Clinical Efficacy of Tongxie Yaofang on Diarrhea-predominant Irritable Bowel Syndrome （IBS-D） Patients with Liver Depression and Spleen Deficiency / 中国实验方剂学杂志

ObjectiveTo explore the clinical efficacy and mechanism of Tongxie Yaofang in treating diarrhea-predominant irritable bowel syndrome（IBS-D） patients with liver depression and spleen deficiency. MethodA total of 168 IBS-D patients with liver depression and spleen deficiency who were treated from August 2017 to June 2021 were divided into observation group and control group by random number table，84 in each group. The observation group was administrated with Tongxie Yaofang decoction-free granules orally，and the control group received oral treatment of pinaverium bromide，both for 4 weeks. The main symptoms of IBS were compared before and after treatment，such as the degree of abdominal pain，stool changes，traditional Chinese medicine pattern curative effect scoring system（TCM-PES），IBS quality of life questionnaire （IBS-QOL），IBS symptom severity scale（IBS-SSS），self-rating anxiety scale （SAS），and self-rating depression scale（SDS）. Nimodipine was used to evaluate the efficacy based on TCM syndrome score of liver depression and Qi stagnation. Enzyme-linked immunosorbent assay（ELISA） was conducted to detect the plasma interleukin-10（IL-10）and IL-12 before and after treatment. ResultAfter 4 weeks of treatment， the response rate of abdominal pain in observation group was 92.86% （78/84）， higher than that in control group （82.14%， 69/84）（χ2=6.254，P<0.05）. The response rates of diarrhea in observation group and control group were 91.67% （77/84）and 77.38% （65/84）， respectively（χ2=8.214，P<0.01）. TCM-PES and IBS-QOL scores of observation group after treatment were higher and IBS-SSS score was lower than those of control group （P<0.05）. The efficacy rate of TCM syndromes in observation group was higher than that of control group （P<0.05）. Additionally， after treatment， the observation group had lower SAS and SDS scores （P<0.05）and IL-12 level（P<0.05）and higher plasma IL-10 level than the control group （P<0.05）. ConclusionTongxie Yaofang can relieve abdominal pain and diarrhea in IBS-D patients with liver depression and spleen deficiency，reduce negative emotion，and improve the quality of life of patients，which may be related to alleviating the visceral hypersensitivity.

Clinical Efficacy and Mechanism of Tongxie Yaofang on Patients with IBS-D of Liver Depression and Spleen Deficiency / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of Tongxie Yaofang on irritable bowel syndrome-D (IBS-D) of liver-stagnation and spleen-deficiency type, in order to explore its mechanism in regulating brain-intestine interaction by changing the intestinal flora before and after treatment. Method:Totally 116 patients with IBS-D with liver stagnation and spleen deficiency who were diagnosed from July 2016 to December 2018 were randomly divided into observation group and control group, with 58 patients in each group. Observation group was treated with Tongxie Yaofang orally. Control group was treated with pivalvonium orally. Both groups were treated for 4 weeks. Scores of traditional Chinese medicine pattern curative effect scoring system (TCM-PES), IBS quality of life questionnaire (IBS-QOL), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) of two groups were compared before and after treatment. Calcitonin gene-related peptide (CGRP) and vasoactive intestinal peptide (VIP) were detected before and after treatment by enzyme-linked immunosorbent assay (ELISA). Real-time fluorescent quantitative polymerase chain reaction(Real-time PCR) was used to detect changes in Escherichia coli, Bifidobacteria, Lactobacillus acidophilus and Streptococcus faecalis and other intestinal flora before and after treatment. Result:TCM-PES and IBS-QOL scores of two groups were improved after treatment. TCM-PES and IBS-QOL scores of observation group were higher than those of control group (P<0.05). TCM syndromes of observation group were significantly higher than those of control group (P<0.05). SAS and SDS scores were significantly lower after treatment. SAS and SDS scores of observation group were lower than those of control group after treatment (P<0.05). Plasma CGRP and VIP decreased after treatment. Plasma CGRP and VIP in observation group were significantly lower than those in control group (P<0.05). There was no significant change in E. coli after treatment in two groups. After treatment, L. acidophilus, Bifidobacterium, and S. faecalis increased (P<0.05). In control group, intestinal L. acidophilus increased after treatment (P<0.05). The differences of intestinal L. acidophilus, Bifidobacterium, S. faecalis in two groups were statistically significant (P<0.05). Conclusion:TCM can alleviate clinical symptoms, such as abdominal pain and diarrhea in patients with IBS-D, improve patients' bad mood and improve their quality of life. This may be related to improvement of intestinal flora imbalance, regulation of brain intestinal peptide secretion and reduction of visceral hypersensitivity.

Efficacy and mechanism of acupuncture combined with for diarrhea-type irritable bowel syndrome of liver depression and spleen deficiency / 中国针灸

OBJECTIVE@#To observe the clinical effect of acupuncture at lower- acupoints and front- acupoints combined with (TXYF) for diarrhea-type irritable bowel syndrome (IBS-D) of liver depression and spleen deficiency, and to explore its possible mechanism.@*METHODS@#A total of 123 IBS-D patients with syndrome of liver depression and spleen deficiency were randomly divided into an acupuncture+TXYF group, a TXYF group and a medication group, 41 cases in each group. The patients in TXYF group were treated with oral administration of TXYF, three times a day. The patients in acupuncture+TXYF group were treated with oral administration of TXYF and routine acupuncture at Shangjuxu (ST 37), Tianshu (ST 25), Taichong (LR 3), Sanyinjiao (SP 6) and Zusanli (ST 36), once a day. The patients in medication group were treated with oral administration of pinaverium bromide, 50 mg, three times a day. All the treatment was given for four weeks. The total score of TCM syndrome scale, self-rating anxiety scale (SAS), self-rating depression scale (SDS) scores as well as the expression of calcitonin gene-related peptide (CGRP), vasoactive peptide (VIP) and MAPK signal pathway indicators of ERK1 mRNA and ERK2 mRNA were compared before and after treatment; the clinical effect was also compared.@*RESULTS@#After treatment, the total score of TCM syndrome scale and SAS and SDS scores in each group were significantly reduced (<0.05), and the scores in the acupuncture+TXYF group were lower than those in TXYF group and medication group (<0.05). The total effective rate was 87.8% (36/41) in the acupuncture+TXYF group, which was higher than 78.0% (32/41) in the TXYF group and 68.3% (28/41) in the medication group (<0.05). After treatment, the levels of CGRP and VIP in each group were decreased (<0.05), and the levels in the acupuncture+TXYF group were lower than those in the TXYF group and the medication group (<0.05). After treatment, the levels of ERK1 mRNA and ERK2 mRNA in each group were decreased (<0.05), and the levels in acupuncture+TXYF group were lower than those in medication group (<0.05).@*CONCLUSION@#The acupuncture at lower- acupoints and front- acupoints combined with TXYF could effectively alleviate the clinical symptoms, improve anxiety and depression in IBS-D patients with syndrome of liver depression and spleen deficiency, and its mechanism may be related to regulating the expression of ERK1 mRNA and ERK2 mRNA in MAPK signaling pathway, and reducing the serum levels of CGRP and VIP.

Effect of Modified Danggui Yinzi on Delayed Allergy in Model Mice with Qi-Blood Deficiency Syndrome / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect of Danggui Yinzi (DY) on delayed allergy in model mice with qi-blood deficiency syndrome (QBDS).</p><p><b>METHODS</b>QBDS model was established in 48 Kuming mice of SPF grade by using reserpine and acetophenone hydrazine. Forty of them were then randomly divided into the model group, the loratadine group, the high dose DY group, the middle dose DY group, and the low dose DY group, 8 in each group. Another 8 in line with the same standard were recruited as a blank group. Mice in high, middle, and low dose DY groups were administered with DY concentrated solution at 60, 30, 15 g/kg by gastrogavage. Mice in the loratadine group were administered with loratadine solution at 1.66 mg/kg by gastrogavage. Equal volume of normal saline was administered to mice in the model group and the blank group by gastrogavage. All medication was given once per day for 1 successive week. Except those in the blank group, the rest mice were evenly smeared with 1% DNCB solution on the abdomen. Five days after skin allergy, 1% DNCB solution was smeared to right ear of all mice to stimulate allergic reaction. Mice in the blank group were smeared in the same way without allergenic reaction. The auricle swelling and the inhibition ratio were determined at 24 h after attack. Blood was collected from orbit and serum IgE level detected using double-antibody sandwich ELISA.</p><p><b>RESULTS</b>Compared with the blank group, auricle swelling obviously increased and serum IgE level was obviously elevated in the model group (P < 0.01). Compared with the model group, auricle swelling obviously decreased and serum IgE level was obviously reduced in the 3 dose DY groups (P < 0.05, P < 0.01). Meanwhile, the auricle swelling degree was superior in high and middle dose DY groups to that in the loratadine group (P < 0.05). The inhibition ratio of auricle swelling was sequenced from high to low as 67.3% in the high dose DY group, 56.0% in the middle dose DY group, 48.1% in the low dose DY group, 47.3% in the loratadine group.</p><p><b>CONCLUSIONS</b>DY could inhibit auricle swelling and lower serum IgE level. It also could inhibit delayed allergic reaction in model mice with QBDS to some extent.</p>