue staining. Result:Compared with normal rats, AWR scores of model rats significantly increased at 60, 40, and 20 mmHg pressure (<italic>P</italic><0.05,<italic>P</italic><0.01), the degranulation rate of mast cells in colon tissue and SP protein expression in colon tissue significantly increased (<italic>P</italic><0.01), TLR2, TLR4, and nuclear NF-<italic>κ</italic>B p65 expression on mast cell membrane significantly increased (<italic>P</italic><0.01). Compared with model rats, the AWR scores of DJZT-H group (pressure of 40, 20 mmHg) and DJZT-M group (pressure of 60, 40, 20 mmHg) significantly decreased. Meanwhile, the degranulation rate of colon mast cells, and the SP, TLR2, TLR4, and NF-<italic>κ</italic>B p65 expression also significantly decreased (<italic>P</italic><0.05,<italic>P</italic><0.01). Conclusion:Da Jianzhongtang can affect mast cell activity and finally decrease visceral pain of IBS rats by down-regulating SP in colon tissue.

19.
Article in Chinese | WPRIM | ID: wpr-906293

ABSTRACT

Objective:To compare the therapeutic efficacies of Wujiwan at two different compatibilities (No.1 and No.2) on irritable bowel syndrome (IBS) based on neuro-endocrine-immune network, and provide a theoretical basis for the treatment based on syndrome differentiation in traditional Chinese medicine (TCM). Method:The chronic animal model of IBS with visceral hypersensitivity was established by colon irritation via percutaneous transluminal coronary angioplasty (PTCA) in suckling rats. The animals were randomly divided into a control group, a model group, a dicetel group (0.01 g·kg<sup>-1</sup>), low- (0.335 g·kg<sup>-</sup><bold><sup>1</sup></bold>), medium- (0.67 g·kg<sup>-</sup><bold><sup>1</sup></bold>), and high-dose (1.34 g·kg<sup>-</sup><bold><sup>1</sup></bold>) No. 1 Wujiwan groups, and low- (0.385 g·kg<sup>-</sup><bold><sup>1</sup></bold>), medium- (0.77 g·kg<sup>-</sup><bold><sup>1</sup></bold>), and high-dose (1.54 g·kg<sup>-</sup><bold><sup>1</sup></bold>) No. 2 Wujiwan groups. The thresholds of abdominal elevation and bow back elevation were evaluated to detect the effect of Wujiwan on intestinal sensitivity of IBS. The density of mast cells (MC) in the colonic tissue of model rats was detected by the modified toluidine blue staining method. The concentrations/positive expression of 5-hydroxytryptamine (5-HT), substance P (SP), somatostatin (SS), and vasoactive intestinal peptide (VIP) in the blood/colon tissue were detected by enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry (IHC) assay. Result:There was no significant difference in body weight among different groups. Compared with the control group, the model group exhibited decreased thresholds of abdominal elevation and bow back elevation (<italic>P<</italic>0.01), increased density of MCs in the colon tissue (<italic>P<</italic>0.05), up-regulated levels of 5-HT, SP, and SS in the blood and colon tissue (<italic>P<</italic>0.05, <italic>P<</italic>0.01), and elevated VIP level in the colon tissue (<italic>P</italic><0.05). Compared with the model group, Wujiwan at different compatibilities could increase the thresholds of abdominal elevation and bow back elevation (<italic>P</italic><0.01), diminish the count of MC in the colon tissue (<italic>P</italic><0.05), and reduce the levels of 5-HT, SP, SS, and VIP (<italic>P</italic><0.05). As demonstrated by the comparison of No. 1 and No. 2 Wujiwan, No. 1 was superior to No. 2 in reducing the concentrations of 5-HT, SP, and SS in the blood, especially in 5-HT (<italic>P</italic><0.01). No significant difference between No. 1 and No. 2 in reducing 5-HT positive expression in the colon tissue was observed. Compared to the No. 1 Wujiwan, No. 2 significantly reduced SP expression, and the intensity and range of SS expression in the colon tissue in the No. 2 groups were smaller than those in the No. 1 groups (<italic>P</italic><0.05). Conclusion:Wujiwan at different compatibilities was capable of improving gastrointestinal hormone disorder of IBS to reduce intestinal sensitivity. In terms of systemic effect, No. 1 was superior to No. 2, while in terms of local effect, No. 2 was advantageous. No. 1 Wujiwan was superior to No. 2 in the effect on intestinal dynamics, while No. 2 had an advantageous effect on intestinal sensation over No. 1.

20.
Arq. gastroenterol ; 57(4): 498-506, Oct.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1142347

ABSTRACT

ABSTRACT BACKGROUND: Lubiprostone is a type 2 chloride channel activator that has been shown to be efficacious and safe in the treatment for chronic constipation. OBJECTIVE: To systematically review randomized clinical trials (RCTs) assessing efficacy of lubiprostone for patients with chronic idiopathic constipation (CIC), irritable bowel syndrome with predominant constipation (IBS-C) and opioid-induced constipation (OIC). METHODS: Searches were conducted in PubMed, LILACS, Cochrane Collaboration Database, and Centre for Reviews and Dissemination. Lubiprostone RCTs reporting outcomes of spontaneous bowel movements (SBM) and abdominal pain or discomfort were deemed eligible. Meta-analysis was performed calculating risk ratios and 95% confidence intervals, using the Mantel-Haenszel method and random effects model. RESULTS: Searches yielded 109 records representing 93 non-duplicate publications, and 11 RCTs (978 CIC, 1,366 IBS-C, 1,300 OIC, total = 3,644) met inclusion criteria. Qualitative synthesis showed that for CIC patients, lubiprostone is superior to placebo in terms of SBM outcomes. Meta-analysis for CIC was feasible for full responder and SBM within 24h rates, indicating superiority of lubiprostone over placebo. For IBS-C, lubiprostone was significantly superior for all SBM outcomes in follow-ups ranging from 1 week-3 months. In terms of abdominal pain, lubiprostone provided significantly better symptoms relief, particularly after 1 month of treatment. For OIC, lubiprostone was more effective than placebo for both SBM and discomfort measures. CONCLUSION: Our findings demonstrated that lubiprostone is superior to placebo in terms of SBM frequency for CIC, IBS-C and OIC. In terms of abdominal symptoms, the most pronounced effect was seen for abdominal pain in IBS-C patients.


RESUMO CONTEXTO: Lubiprostona é um ativador de canal de cloreto tipo 2 que tem se demonstrado eficaz e seguro no tratamento da constipação crônica. OBJETIVO: Revisar sistematicamente ensaios clínicos randomizados (ECRs) avaliando a eficácia da lubiprostona para pacientes com constipação idiopática crônica (CIC), síndrome do intestino irritável com constipação predominante (IBS-C) e constipação induzida por opioide (OIC). MÉTODOS: Buscas foram conduzidas no PubMed, LILACS, Cochrane Collaboration Database e Centre for Reviews and Dissemination. ECRs de lubiprostona relatando desfechos de movimentos intestinais espontâneos (SBM) e dor ou desconforto abdominal foram considerados elegíveis. Metanálise foi realizada calculando razão de riscos e intervalos de confiança de 95%, utilizando o método de Mantel-Haenszel e modelo de efeitos aleatórios. RESULTADOS: As buscas identificaram 109 registros representando 93 publicações não-duplicadas e 11 ECRs (978 pacientes de CIC, 1366 de IBS-C e 1300 OIC, total = 3644) preencheram os critérios de inclusão. Síntese qualitativa mostrou que, para pacientes com CIC, a lubiprostona foi superior ao placebo em termos de desfechos SBM. Metanálise para CIC foi possível para os desfechos de responder completo e taxa de SBM em 24 horas, indicando superioridade da lubiprostona sobre o placebo. Para IBS-C, lubiprostona foi significativamente superior para todos os desfechos de SBM em tempos de seguimento variando de 1 semana a 3 meses. Em termos de dor abdominal, lubiprostona proporciono alívio dos sintomas significativamente melhor, particularmente após 1 mês de tratamento. Para OIC, lubiprostona foi mais efetiva do que placebo tanto para medidas de SBM quando de desconforto abdominal. CONCLUSÃO: Nossos achados demonstraram que lubiprostona é superior ao placebo em termos de frequência de SBM para CIC, IBS-C e OIC. Em termos de sintomas abdominais, o efeito mais pronunciado foi visto para dor abdominal em pacientes com IBS-C.


Subject(s)
Humans , Constipation/drug therapy , Lubiprostone/therapeutic use , Treatment Outcome , Constipation/chemically induced , Defecation , Irritable Bowel Syndrome/drug therapy , Analgesics, Opioid
SELECTION OF CITATIONS
SEARCH DETAIL