双歧杆菌三联活菌胶囊与利福昔明治疗肠易激综合征合并小肠细菌过度生长临床效果分析

目的对比双歧杆菌三联活菌胶囊与利福昔明治疗肠易激综合征合并小肠细菌过度生长的临床效果。方法选择2016年8月—2017年11月来我院接受治疗的50例肠易激综合征合并小肠细菌过度生长患者,采用硬币法将其分为对照组24例与试验组26例。对照组患者应用利福昔明治疗,试验组患者应用双歧杆菌三联活菌胶囊治疗,观察与比较2组临床疗效与转阴率。结果试验组临床总有效率与转阴率远高于对照组(P<0.05)。结论与利福昔明相比,应用双歧杆菌三联活菌胶囊治疗肠易激综合征合并小肠细菌过度生长的临床效果更好,可提高转阴率,缓解临床症状,值得推广应用。

Visceral hypersensitivity and altered colonic motility after subsidence of inflammation in a rat model of colitis

AIM:Irritable bowel syndrome(IBS)is a functional bowel disorder characterized by visceral hypersensitivity and altered bowel motility.There is increasing evidence suggesting the role of inflammation in the pathogenesis of IBS,which addresses the possibility that formerly established rat model of colitis could be used as an IBS model after the inflammation subsided. METHODS:Colitis was induced by intracolonic instillation of 4% acetic acid in male Sprague-Dawley rats.The extent of inflammation was assessed by histological examination and myeloperoxidase(MPO)activity assay.After subsidence of colitis,the rats were subjected to rectal distension and restraint stress,then the abdominal withdrawal reflex and the number of stress-induced fecal output were measured, respectively. RESULTS:At 2 days post-induction of colitis,the colon showed characteristic inflammatory changes in histology and 8-fold increase in MPO activity.At 7 days post-induction of colitis,the histological features and MPO activity returned to normal.The rats at 7 days post-induction of colitis showed hypersensitive response to rectal distension without an accompaning change in rectal compliance,and defecated more stools than control animals when under stress.CONCLUSION: These results concur largely with the characteristic features of IBS, visceral hypersensitivity and altered defecation pattern in the absence of detectable disease, suggesting that this animal model is a methodologically convenient and useful model for studying a subset of IBS.

Effects of moxibustion on miRNA-133b,Pitx3/TH,and neurotransmitters in the midbrain of rats with diarrhea-predominant irritable bowel syndrome

Objective:To investigate the mechanism of moxibustion in the treatment of diarrhea-predominant irritable bowel syndrome(IBS-D),by observing the effects of moxibustion at Tianshu(ST25)and Shangjuxu(ST37)on microRNA-133b(miRNA-133b),pituitary homeobox family factor 3(Pitx3)/tyrosine hydroxylase(TH),and neurotransmitters in the brain tissue of IBS-D rats.Methods:Healthy Sprague-Dawley rats were randomly divided into a normal group,a model group,a moxibustion group,and a Western medicine group,with 12 rats in each group.Except for the normal group,the IBS-D rat model was established by mother-offspring separation and acetic acid enema combined with restraint stress stimulation in all the other groups.No intervention was performed in the normal and model groups.Mild moxibustion was applied to both Tianshu(ST25)and Shangjuxu(ST37)in the moxibustion group.Rifaximin was given by gavage in the Western medicine group.The physical status of rats in each group was observed at different periods.After the intervention,hematoxylineosin staining was performed to observe the histopathological morphology of rat colon;enzyme-linked immunosorbent assay was used to measure the levels of dopamine(DA),noradrenaline(NE),and 5-hydroxytryptamine(5-HT)in plasma,colon,and midbrain tissue of rats;the relative expression levels of miRNA-133b,Pitx3 mRNA,and TH mRNA in the midbrain tissue were measured by real-time fluorescence quantitative polymerase chain reaction,and the relative expression levels of Pitx3 and TH proteins in the midbrain tissue were measured by Western blotting and immunofluorescence.Results:The body weights of rats among groups and at different time points were statistically different(P<0.01).The body weight of the normal group was higher than that of the other groups over time(P<0.01).After modeling,the minimum volume threshold of abdominal withdrawal reflex(AWR)was significantly lower(P<0.01)and the loose stool rate was significantly higher(P<0.01)in the model,moxibustion,and Western medicine groups compared with the normal group;the miRNA-133b expression in the midbrain tissue was significantly lower(P<0.01),the expression levels of Pitx3 and TH in the midbrain tissue were significantly higher(P<0.01),and the levels of DA,NE,and 5-HT in plasma,colon and midbrain tissue were significantly higher(P<0.01).After the intervention,the minimum volume threshold of AWR was significantly higher(P<0.01),the loose stool rate was significantly lower(P<0.01),the miRNA-133b expression was significantly increased(P<0.01 or P<0.05)and the expression levels of Pitx3 and TH were significantly decreased(P<0.01)in the midbrain tissue,the levels of DA,NE,and 5-HT in plasma,colon,and midbrain tissue were significantly reduced(P<0.01)in the moxibustion and Western medicine groups compared with the model group;the levels of 5-HT in the colon and midbrain tissue of the moxibustion group were significantly lower than those in the Western medicine group(P<0.05),and there was no statistical difference compared with the remaining groups(P>0.05).Linear correlation analysis showed that miRNA-133b was negatively correlated with Pitx3(r<0,P<0.01);Pitx3 with TH,TH with DA,and NE with 5-HT were positively correlated(r>0,P<0.01).Conclusion:Moxibustion at Tianshu(ST25)and Shangjuxu(ST37)improves diarrhea symptoms and visceral hypersensitivity in IBS-D rats.The mechanism may be related to up-regulating miRNA-133b,inhibiting Pitx3/TH,and reducing neurotransmitter expression levels in the midbrain tissue.