加味济川煎对老年阳虚慢传输型便秘患者MTL、SP、VIP影响的研究

Study of the effects of JiaWei Jichuan Decoction on MTL、SP and VIP in Elderly Patients with Yang Deficiency and Slow Transit Constipation

目的观察加味济川煎对慢传输型便秘(STC)患者MTL、SP、VIP表达影响,探讨加味济川煎治疗STC的机制,为临床提供疗效依据。方法选取2019年1月—2019年7月井冈山大学附属医院肛肠科就诊的STC患者,采用随机数字表法分为2组,治疗组(加味济川煎)30例和对照组(莫沙必利片口服)30例,2组均以1周为1个疗程,共2个疗程,对比2组患者治疗后的临床疗效,首次排便时间,便秘症状评分及粪便性状评分,采用ELISA测定2组患者胃动素(MTL)、P物质(SP)、血管活性肠肽(VIP)在0、7、14 d后的表达水平,并记录不良反应。结果疗程结束后,治疗组总有效率高于对照组;治疗组首次排便时间明显短于对照组(P<0.05);与治疗前比较,2组患者治疗后CCS评分明显降低(P<0.05),与对照组相比,治疗组粪便性状有明显改善(P<0.05);与对照组同时间点相比,治疗组MTL、SP表达水平升高,VIP降低(P<0.05)。结论加味济川煎能明显改善STC患者症状,其机制可能与调节MTL、SP、VIP的表达水平相关。

Objective To observe the effect of Jiawei Jichuan decoction on the expression of MTL,SP and VIP in patients with slow transit constipation(STC),and to explore the mechanism of Jiawei Jichuan Decoction in the treatment of STC,so as to provide a basis for clinical efficacy.Methods The 60 elderly with STC patients from January 2019 to July 2019 in Anorectal Clinic of Affiliated Hospital of Jinggangshan University were divided into two groups by random number table.The treatment group(Jiawei Jichuan Decoction)had 30 cases and the control group(Mosapride Tablet orally)had 30 cases.The clinical treatment of the two groups after treatment was compared.The expression levels of plasma motilin(MTL),substance P(SP)and vasoactive intestinal peptide(VIP)were measured by ELISA after 0,1 and 2 weeks,and adverse reactions were recorded.Results After the treatment,the total effective rate of the treatment group was higher than the control group(P<0.05);the first defecation time of the treatment group was significantly shorter than the control group(P<0.05);the CCS score of the two groups after treatment was significantly lower than that before treatment(P<0.05);compared with the control group,the fecal characteristics of the treatment group were significantly improved(P<0.05);Compared with the control group at the same time point,the expression of MTL and SP increased and VIP decreased in the treatment group(P<0.05).Conclusion Jiawei Jichuan Decoction can significantly improve the symptoms of STC patients,and its mechanism may be related to the regulation of MTL,SP,VIP expression levels.