Clinical Efficacy of Modified Zhishi Daozhiwan on Slow Transit Constipation / 中国实验方剂学杂志

Objective::To observe the clinical efficacy of modified Zhishi Daozhiwan on slow transit constipation (STC) and the effect on gastrointestinal hormones and intestinal flora. Method::One hundred and sixty patients were randomly divided into control group and observation group by random number table. Patients in control group got Maren Wan, 1-2 pills/time, 2 times/days, and mosapride citrate tablets, 1 piece/time, 3 times/days. Patients in observation group got modified Zhishi Daozhiwan, 1 dose/day. A course of treatment was 4 weeks. Before and after treatment, the main symptoms of constipation and patient assessment of constipation symptoms (PAC-SYM) were scored. And times of spontaneous complete bowel movement (SCBM) and colonic transmission test were recorded. And levels of intestinal flora and motilin (MTL), vasoactive intestinal peptide (VIP), substance P (SP) and gastrin (GAS) were detected. The 12-week follow-up of patients (SCBM≥3) was recorded, and the relapse of disease was calculated. Result::According to rank sum test analysis, the clinical efficacy in observation group was better than that in control group (Z=2.275, P<0.05). After treatment, scores of the main symptoms of constipation, PAC-SYM, and the total score of PAC-SYM were all lower than those in control group (P<0.01). At the second, third and fourth weeks after treatment, the times of SCBM were more than those in control group (P<0.01). Ratio of residual marker at 24, 48 and 72 h was lower than that in control group (P<0.01). Count of enterococcus and enterobacter were lower than those in control group (P<0.01), while counts of bifidobacterium and lactobacillus were higher than in control group (P<0.01). Levels of GAS, MTL and SP were higher than those in control group, whereas level of VIP was lower than that in control group (P<0.01). And relapse rate in observation group was 33.85%, which was lower than 57.69% in control group (χ2=6.653, P<0.05). Conclusion::Modified Zhishi Daozhiwan can alleviate constipation and other symptoms, increase the number of SCBM, regulate gastrointestinal hormones and intestinal flora, and improve colonic transit function, with a good clinical efficacy and low recurrence rate, so it is worth clinical application.

Effect of Addition and Subtraction Therapy of Xiaoyaosan Combined with Simotang to Gut-brain Axis of Patients with Irritable Bowel Syndrome with Predominant Constipation and Syndrome of Stagnation of Liver Qi / 中国实验方剂学杂志

Objective:To observe clinical effect of addition and subtraction therapy of Xiaoyaosan combined with Simotang to irritable bowel syndrome with predominant constipation （IBS-C） and syndrome of stagnation of liver Qi and to study influence to gut-brain axis. Method:One hundred and forty-four patients were randomly divided into control group （72 cases） and observation group （72 cases） by random number table. The 66 patients in control group completed the therapy （2 patients were falling off or missing visit， 5 patients were eliminate）， 65 patients in observation group completed the therapy （4 patients were falling off or missing visit， 2 patients were eliminate）. Patients in control group got Simotang， 20 mL/time， 3 times/day. In control group， patients in observation group added addition and subtraction therapy of Xiaoyaosan combined with Simotang， 1 dose/day. And courses of treatment in two groups were 4 weeks. Before and after treatment， degree of abdominal pain， irritable bowel syndrome （IBS） symptom severity scale （IBS-SSS）， quality of life in irritable bowel syndrome （IBS-QOL）， syndrome of stagnation of liver Qi， scores of Hamilton anxiety scale-14（HAMA-14）， Hamilton depression scale-17（HAMD-17）， complete spontaneous bowel movement （CSBM）， response rate of abdominal pain and defecation， remission rate of IBS-SSS were all recorded. And levels of vasoactive intestinal peptide （VIP）， substance P （SP）， neuropeptide Y （NPY）， 5-hydroxytryptamine （5-HT）， somatostatin （SS） and calcitonin related gene peptide were detected， and safety was evaluated. Result:Degree of abdominal pain， scores of IBS-SSS， syndrome of stagnation of liver Qi ， HAMA-14， HAMD-17 and levels of VIP， NPY， 5-HT， SS and CGRP in observation group were all lower than those in control group （P<0.01）. And times of CSBM， score of IBS-QOL and level of SP were all higher than those in control group （P<0.01）. Besides， response rate of abdominal pain and defecation and remission rate of IBS-SSS in observation group 95.38%（62/65）， 93.85%（61/65） and 90.77%（59/65）were higher than 83.33%（55/66），78.79%（52/66）and 75.76%（50/66） in control group （P<0.05）. And curative effect of traditional Chinese medicine （TCM） syndromes in was better than that in control group （Z=2.1034， P<0.05）. No serious adverse events happened and no adverse reaction caused by TCM. Conclusion:Addition and subtraction therapy of Xiaoyaosan combined with Simotang can significantly ameliorate IBS-C symptoms， reduce bad mood， improve patients' quality of life， regulate a variety of brain gut peptide factors， and improve brain gut axis disorder. It has good clinical efficacy and safety.

Clinical Efficacy of Taohua Tang and Buzhong Yiqi Tang in Treatment of Deficiency Syndrome of Crohn's Disease / 中国实验方剂学杂志

Objective:To observe clinical efficacy of Taohua Tang and Buzhong Yiqi Tang on Crohn's disease (CD) at active phase (deficiency-cold in spleen and stomach), in order to observed its effect on Th1 and Th17 cytokines. Method:According to random number table, 86 patients with CD were divided into control group (42 cases) and observation group (44 cases). The control group (mild) was given SASP, 3-4 g·d-1, Po, tid. The control group (moderate or poor efficacy of SASP) was given prednisone acetate, 0.75 mg·kg-1·d-1, Po, tid. Observation group was given Taohua Tang and Buzhong Yiqi Tang in addition to therapy of the control group, 1 dose·d-1. The course of treatment was 12 weeks. Before and after treatment, Best CDAI, SES-CD, IBDQ and deficiency syndrome were scored, and levels of CRP, ESR, ALB, HB, PLT, IFN-γ, TNF-α, IL-2 and IL-17 were measured before and after treatment. Result:After treatment, the effect of traditional Chinese medicine(TCM) syndromes in the observation group was better than that in the control group (Z=2.058, PPPPZ=2.112, PZ=2.288, PPPγ, TNF-α, IL-2 and IL-17 levels in the observation group were lower than those in the control group (PConclusion:In addition to the therapy of conventional western medicine, Taohua Tang and Buzhong Yiqi Tang in treatment of deficiency syndrome of Crohn's disease (CD) can control the activity degree of the disease, reduce the degree of illness and inflammation, and improve the remission rate and the quality of life, with a better clinical efficacy than the pure western medicine therapy.