The different effects of Chinese Herb Solid Drink and lactulose on gut microbiota in rats with slow transit constipation induced by compound diphenoxylate.

Slow transit constipation (STC) has become an epidemic medical problem. There are several kinds of drugs for constipation; however, each drug has its limitations. The gut microbiota has a close relationship with STC. Lactulose is an effective drug for constipation because it is a kind of bulking laxative and microbioecologic, and it relieves the syndromes of STC. We found that the Chinese Herb Solid Drink (CHSD), which contains medicine food homologous materials such as psyllium husk, sweetalmond, semen sesami nigrum, and hemp seed, has a similar effect on relieving constipation as lactulose, although it has different effects on the gut microbiota. We investigated the mechanisms of CHSD in rats with STC, induced by diphenoxylate, via constipation index and enzyme linked immunosorbent assay (ELISA) analyses using serum and 16S rDNA amplicon and gas chromatography-mass spectroscopy (GC-MS). CHSD enhanced the relative abundance of some types of gut microbiota, such as Blautia, Ruminococcus, Roseburia, Coprococcus, Lachnospira, and Phascolarctobacterium, while lactulose enhanced the relative abundance of Blautia, Phascolarctobacterium, Eubacterium, and Akkernansia in diphenoxylate-induced STC rats. Both CHSD and lactulose enhanced the level of short-chain fatty acids in the faeces of rats; however, the composition of those were different between the two drugs. From the perspective of the gut neuroendocrine system, both CHSD and lactulose could elevate neurotransmitters, such as motilin (MTL) and substance P (SP), which promote intestinal peristalsis and reduce the expression of vasoactive intestinal peptide, which inhibits intestinal peristalsis in the serum of STC rats. CHSD could elevate gastrin expression, which also promoted intestinal peristalsis in serum, while lactulose did not have this effect. Our findings suggest that CHSD may be an effective and safe therapeutic choice for STC.

Study of Evodia hot compress plus electro-acupuncture in patients who have undergone abdominal surgery.

BACKGROUND: The importance of postoperative gastrointestinal function recovery is being increasingly recognized. In this multi-center randomized controlled study, we evaluated the efficacy and safety of Evodia hot compress (ECS) plus electro-acupuncture (EA) for patients who developed postoperative gastrointestinal tract dysfunction after abdominal surgery. METHODS: 1009 patients who developed postoperative gastrointestinal tract dysfunction after abdominal surgery were enrolled. All patients received conventional therapies for 7 days from the 1st postoperative day and were randomly assigned to receive coarse salt hot compress, Evodia hot compress or Evodia hot compress plus electro-acupuncture twice a day for 7 days. RESULTS: The mean time to first flatus and to first bowel sounds was comparable among the four groups (P>0.05). The control group had a significantly shorter time to defecation compared with patients receiving coarse salt hot compress, Evodia hot compress or Evodia hot compress plus electro-acupuncture (P<0.05). In patients undergoing open hepatectomy, the time to first defecation was the shortest in those who received Evodia hot compress plus electro-acupuncture (89.3±25.5 h), which was significantly different from that of controls(134±31.1 h), those who received coarse salt hot compress (106.7±36.4 h) and those who received Evodia hot compress (109.9±42.1 h) (P<0.05) in patients undergoingopen cholecystectomy, the time to first defecation was the shortest in those who received Evodia hot compress (73.1± 24.7), which was significantly different from that of controls (77.8±29.7), those who received coarse salt hot compress 90.5±30.2) and those who received Evodia hot compress plus electro-acupunctur (83.9±34.0). CONCLUSION: Evodia hot compress plus electro-acupuncture confers benefit in postoperative recovery of gastrointestinal function of patients who have undergone abdominal surgery and it is overall safe to use. TRIAL REGISTRATION: Chinese Clinical Trial RegistryChiCTR-TRC-09000527.

[Safety and efficacy of QianlieanSuppository for chronic prostatitis of damp-heat and blood-stasis syndrome: a randomized, single-blind, parallel controlled, multi-centered phase III clinical trial].

OBJECTIVE: To evaluate the safety and efficacy of Qianliean Suppository in the treatment of chronic prostatitis of damp-heat and blood-stasis syndrome. METHODS: We conducted a randomized, single-blind, parallel-controlled, multi-centered clinical trial among 467 subjects, who were assigned to a trial group (n = 349) and a control group (n = 118), the former treated with Qianliean Suppository anally one pill per night for 28 days and the latter given Yejuhua Suppository in the same way. The efficacy was evaluated by the TCM syndrome, NIH-CPSI, main clinical symptoms and WBC count in EPS. RESULTS: After the treatment, the total rates of recovery, excellence and effectiveness for the TCM syndrome were 4.4%, 58.0% and 90.7% respectively in the trial group, significantly higher than 0.9%, 33.1% and 70.4% in the control group (P < 0.025). Remarkable decreases were observed in the NIH-CPSI total score and the scores on pain and discomfort, voiding symptoms and quality of life in the former group compared with the latter (P < 0.025). The trial group also showed a marked alleviation of such main chronic prostatitis symptoms as urgent micturition and perineal pain and discomfort (P < 0.05), as well as an obvious improvement (55.2%) of the WBC count in EPS as compared with 32.4% in the control group (P < 0.05). No serious adverse events occurred in either of the two groups (0.56% [2/349 ] vs 0.83% [1/118]). CONCLUSIONS: Qianliean Suppository is safe and effective for the treatment of chronic prostatitis of damp-heat and blood-stasis syndrome.