功能性腹泻从脾论治及与肠道甜味觉信号分子的相关性研究

Study of the Treatment of Functional Diarrhea from Perspective of Tonifying Spleen and Its Relationship to Gut Sweet Taste Signal Molecule

目的:研究健脾方案治疗功能性腹泻的临床疗效以及对肠道甜味觉信号分子T1R1、T1R2、T1R3、TRPM5、Gαgust蛋白表达的影响。方法:将功能性腹泻分为脾胃虚弱组及脾胃湿热组(各20例),分别给予健脾I号方和Ⅱ号方口服,在服药前及服药4周后进行临床疾病证候疗效、主要及次症状疗效评价以及Western blot方法检测治疗前后十二指肠黏膜T1R1、T1R2、T1R3、TRPM5、Gαgust蛋白表达情况。结果:两种治疗方法对中医证候疗效改善相仿,对主要症状均有改善作用,但在改善肠鸣、食欲不振、倦怠乏力、神疲懒言、口渴、小便短黄等次要症状方面脾胃虚弱组的总有效率高于脾胃湿热组。两组治疗后均可增加肠道甜味觉受体细胞T1R1、T1R2、T1R3及关键信号分子Gα-gust、TRPM5蛋白的表达,但治疗后脾胃虚弱组表达明显高于脾胃湿热组。结论:健脾为主法治疗功能性腹泻是有效的,并且对肠道甜味觉受体细胞及信号转导通路中关键信号分子Gαgust、TRPM5蛋白表达有明显的调节作用。

Objective： To observe the clinical effect for functional diarrhea using the treatment of tonifying spleen and its influence on the expressions of T1R1,T1R2,T1R3,TRPM5 and Gαgust protein which are the gut sweet taste signal molecules. Methods： 40 cases with functional diarrhea were divided into two groups including 20 cases with spleen deficiency syndrome and 20 cases with dampness-heat of spleen and stomach syndrome and No. 1 prescription of tonifying spleen and No. 2 prescription of tonifying spleen respectively were given orally. In the period of taking medicine and after 4 weeks of taking medicine,the evaluation of the clinical effect of syndromes,primary and secondary symptoms were conducted and the expressions of the T1R1,T1R2,T1R3,TRPM5 and Gαgust protein of duodenal mucosa were detected using Western blot method. Results： The two treatments had the similar clinical effect on syndromes and could improve the primary symptoms,but the improvement of some secondary symptoms in the group of spleen deficiency was better than that in the dampness-heat of spleen and stomach group. After the treatment,the two groups could increase the expressions of T1R1,T1R2,T1R3,which were the gut sweet taste receptor cells,and TRPM5 and Gαgust protein,which were the key signal molecule of it,but the expression in the group of spleen deficiency was higher than that in the dampness-heat of spleen and stomach group. Conclusion： The treatment of tonifying spleen is effective for functional diarrhea and it also has the significant regulation function on the expressions of Gαgust and TRPM5 protein,which are the key signal molecule of gut sweet taste receptor cells and signal transduction pathway.