Effects of Changtong Recipe on levels of neurotransmitters and inflammatory cytokines in elderly patients with functional constipation / 国际中医中药杂志

ABSTRACT

Objective:To explore the effects of Changtong Recipe on levels of intestinal neurotransmitters and inflammatory cytokines in the elderly with functional constipation (FC).Methods:A total of 90 elderly patients with FC meeting the inclusion criteria in the hospital were enrolled between June 2020 and October 2021. According to the principle of random allocation, they were divided into control group (45 cases, treated with oral polyethylene glycol electrolyte powder) and treatment group (45 cases, Changtong Recipe). All were treated for 3 months and followed up for 30 d. Before and after treatment, TCM symptoms were scored. The levels of vasoactive intestinal peptide (VIP) and substance P (SP) were detected by radioimmunoassay. The levels of IL-17A and IL-18 were detected by ELISA. The constipation severity and quality of life were evaluated by clinical constipation scale (CCS) and Patient Assessment of Constipation Quality of Life scale (PAC-QOL). The adverse events during treatment and recurrence during follow-up were recorded. The clinical responsive effect was evaluated.Results:After treatment, there were 44 cases in treatment group and 43 cases in control group included into the statistics. The differences in total response rate between treatment group and control group were statistically significant [97.7% (43/44) vs. 81.4% (35/43); χ2=6.25, P=0.012]. After treatment, scores of TCM symptoms (mental fatigue, shortness of breath and abdominal distension, foreign body sensation in the throat, palpitation, cold extremities) and total score in the treatment group were significantly lower than those in the control group ( t=3.71, 10.25, 2.87, 2.87, 5.68, 26.94, all Ps<0.01), and scores of CCS and PAC-QOL were significantly lower than those in the control group ( t=11.71, 18.84, all Ps<0.001). After treatment, levels of serum VIP [(41.86±1.16) ng/L vs. (35.71±1.97) ng/L, t=17.79] and SP [(42.15±1.90) ng/L vs. (39.53±2.13) ng/L, t=6.06] in treatment group were higher than those in the control group ( P<0.01), while levels of IL-17A [(35.71±5.97 ) pg/L vs. (41.86±5.16) pg/L, t=5.14] and IL-18 [(22.15±3.90) pg/L vs. (26.53±4.13) pg/L, t=5.09] in treatment group were significantly lower than those in the control group ( P<0.01). During treatment, difference in incidence of adverse events between treatment group and control group was not statistically significant [9.1% (4/44) vs. 14.0% (6/43); χ2=0.13, P=0.716]. During the 30d of follow-up, differences in recurrence rate between treatment group and control group were statistically significant [2.3% (1/44) vs. 16.3% (7/43); χ2=5.11, P=0.024]. Conclusion:The Changtong Recipe can improve levels of intestinal neurotransmitters (VIP, SP) and quality of life in elderly patients with FC, reduce levels of inflammatory cytokines (IL-17A, IL-18) and improve clinical curative effect safely.