Assessment of the triglyceride glucose index in adult patients with chronic diarrhea and constipation

BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and constipation,and the triglyceride glucose(TyG)index,a marker of IR,has not yet been investigated.AIM To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation.METHODS This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010.TyG was used as an exposure variable,with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables.A demographic investigation based on TyG quartile subgroups was performed.The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG,chronic diarrhea,and constipation.Subgroup analyses were performed to examine the stability of any potential associations.RESULTS In the chosen sample,chronic diarrhea had a prevalence of 8.00%,while chronic constipation had a prevalence of 8.04%.In multiple logistic regression,a more prominent positive association was found between TyG and chronic diarrhea,particularly in model 1(OR=1.45;95%CI:1.17-1.79,P=0.0007)and model 2(OR=1.40;95%CI:1.12-1.76,P=0.0033).No definite association was observed between the TyG levels and chronic constipation.The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63(OR=1.89;95%CI:1.05-3.41,P=0.0344),and another positive association with chronic constipation when it was greater than 8.2(OR=1.74;95%CI:1.02-2.95,P=0.0415).The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations.CONCLUSION Higher TyG levels were positively associated with abnormal bowel health.

Relationship between dietary fiber intake and chronic diarrhea in adults

BACKGROUND Dietary fiber is essential for human health and can help reduce the symptoms of constipation.However,the relationship between dietary fiber and diarrhea is,poorly understood.AIM To evaluate the relationship between dietary fiber and chronic diarrhea.METHODS This retrospective study was conducted using data from the United States National Health and Nutrition Examination Survey,conducted between 2005 and 2010.Participants over the age of 20 were included.To measure dietary fiber consumption,two 24-hour meal recall interviews were conducted.The independent relationship between the total amount of dietary fiber and chronic diarrhea was evaluated with multiple logistic regression and interaction analysis.RESULTS Data from 12829 participants were analyzed.Participants without chronic diarrhea consumed more dietary fiber than participants with chronic diarrhea(29.7 vs 28.5,P=0.004).Additionally,in participants with chronic diarrhea,a correlation between sex and dietary fiber intake was present:Women who consume more than 25 g of dietary fiber daily can reduce the occurrence of chronic diarrhea.CONCLUSION Dietary fiber can reduce the occurrence of chronic diarrhea.

Mycobacterium ulcerans infection as a cause of chronic diarrhea in an AIDS patient: A case report

Chronic diarrhea is one of the most frequent gastro-intestinal manifestations in acquired immunodeficiency syndrome (AIDS). Protozoa and nontuberculous mycobacteria (NTM) are opportunistic pathogens that can easily infect these patients. Among the NTM, Mycobacterium avium complex (MAC) is the most frequently observed pathogen in HIV-infected patients. However, NTMs other than MAC have not been reported as a gastrointestinal pathogen as yet. We present a case of chronic diarrhea in an AIDS patient in whom Mycobacterium ulcerans and cryptosporidium co-infection is evidenced from colonic tissue.

Introduction on Professor YUAN Shi-liang's Experience in Treatment of Chronic Diarrhea

Chronic diarrhea is one of the most common clinical diseases in the department of spleen and stomach diseases.This paper mainly introduces the key points of Professor YUAN Shi-liang diagnosing and treating chronic diarrhea,methods of dealing with common accompanying symptoms,as well as typical cases,which have certain guiding role in clinical practice.

Atypical Presentation of Classical Bartter Syndrome as a Case of Chronic Diarrhea and Failure to Thrive

The classical Bartter syndrome is an uncommon tubular disorder of autosomal recessive inheritance, characterized by early childhood onset of polyuria, polydipsia, vomiting, dehydration, constipation and salt craving habit. The long-term outlook for patients with Bartter syndrome is not certain. If not properly treated, it may lead to failure to thrive and growth retardation. We herein report a case of 18-month-old girl child who presented chronic diarrhea and failure to thrive and then was diagnosed as a case of classical Bartter syndrome. She was successfully treated with potassium supplementation and ibuprofen therapy.

Case Report: Mediastinal Ganglioneuroma Presented as Chronic Diarrhea in a Young Saudi Girl

Ganglioneuromas (GN) are rare, benign neurogenic tumors that arise from sympathetic ganglia. They are often asymptomatic. However, in rare cases, they may secrete catecholamines, vasoactive intestinal polypeptides (VIP), or androgenic hormones and manifest with flushing, symptoms of catecholamine excess or chronic diarrhea. We report a young Saudi girl with chronic secretory diarrhea, severe hypokalemia and abdominal distension. After an extensive work up, a well-defined hypodense heterogeneous mediastinal mass was noted in radio imaging. A complete recovery was seen after surgical removal of that mediastinal mass which turned to be a ganglioneuroma.

Relationship between chronic diarrhea with normal colonoscopy findings and terminal ileum lesions

Background The causes and mechanisms of chronic diarrhea are complex.This study aimed to explore the relationship between chronic diarrhea with normal colonoscopy findings and terminal ileum lesions.Methods All cases were collected from January 2009 to June 2010.The 40 patients in the patient group had chronic diarrhea with normal colonoscopy findings.Those who had hyperthyroidism,diabetes,chronic pancreatitis,cirrhosis,atrophic gastritis,short bowel syndrome and connective tissue diseases had been excluded.The control group contained 40 healthy individuals without diarrhea.Endoscopy of the terminal ileum was applied in both groups,with the endoscope inserted into terminal ileum for more than 20 cm.The patients diagnosed of chronic diarrhea with terminal ileum lesions were treated with metronidazole and probiotics for 10-14 days.Results Before treatment there were significant differences in endoscopy findings of the terminal ileum between the two groups （P 〈0.05）.In the patient group,endoscopy showed congestion,edema,erosion and ulcers in 29 cases,hyperplasia and enlargement of lymphoid follicles in 10 cases with a maximal diameter of 7-8 mm,and 1 case showed normal endoscopy results.After treatment,35 patients recovered from diarrhea,and terminal ileum lesions disappeared in 30 cases as determined by endoscopy.In the control group,endoscopy showed scattered hyperplasia of lymphoid follicles in 5 cases,and the follicles were small with the maximal diameter being 3 mm.There was no hyperemia,edema,erosion or ulcers.Conclusions Chronic diarrhea patients with normal colonoscopy findings may have lesions in the terminal ileum that can be detected by endoscopy; including hyperemia,erosion,ulcers and lymphoid follicle hyperplasia.Therapeutic effect is good with metronidazole and probiotics.

Transcriptome analysis suggests broad jejunal alterations in Linghu’s obesity-diarrhea syndrome:A pilot study

BACKGROUND Obesity is associated with a significantly increased risk for chronic diarrhea,which has been proposed as Linghu’s obesity-diarrhea syndrome(ODS);however,its molecular mechanisms are largely unknown.AIM To reveal the transcriptomic changes in the jejunum involved in ODS.METHODS In a cohort of 6 ODS patients(JOD group),6 obese people without diarrhea(JO group),and 6 healthy controls(JC group),high-throughput sequencing and bioinformatics analyses were performed to identify jejunal mucosal mRNA expression alterations and dysfunctional biological processes.In another cohort of 16 ODS patients(SOD group),16 obese people without diarrhea(SO group),and 16 healthy controls(SC group),serum diamine oxidase(DAO)and D-lactate(DLA)concentrations were detected to assess changes in intestinal barrier function.RESULTS The gene expression profiles of jejunal mucosa in the JO and JC groups were similar,with only 1 differentially expressed gene(DEG).The gene expression profile of the JOD group was significantly changed,with 411 DEGs compared with the JO group and 211 DEGs compared with the JC group,129 of which overlapped.The enrichment analysis of these DEGs showed that the biological processes such as digestion,absorption,and transport of nutrients(especially lipids)tended to be up-regulated in the JOD group,while the biological processes such as rRNA processing,mitochondrial translation,antimicrobial humoral response,DNA replication,and DNA repair tended to be down-regulated in the JOD group.Eight DEGs(CDT1,NHP2,EXOSC5,EPN3,NME1,REG3A,PLA2G2A,and PRSS2)may play a key regulatory role in the pathological process of ODS,and their expression levels were significantly decreased in ODS patients(P<0.001).In the second cohort,compared with healthy controls,the levels of serum intestinal barrier function markers(DAO and D-LA)were significantly increased in all obese individuals(P<0.01),but were higher in the SOD group than in the SO group(P<0.001).CONCLUSION Compared with healthy controls and obese individuals without diarrhea,patients with Linghu’s ODS had extensive transcriptomic changes in the jejunal mucosa,likely affecting intestinal barrier function and thus contributing to the obesity and chronic diarrhea phenotypes.

Treatment of 28 Chronic Diarrhea Patients by Ginger-partitioned Moxibustion

Tianshu (ST 25), Shongwan (CV 12), Qihai (CV 6), Zusanli (ST 36) and etc were selected to treat chronic diarrhea. The curative effect between ginger moxibustion and acupuncture was compared. The effective rate of two groups was respectively 93% and 82%. Key Words Diarrhea, Chronic - Ginger-partitioned Moxibustion - Acupuncture-moxibustion Translator: WANG Si-you

Treatment of Chronic Diarrhea with Point-irradiation of He-Ne Laser in 50 Cases

To treat 50 cases of chronic diarrhea by laser point-radiation on Shenque (CV 8), Tianshu (ST 25), Zusanli (ST 36) and Point Anti-diarrhea with low power He?Ne laser. The total effective rate was 96%. Key Words Laser Acupuncture - Diarrhea, Chronic - Acupuncture Therapy Author: WU Tong-fa (1936-), male, professor

Diarrhea in neonatal intensive care unit

AIM:To investigate the frequency,etiology,and current management strategies for diarrhea in newborn.METHODS:Retrospective,nationwide study involving 5801 subjects observed in neonatal intensive care units during 3 years.The main anamnesis and demographic characteristics,etiology and characteristics of diarrhea,nutritional and therapeutic management,clinical outcomes were evaluated.RESULTS:Thirty-nine cases of diarrhea(36 acute,3 chronic) were identified.The occurrence rate of diarrhea was 6.72 per 1000 hospitalized newborn.Etiology was defined in 29 of 39 newborn(74.3%):food allergy(20.5%),gastrointestinal infections(17.9%),antibiotic-associated diarrhea(12.8%),congenital defects of ion transport(5.1%),withdrawal syndrome(5.1%),Hirschsprung's disease(2.5%),parenteral diarrhea(2.5%),cystic fibrosis(2.5%),and metabolic disorders(2.5%).Three patients died due to complications related to diarrhea(7.7%).In 19 of 39 patients(48.7%),rehydration was performed exclusively by the enteral route.CONCLUSION:Diarrhea in neonates is a challenging clinical condition due to the possible heterogeneous etiologies and severe outcomes.Specific guidelines are advocated in order to optimize management of diarrhea in this particular setting.

Chronic Consequences of Uncomplicated Yersinia Enterocolitica Infection:A Retrospective Study(2004)of Military Recruits Previously(1987)Screened for Antibodies to Yersinia Enterocolitica O:3

In 1987, a serological survey among 755 male Norwegian military recruitsshowed that 68 (9.0%) had IgG (7.4%) and / or IgA (4.5%) antibodiesto Y.enterocolitica O:3, consistent with previous infection.In 2004,433 of the former recruits (mean age 37.5 years, range 35 - 42 years) answered a questionnaire, in order to investigatedevelopment of possible chronic disorders and complaints related to uncomplicated Y.enterocolitica infection. The questionnaire covered per-sonal and demographic data, behavioral risk factors, and possible chronic complaints related to yersiniosis.Among the 433 responders, 51 (11.8%) were seropositive for IgG or IgA in the 1987 survey, 380 were seronegative, and 2 had ambiguous results.No difference was observed between the seropositive and seronegativegroups regarding education, annual income, general behavioral risk factors like smoking, alcohol consumption, physical activity, and dietary parameters;or diagnosed chronic illness. However, the seropositives weresignificantly more likely than the seronegatives to report recurrent diarrhea, painful or swollen joints, and muscle pain. Also, presence of all three complaints was more common among seropositives. Conclusion: The present study shows that uncomplicated Y.enterocolitica O:3 infection is a risk factor regarding future development of chronic complaintssuch as diarrhea, and joint and muscle complaint.

Sporadic gastrinoma with refractory benign esophageal stricture:A case report

BACKGROUND Gastrinoma is characterized by an excessive release of gastrin,leading to hypersecretion of gastric acid,subsequently resulting in recurrent peptic ulcers,chronic diarrhea,and even esophageal strictures.This case report aims to improve awareness and facilitate early diagnosis and treatment of gastrinoma by presenting a rare case of gastrinoma with refractory benign esophageal stricture(RBES).Additionally,it highlights the persistent challenges that gastroenterologists encounter in managing RBES.CASE SUMMARY This case demonstrates a patient with gastrinoma who developed RBES and complete esophageal obstruction despite management with maximal acid suppressive therapy,multiple endoscopic bougie dilations and endoscopic incisional therapy(EIT).CONCLUSION It is essential to diagnose gastrinoma as early as possible,as inadequately controlled acid secretion over an extended period increases the risk of developing severe esophageal strictures.In patients with esophageal strictures causing complete luminal obstruction,blind reopening EIT presents challenges and carries a high risk of perforation.

慢性迁延性腹泻儿童食物过敏的特征分析

目的:分析慢性迁延性腹泻儿童食物过敏的特征。方法:选取2017年2月—2023年2月北京丰台医院收治的75例慢性迁延性腹泻患儿作为研究对象,所有患儿进行14种食物过敏原特异性免疫球蛋白(IgE)抗体检测,进行常规饮食指导,随访并逐年记录过敏情况。结果:<1岁的患儿中,14种食物过敏原特异性IgE抗体均存在阳性情况,阳性率前3位依次为牛奶(81.8%)、蛋类(60.0%)及大米(30.9%);≥1岁的患儿中,存在除猪肉之外的13种食物过敏原特异性IgE抗体阳性情况,阳性率前3位依次为牛奶(75.0%)、蛋类(60.0%)、大米与大豆(30.0%,并列第3)。≥1岁的患儿西红柿、大豆、蘑菇、玉米、虾、蟹、鳕鱼食物过敏原特异性IgE抗体阳性率高于<1岁的患儿,差异有统计学意义(P<0.05)。75例患儿经1~2年的随访,均对过敏食物耐受。结论:慢性迁延性腹泻儿童与多种食物过敏有关,食物过敏原特异性IgE抗体是诊断的重要指标之一,临床应给予患儿高度关注及饮食指导。

俞募配穴温针灸法联合健脾止泻汤治疗慢性小儿腹泻临床观察

目的研究俞募配穴温针灸法联合健脾止泻汤治疗慢性小儿腹泻的临床效果。方法选择2020年6月—2022年3月江西省兴国县人民医院儿科收治的50例慢性腹泻患儿,以随机抽签法分为观察组与参照组,各25例。观察组施予俞募配穴温针灸法联合健脾止泻汤治疗,参照组给予常规西药治疗。观察两组各项症状缓解时间;检验免疫蛋白及肠道微生物数量。结果观察组各项症状缓解时间均较参照组短(P<0.05)。治疗2周后,两组免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)水平均升高,且观察组高于参照组(P<0.05);两组双歧杆菌属、乳杆菌属肠道微生物数量均升高,且观察组高于参照组(P<0.05);两组大肠杆菌属、肠球菌属肠道微生物数量均降低,且观察组低于参照组(P<0.05)。结论慢性腹泻患儿接受俞募配穴温针灸法联合健脾止泻汤治疗,症状改善明显,有利于患儿优势菌群数量恢复,提高免疫功能。

B族维生素与慢性便秘、慢性腹泻的相关性:一项基于美国国家健康与营养调查数据库的横断面研究

目的探讨B族维生素(维生素B1、B2、B6,烟酸)的摄入量与慢性便秘、慢性腹泻的关系。方法合并美国国家健康和营养调查数据库(National Health and Nutrition Examination Survey,NHANES)3个周期(2005-2006年、2007-2008年和2009-2010年)的数据信息进行分析,共纳入13788名参与者,通过24 h饮食回忆访谈评估维生素B1、B2、B6,烟酸的摄入量。采用多元Logistic回归分析探讨B族维生素与慢性便秘、慢性腹泻的相关性,并进行了分层分析和曲线拟合相关分析。结果纳入的受试者中有2520人(18.28%)存在慢性便秘,2138人(15.51%)存在慢性腹泻。多元Logistic回归和分层分析结果显示,维生素B1、烟酸、维生素B6的摄入量与慢性便秘、慢性腹泻呈线性相关(P<0.05),每日摄入量的增加可降低慢性便秘的发生风险,但会增加慢性腹泻的发生风险(P<0.05)。结论维生素B1、B2、B6,烟酸与慢性便秘、慢性腹泻存在相关性。

白细胞介素10受体A基因突变导致的极早发型炎症性肠病临床特点及基因分析

目的总结白细胞介素10受体A(interleukin 10 receptor A,IL-10RA)基因突变导致的极早发型炎症性肠病(very early onset inflammatory bowel disease,VEO-IBD)患儿临床特点和遗传学特征。方法回顾性分析2007年3月到2019年5月在首都医科大学附属北京儿童医院院消化科住院的慢性腹泻的患儿中,确诊为VEO-IBD的患儿,其中病因为IL-10RA基因突变的患儿15例,对照组为15例非IL-10RA突变所致VEO-IBD患儿,统计分析其临床特点及基因报告。结果IL-10RA基因突变所致的VEO-IBD患儿,克罗恩病(Crohn s disease,CD)11例,溃疡性结肠炎(ulcerative colitis,UC)4例,临床症状以慢性腹泻(15/15例,100.0%)、便血(15/15例,100.0%)为主,肠外表现依次为口腔黏膜溃疡(6/15例,40.0%)、皮肤红斑(5/15例,33.3%);肛周表现依次为直肠会阴瘘5例(5/15,33.3%),肛瘘4例(4/15,26.7%),肛裂3例(3/15,20.0%),直肠会阴瘘、皮赘并存1例(1/15,6.7%);全身表现为IL-10RA基因突变组营养不良13例(13/15例,86.7%),肛周病变13例(13/15例,86.7%);对照组营养不良6例(6/15例,40.0%),肛周病变5例(5/15例,33.3%),此两项指标与IL-10RA基因突变组相比,差异有统计学意义(P<0.05)。15例IL-10RA突变患儿中,共检测到9个突变位点,其中c.301c>T(p.R101W)和c.537G>A(p.T179T)为最常见的突变位点。IL-10RA突变导致炎症因子增高,引起肠道炎症反应。凝血酶原时间和部分凝血活酶时间均明显延长。结论IL-10RA基因突变导致的VEO-IBD患儿发病年龄早,除消化道症状外,肠外表现和肛周病变较为常见,结肠镜下病变特点以结肠多发溃疡最常见,其次为炎性息肉。c.301c>T(p.R101W)和c.537G>A(p.T179T)为最常见的基因突变位点。IL-10RA突变导致炎症因子增高,引起肠道炎症反应。

从厥阴病机论乌梅丸现代临床证治思路

从厥阴病寒热错杂,阴阳失和的病机入手,探析乌梅丸收敛气血,调和阴阳的作用及其临床应用范围。结合现代药理学研究及古今医家经验,总结出乌梅丸在治疗糖尿病性胃轻瘫、胃食管反流病、慢性顽固性腹泻、慢性胆囊炎、顽固性失眠和溃疡性结肠炎上所取得的显著疗效,为经方临床应用提供思路。

天突穴穴位敷贴联合针灸治疗慢性咽炎急性发作的效果及对临床症状改善、复发率的影响

目的探讨天突穴穴位敷贴联合针灸治疗慢性咽炎(CP)急性发作的效果及对临床症状改善、复发率的影响。方法选取2019年10月—2022年10月于该院接收治疗的90例CP急性发作患者作为本次研究对象,通过随机信封法将其分为以下两组,对照组(n=45,给予针灸治疗),研究组(n=45,给予天突穴穴位敷贴联合针灸治疗),比较两组的临床疗效、治疗前后中医症状积分、炎症因子水平、免疫功能及CP复发率。结果研究组总有效率为93.33%,高于对照组的77.78%(P<0.05);治疗后,研究组咽喉干涩、红肿微痛、咽喉痒紧、咽喉灼热以及喉部异物感等中医积分低于对照组(P<0.05);治疗后,研究组肿瘤坏死因子-α、白细胞介素-6及C反应蛋白水平皆低于对照组(P<0.05);治疗后,研究组CD_(3)^(+)与对照组相比,差异无统计学意义(P>0.05),CD_(4)^(+)比例则高于对照组(P<0.05);在3个月后的追踪随访中发现,研究组CP复发率为11.11%,低于对照组的28.89%(P<0.05)。结论天突穴穴位敷贴联合针灸治疗CP急性发作患者临床疗效良好,且可明显改善其临床症状,减轻炎性反应,提高免疫功能,降低其短期复发率。

补中益气方通过MLCK/p-MLC_(20)通路调节慢性腹泻大鼠结肠动力的机制研究

目的探讨补中益气方对慢性腹泻大鼠MLCK/p-MLC_(20)通路介导的结肠动力的影响。方法大鼠随机分为正常组,模型组和补中益气低、中、高剂量组。模型组及补中益气方组应用大黄灌胃的方法建立慢性腹泻大鼠模型。慢性腹泻模型建立成功后,补中益气汤颗粒低剂量:0.4725 g/(kg·d),中剂量:0.945 g/(kg·d),高剂量:1.89 g/(kg·d),正常组和模型组则每天给予等体积的生理盐水灌胃。在治疗结束时,检测各组大鼠一般情况如体质量、饮食量、悬空拉尾抵抗实验、免疫指标(胸腺指数、脾脏指数)变化和24小时粪便含水量。进一步探讨机制,采用离体张力测定灌流系统,测定各组大鼠结肠纵行平滑肌肌条收缩力(colonic longitudinal smooth muscle strips,CLSMs)和结肠环型平滑肌肌条(colonic circular smooth muscle strips,CCSMs)的变化,并蛋白印迹法测定磷酸化肌球蛋白轻链(phosphorylation level of myosin light chain,p-MLC_(20))水平及实时荧光定量PCR法检测大鼠结肠组织肌球蛋白轻链激酶(myosin light chain kinase,MLCK)的表达。结果各组大鼠一般情况比较有统计学意义(P<0.05),与正常组比较,模型组一般情况表现为(体质量下降:P<0.01;饮食量减少:P<0.01;悬空拉尾抵抗实验时间缩短:P<0.01;胸腺指数降低:P<0.01;脾脏指数降低:P<0.01),与模型组比较,补中益气低、中、高剂量组一般情况明显改善(体质量增加:低剂量:P<0.05,中、高剂量:P<0.01;饮食量增多:低剂量:P<0.05,中、高剂量:P<0.01;悬空拉尾抵抗实验时间延长:低剂量:P<0.05,中、高剂量:P<0.01;胸腺指数升高:P<0.01;脾脏指数升高:P<0.01)。各组大鼠粪便含水量差异有统计学意义(P<0.01),与正常组比较,模型组粪便含水量明显增加(P<0.01),与模型组比较,补中益气中、高剂量组粪便含水量明显下降(P<0.01)。同时,正常组、模型组和补中益气中剂量组大鼠结肠CLSMs和CCSMs收缩差异有统计学意义(P<0.05),与正常组比较,模型组大鼠CLSMs和CCSMs收缩张力、振幅、速率明显增加(P<0.01),与模型组比较,补中益气中剂量组大鼠CLSMs和CCSMs收缩张力、振幅、速率有所下降(P<0.05);三组大鼠结肠p-MLC_(20)含量差异有统计学意义(P<0.05),与正常组比较,模型组大鼠p-MLC_(20)含量明显增加(P<0.01),与模型组比较,补中益气中剂量组大鼠p-MLC_(20)含量明显下降(P<0.01);三组大鼠结肠MLCK的表达差异有统计学意义(P<0.01),与正常组比较,模型组大鼠MLCK的表达升高(P<0.01),与模型组比较,补中益气中剂量组MLCK的表达降低(P<0.01)。结论补中益气方对慢性腹泻大鼠治疗作用可能是通过调节MLCK/p-MLC20通路抑制结肠动力来实现的。