温阳健脾方治疗脾肾阳虚型便秘的临床疗效及对SCF/c-kit信号通路的影响

Clinical curative effect of Wenyang Jianpi decoction on spleen-kidney yang deficiency type constipation and its effect of stem cell factor/c-kit signaling pathway

目的探讨温阳健脾方治疗脾肾阳虚型泻药性便秘的临床疗效及对c-kit配体干细胞因子(SCF)/c-kit信号通路的影响。方法选取2015年1月至2016年12月收治的160例脾肾阳虚型泻药性便秘患者,随机分至对照组和观察组各80例。对照组予以莫沙必利口服,每次5 mg,每日3次。观察组予以温阳健脾方治疗。均治疗4周,治疗结束后比较两组患者治疗前后中医各症状积分及中医症状总积分变化情况、临床疗效,同时采用蛋白免疫印迹(western blot)法检测两组患者经结肠镜检查获取的结肠组织SCF、c-kit蛋白表达水平。结果治疗后,对照组及观察组的排便难度、大便性质、排便时间、排便间隔时间、中医症状总积分均显著低于治疗前,且观察组明显低于对照组(P<0.05,P<0.01);对照组的总有效率为77.50%,观察组的总有效率为93.75%,观察组疗效高于对照组(Z=5.56,P<0.05);观察组治疗后结肠组织SCF、c-kit蛋白表达水平明显高于治疗前及对照组治疗后(P均<0.05),对照组治疗后的结肠SCF、c-kit蛋白表达水平与治疗前比较,差异无统计学意义(P均>0.05)。结论采用温阳健脾方治疗脾肾阳虚型泻药性便秘患者,可有效改善患者的临床症状,提高临床疗效,这可能与温阳健脾方提高结肠SCF、c-kit蛋白的表达水平,改善SCF/c-kit信号通路有关。

Objective To investigate the clinical curative effect of Wenyang Jianpi decoction on spleen-kidney yang deficiency type laxative constipation and its effect of stem cell factor （SCF）/c-kit signaling pathway. Methods One hundred and sixty spleen-kidney yang deficiency type laxative constipation patients who were hospitalized from January 2015 to December 2016 were selected,and all the patients were divided into control group and study group randomly （n = 80）. Patients in control group were given mosapride oral, each time 5 mg and 3 times a day. The study group was given Wenyang Jianpi decoction. Both groups were treated for 4 weeks. After the course of treatment, apart and total tradition Chinese medical （TCM） symptom score and clinical curative of each group were compared. At the same time, western bolt was used to detect the expression level of SCF and c-kit protein in the colon tissues which were taken by colonoscopy. Results After the treatment, the defecation difficulty, stool property, defecation time, defecation interval and total TCM symptom score in both groups were all significantly lower than those before the treatment, and all these indexes in the study group was lower than the control group （ P 〈 0.05, P 〈 0.01 ）. The clinical curative effect in the study group was significant higher than that in control group （Z =5.56,P 〈0.05）. Expression level of SCF and c-kit protein in the study group was higher than the control group after the treatment （ P 〈 0.05 ）. In the study group, expression level of SCF and c-kit protein were higher after the treatment （ P 〈 0.05 ） , while there was no statistically difference before and after the treatment in the control group （P 〉 0.05）. Conclusion Using Wenyang Jianpi decoction in the treatment of spleen-kidney yang deficiency type laxative constipation patients could improve patient＇s clinical symptoms and clinical curative effect. It may be related to the high expression level of SCF and c-kit protein and the improvement of SCF/c-kit signaling pathway by Wenyang Jianpi decoction.