Jianqu,a traditional Chinese medicine,alleviates functional dyspepsia in high-calorie and high-protein diet mice

Background:Jianqu has been used to alleviate symptoms in patients with functional dyspepsia,but its specific anti-functional dyspepsia effect is still unclear.Therefore,our study aimed to investigate the impact of Jianqu on functional dyspepsia in mice.Methods:The phytochemical profile of Jianqu was analyzed by UPLC-Q-TOF-MS.Subsequently,Kunming mice were fed a high-calorie or high-protein diet(HCHP)for 7 days,and then orally treated with vehicle or Jianqu(1.62 g/kg body weight(b.w.)and 3.25 g/kg b.w.)for 10 days.A carbon powder solution was used to detect the gastric emptying and intestinal transit rate.The pathological changes in stomach and duodenum were evaluated by hematoxylin-eosin staining.The occludin,claudin-1,ZO-1 and CD45 expression was measured by immunocytochemical staining.Importantly,the serum gastrointestinal hormones were detected by ELISA.In addition,the gut microbiota composition was determined using 16S rRNA gene sequencing.The cecal short chain fatty acids were assessed by gas chromatography.Results:In general,17 phytochemical compounds were identified from Jianqu,which significantly improved the gastric emptying rate and intestinal transit rate(p<0.01),increased the body weight and food intake(p<0.0001)in HCHP mice as well.Though HCHP did not cause significant pathological lesions in the gastrointestinal tract,increased the expression of CD45 in the duodenum(p<0.05)was observed.Notably,Jianqu attenuated this abnormal expression of CD45(p<0.05).The levels of serum gastrointestinal hormones were significantly normalized by Jianqu intervention(p<0.05).Moreover,Jianqu increased the relative abundance of Roseburia as well as short chain fatty acids levels in cecum(p<0.05).Conclusion:The present results showed that Jianqu alleviated dyspeptic symptoms in HCHP mice possibly through reducing the duodenal leukocyte infiltration,and regulating the expression of gastrointestinal hormones.These effects may be partly related to the increasing cecal short chain fatty acids levels probably via gut microbial modulation.

Yield of alarm features in predicting significant endoscopic findings among hospitalized patients with dyspepsia

BACKGROUND Dyspepsia is a very prevalent upper gastrointestinal tract symptoms complex.Some of these symptoms might arise from serious underlying diseases,so the promotion of evidence-based guidelines could potentially better align evaluation and treatment.AIM To determine the value of alarm features as a predictive factor for significant endoscopic findings(SEFs)among hospitalized patients presenting with dyspepsia.METHODS We conducted a retrospective case-control study including information about 6208 endoscopic procedures performed for hospitalized patients.Patients were divided into two groups,with and without SEFs,and compared to elucidate the ability of the different alarm features to predict SEFs.RESULTS During the study,605 patients fulfilled the inclusion criteria.When the demographics and clinical characteristics of the two groups were compared,tachycardia(P<0.05),normocytic anemia,(P<0.05),leukocytosis(P<0.05),and hypoalbuminemia(P<0.05)documented on admission prior to endoscopy were strong predictors of SEFs.Among the alarm features,upper gastrointestinal bleeding,persistent vomiting,odynophagia[odds ratio(OR)=3.81,P<0.05;OR=1.75,P=0.03;and OR=7.81,P=0.07,respectively]were associated with SEFs.Unexplained weight loss was strongly associated with malignancy as an endoscopic finding(OR=2.05;P<0.05).In addition,long-term use of anti-aggregate medications other than aspirin(P<0.05)was correlated to SEFs.CONCLUSION Novel predictors of SEFs were elucidated in this study.These parameters could be used as an adjunctive in decision making regarding performing upper endoscopy in hospitalized patients with dyspepsia.

The Therapeutic Effect of Biling Weitong Granules Combined with Oryz-Aspergillus Enzyme and Pancreatin Tablet on Reflux Esophagitis with Functional Dyspepsia

Objective:To investigate the therapeutic effect of Biling Weitong Granules combined with oryz-aspergillus enzyme and pancreatin tablets on patients with reflux esophagitis with functional dyspepsia.Methods:Sixty patients diagnosed with reflux esophagitis with functional dyspepsia who were admitted to the Affiliated Hospital of Hebei University between June 2020 and June 2023 were selected and divided into two groups:the control group and the observation group,each consisting of 30 cases.The control group received oryz-aspergillus enzyme and pancreatin tablets only,while the observation group received Biling Weitong Granules in addition to the tablets.The clinical efficacy,Chinese medicine syndrome points,esophageal kinetic indexes,gastrointestinal hormone levels,and therapeutic safety of both groups were evaluated.Results:The total efficiency of the observation group reached 93.33%,significantly higher than the 73.33%of the control group(P<0.05).After treatment,patients in the observation group exhibited significantly lower scores for Chinese medicine symptoms such as early satiety,belching,abdominal distension,abdominal pain,and loss of appetite compared to the control group(P<0.05).Furthermore,the observation group showed significantly higher upper esophageal sphincter pressure,lower esophageal sphincter pressure,and distal esophageal contraction scores compared to the control group(P<0.05).Additionally,levels of gastric motility hormone,vasoactive intestinal peptide,and gastrin were significantly higher in the observation group compared to the control group(P<0.05).Throughout the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups,indicating comparable safety of the two treatment modalities(P>0.05).Conclusion:The combination of Biling Weitong Granules with oryz-aspergillus enzyme and pancreatin tablets demonstrates significant efficacy in the treatment of reflux esophagitis with functional dyspepsia,with a better safety profile.This finding warrants further clinical promotion.

Paradoxical association between dyspepsia and autoimmune chronic atrophic gastritis:Insights into mechanisms,pathophysiology,and treatment options

BACKGROUND Autoimmune gastritis(AIG)is a progressive,chronic,immune-mediated inflammatory disease characterized by the destruction of gastric parietal cells leading to hypo/anacidity and loss of intrinsic factor.Gastrointestinal symptoms such as dyspepsia and early satiety are very common,being second in terms of frequency only to anemia,which is the most typical feature of AIG.AIM To address both well-established and more innovative information and knowledge about this challenging disorder.METHODS An extensive bibliographical search was performed in PubMed to identify guidelines and primary literature(retrospective and prospective studies,systematic reviews,case series)published in the last 10 years.RESULTS A total of 125 records were reviewed and 80 were defined as fulfilling the criteria.CONCLUSION AIG can cause a range of clinical manifestations,including dyspepsia.The pathophysiology of dyspepsia in AIG is complex and involves changes in acid secretion,gastric motility,hormone signaling,and gut microbiota,among other factors.Managing dyspeptic symptoms of AIG is challenging and there are no specific therapies targeting dyspepsia in AIG.While proton pump inhibitors are commonly used to treat dyspepsia and gastroesophageal reflux disease,they may not be appropriate for AIG.Prokinetic agents,antidepressant drugs,and non-pharmacological treatments may be of help,even if not adequately evidence-based supported.A multidisciplinary approach for the management of dyspepsia in AIG is recommended,and further research is needed to develop and validate more effective therapies for dyspepsia.

A Clinical Study of Integrated Traditional Chinese and Western Medicine in the Treatment of Liver-Stomach Disharmony Functional Dyspepsia

Objective:To explore the clinical effect of integrated traditional Chinese and Western medicine in the treatment of liver-stomach disharmony functional dyspepsia.Methods:Sixty patients with functional dyspepsia of liver-stomach disharmony type admitted to our hospital from January to August 2022 were selected as research subjects and randomly divided into two groups,a study group and a control group,with 30 cases in each group.The main observations were stomachache or pain over bilateral flanks,emotionally depressed,belching,fullness and discomfort over the abdomen and flanks,acid regurgitation,loss of appetite,frequent sighing,noisy epigastric,and the treatment effect.Results:According to the classification of symptom severity on the traditional Chinese medicine(TCM)symptom score table,statistics were made on the corresponding severity of the main symptoms and secondary symptoms of the two groups of patients,and the data of the two groups were compared by Wilcoxon test.The results showed that there was no significant difference in the distribution of TCM symptoms between the two groups;the study group’s total effective rate of pain relief(recovery+markedly effective+effective)was 96.67%,and Fisher’s χ^(2) test indicated a significant difference in the total effective rate of pain relief between the two groups(P=0.027<0.05).Conclusion:The use of integrated traditional Chinese and western medicine is clearly better than the simple application of western medicine.It is safe and has no side effects.It can be used as a treatment for patients with functional dyspepsia.

奥美拉唑联合不同益生菌调节肠道菌群减轻小儿功能性消化不良

目的 探讨奥美拉唑联合不同益生菌调节肠道菌群减轻小儿功能性消化不良(FD)的作用。方法 选取佛山市妇幼保健院儿科2022年1月至2023年2月收治的200例FD患儿为研究对象,随机分为奥美拉唑组,奥美拉唑分别联合布拉氏酵母菌散组、酪酸梭菌二联活菌组和双歧杆菌四联活菌片组。治疗2周,对比各组患儿血清炎性因子、胃肠激素、肠道菌群、症状评分等指标变化。统计各组临床疗效及治疗期间不良反应发生率。结果 治疗后各组血清IL-6、TNF-α、IL-1β、超敏C反应蛋白(hs-CRP)、血管活性肠肽(VIP)、生长抑素(SS)水平、肠杆菌、肠球菌较治疗前显著下降(P<0.05),3个联合治疗组显著低于奥美拉唑组(P<0.05);治疗后各组血清胃动素(MOT)水平、双歧杆菌、乳杆菌显著升高(P<0.05),3个联合治疗组显著高于奥美拉唑组(P<0.05);治疗后各组症状评分较治疗前显著降低(P<0.05),3个联合治疗组显著低于奥美拉唑组(P<0.05);各组治疗期间不良反应发生率比较差异无统计学意义。结论 奥美拉唑联合不同益生菌在治疗小儿FD中均取得良好效果。

Study of the potential mechanism of acupuncture treatment for functional dyspepsia based on association rule mining and bioinformatics/network pharmacology approach

Objective:To explore the main acupoint prescription and mechanism of acupuncture in treating Functional dyspepsia(FD)by analyzing the clinical randomized controlled trial literature on acupoints and targets of acupuncture in the treatment of FD combined with association rule mining and bioinformatics/network pharmacology methods.Methods:Search relevant clinical randomized controlled trial literature on acupoints and therapeutic targets of acupuncture in the treatment of FD from eight databases from their inception to June 18th,2022.We obtained acupuncture selection points,meridian,and therapeutic targets and established acupoints database for acupuncture treatment of FD.FD-related targets were collected from GeneCards,DisGeNET,OMIM,and DrugBank databases.We obtained the potential targets of acupuncture on FD by taking the intersection of acupuncture for FD therapeutic targets and FD-related targets.We performed the protein-protein interaction network,Gene Ontology(GO)analysis,and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis.Results:In this study,26 Randomized Controlled Trials related to acupuncture treatment of FD were retrieved.We obtained 29 acupoints,17 acupuncture for FD therapeutic targets,and 10 intersection targets.Tumor necrosis factor(TNF),Interleukin(IL)-1,and Neuropeptide Y(NPY)are key targets of acupuncture in the treatment of FD.Conclusion:ST36-CV12-PC6-LR3 is the main acupoint prescription for FD.Acupuncture may affect Neuroactive ligand-receptor interaction,Gastric acid secretion,and IL-17,TNF signaling pathways by regulating related key targets,and play a synergistic role in the treatment of FD by inhibiting gastric acid secretion,alleviating inflammatory response,regulating the brain-gut axis,improving mood and other aspects.

子午流注纳子法穴位贴敷联合穴位药熨治疗脾胃虚寒型功能性消化不良临床观察

目的观察子午流注纳子法穴位贴敷联合穴位药熨治疗脾胃虚寒型功能性消化不良(FD)的临床疗效。方法将120例脾胃虚寒型FD患者按照随机数字表法分为2组,治疗组60例予子午流注纳子法穴位贴敷联合穴位药熨治疗,对照组60例予多潘立酮片治疗,2组均治疗28天。比较2组疗效;比较2组治疗前后主要症状评分变化;比较2组治疗前后焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分变化。结果治疗组总有效率96.67%(58/60),对照组总有效率76.67%(46/60),治疗组疗效优于对照组(P<0.05)。2组治疗后各项主要症状评分及总积分均较本组治疗前降低(P<0.05),治疗后治疗组各项主要症状评分及总积分均低于对照组(P<0.05)。2组治疗后SAS评分、SDS评分均较本组治疗前降低(P<0.05),治疗后治疗组SAS评分、SDS评分均低于对照组(P<0.05)。结论子午流注纳子法穴位贴敷联合穴位药熨治疗脾胃虚寒型FD疗效显著,可改善患者主要症状及焦虑、抑郁状态。

中医推拿按摩结合五行健脾汤治疗小儿功能性消化不良临床疗效

目的:观察中医推拿按摩结合五行健脾汤加减化裁治疗小儿功能性消化不良(FD)的效果及对胃肠动力的影响。方法:选取南阳市第一人民医院2020年10月至2023年2月期间收治的125例FD患儿,以随机数字表法对其进行分组,分别列为中医组(63例)和西医组(62例)。中医组患儿实施推拿按摩结合五行健脾汤加减化裁治疗,西医组患儿实施常规西医治疗,比较两组患儿治疗前后的中医证候积分,胃动力参数,胃肠激素水平变化情况,及治疗后的不良反应发生情况。结果:治疗后中医组患儿的中医主证、次证积分均低于西医组,差异具有统计学意义(P<0.05)。治疗后中医组患儿的胃窦收缩幅度、胃窦收缩频率、胃窦运动指数(MI)均高于西医组,差异具有统计学意义(P<0.05)。治疗后中医组患儿的血清胃泌素(GAS)、生长抑素(SS)水平均低于西医组,胃动素(MLT)水平高于西医组,差异具有统计学意义(P<0.05)。中医组患儿的不良反应发生率为6.35%(4/63),低于西医组的17.74%(11/62),差异具有统计学意义(P<0.05)。结论:中医推拿按摩结合五行健脾汤加减化裁能有效改善FD患儿胃肠功能并促进胃肠动力恢复,且与常规西药相比,上述中医疗法所致不良反应发生率低,治疗安全性更高。

越鞠丸干预CUMS小鼠对抑郁样行为、功能性消化不良及PACAP/PAC1-R表达的影响

目的探讨越鞠丸对抑郁共病功能性消化不良小鼠抑郁样行为和胃肠功能的影响。方法将C57BL/6J小鼠随机分为对照组、模型组、越鞠丸低剂量组、越鞠丸高剂量组和阳性药组,采用慢性不可预知温和应激(CUMS)构建共病模型,通过行为学检测、尼氏染色评估小鼠抑郁样行为和神经元损伤;胃肠组织病理、胃排空率、小肠推进率评估胃肠功能;ELISA法检测PACAP、VIP、IL-6、TNF-α、BDNF表达;Western blot检测PAC1-R、Vipr1、Vipr2蛋白表达。结果模型组小鼠表现出抑郁样行为,海马尼氏体数量减少,胃肠运动减慢,血清炎症因子IL-6、TNF-α水平升高(P<0.05,P<0.01),PACAP、VIP、BDNF表达降低(P<0.05,P<0.01),海马、胃窦、十二指肠组织PAC1-R、Vipr1、Vipr2表达降低(P<0.05,P<0.01)。与模型组比较,越鞠丸低、高剂量组可改善除Vipr1、Vipr2之外的其他上述指标(P<0.05,P<0.01)。结论越鞠丸可通过PACAP/PAC1-R降低炎症因子,升高BDNF水平,改善CUMS小鼠抑郁样行为和功能性消化不良。

以脉调气理论指导下的脏腑推拿治疗小儿功能性消化不良疗效研究

目的探究以脉调气理论指导下的脏腑推拿治疗小儿功能性消化不良的疗效研究。方法采用随机数字表法将黑龙江中医药大学附属第一医院治未病中心2020年2月—2022年2月收治的106例功能性消化不良患儿分为观察组(53例)与对照组(53例)。对照组采用一般推拿治疗,观察组在此基础上采用“以脉调气”理论指导下的脏腑推拿治疗方法。观察两组患儿治疗前以及治疗20 d后的中医症状积分、血锌浓度水平、胃动素、胃泌素、食欲调节因子水平、尼平消化不良指数。观察两组患儿临床疗效与复发率。结果两组患儿治疗前食后腹胀、纳呆食少、大便异常和面色萎黄的证候积分对比差异无统计学意义(P>0.05)。治疗20 d后观察组食后腹胀、食少纳呆、面色萎黄和大便异常证候积分显著低于对照组(P<0.05)。两组患儿治疗前胃动素、血锌含量、胃泌素水差异无统计学意义(P>0.05)。治疗20 d后观察组胃动素、血锌含量、胃泌素水平显著高于对照组(P<0.05)。两组患儿治疗前Ghrelin、NPY和Leptin水平差异无统计学意义(P>0.05)。治疗20 d后观察组NPY、Ghrelin浓度水平明显较对照组高,而Leptin水平明显较对照组低(P<0.05)。两组患儿治疗前NDI评分差异无统计学意义(P>0.05)。治疗20 d后观察组NDI评分显著低于对照组(P<0.05)。观察组总有效率为90.57%(48/53),显著高于对照组[75.47%(40/53)](χ^(2)=4.283,P=0.039)。观察组复发率为3.77%(2/53)(40/53)略低于对照组9.43%(5/53),但两组复发率差异无统计学意义(χ^(2)=1.377,P=0.241)。结论“以脉调气”理论指导下的脏腑推拿能有效提高临床疗效、提升食欲、调节因子水平、提高生活质量、改善胃动素、血锌含量、胃泌素水平,值得临床推广。

基于网络药理学的柴胡-枳壳配伍治疗功能性消化不良的机制研究

目的基于网络药理学筛选柴胡-枳壳配伍治疗功能性消化不良(FD)的机制。方法通过TCMSP平台收集柴胡、枳壳的成分及靶点。通过GeneCards数据库收集FD的基因,使用STRING 11.0数据库进行分析。结果共获得柴胡成分349个、枳壳17个。FD疾病相关基因1561个,药物与疾病共有的靶点为59个。蛋白互作(PPI)网络发现VEGFA、MAPK8、EGFR等可能是柴胡-枳壳配伍治疗FD的关键靶点。涉及PI3K-AKT、AGE-RAGE、HIF-1等经典信号通路。结论柴胡-枳壳配伍治疗FD具有多途径、多靶点作用的特点,为接下来的实验验证提供了参考和依据。

张照兰从燮理肝脾论治功能性消化不良经验介绍

介绍张照兰主任医师从燮理肝脾论治功能性消化不良的临床经验。痞满病机虚实夹杂,病位在胃,与肝脾密切相关,肝失疏泄、脾失健运,脾胃气机升降失常。张照兰以“燮理肝脾”为思路,提出“厚土气,挑萌芽,通气路”的治法,创立燮肝理脾消痞方,通过灵活化裁,联合非药物处方,取得良好效果。

气滞胃痛颗粒对伴幽门螺杆菌感染功能性消化不良患者幽门螺杆菌清除率、胃肠动力的影响

目的探究气滞胃痛颗粒对伴幽门螺杆菌(Hp)感染功能性消化不良(FD)患者Hp清除率、胃肠动力的影响,以指导临床治疗措施拟定,促使伴Hp感染FD患者临床获益。方法选取2023年1月至6月赣州市人民医院接收的100例伴Hp感染FD患者作为研究对象,按随机数字表法分为对照组和观察组,每组各50例。对照组行常规西医治疗,观察组在此基础上加用气滞胃痛颗粒。评估两组疗效,统计两组Hp清除率,比较两组治疗前后的胃肠动力指标,对两组治疗期间不良反应进行统计。结果观察组总有效率、Hp清除率高于对照组,差异有统计学意义(P<0.05)。治疗4周,观察组瘦素、胃动素以及血清胃泌素均高于对照组,促肾上腺皮质激素释放激素(CRH)低于对照组,差异有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论在常规西药治疗基础上使用气滞胃痛颗粒可提高伴Hp感染FD患者的Hp清除率,改善其胃肠动力,疗效显著,且不会增加不良反应。

基于信息-动机-行为技巧模型的护理干预对功能性消化不良患者心理状态及胃肠动力的影响

目的分析基于信息-动机-行为技巧(IMB)模型的护理干预对功能性消化不良患者的作用。方法选取2022年12月—2023年6月新乡医学院第一附属医院收治的160例功能性消化不良患者为研究对象,根据随机数字表法将其分为对照组和观察组,每组80例。对照组患者应用常规护理干预,观察组患者在对照组基础上应用基于IMB模型的护理干预。比较2组患者干预前后心理状态、胃肠动力及生活质量情况。结果干预后,2组患者汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)评分均有所下降,且观察组低于对照组,差异有统计学意义(P<0.05)。干预后,2组患者胃肠激素一氧化氮(NO)、血清胃动素(MTL)和血清胃泌素(GAS)水平均有所改善,观察组各指标水平均优于对照组,差异有统计学意义(P<0.05)。干预后,2组患者胃肠道生活质量指数(GIQLI)评分均有所提高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论基于IMB模型的护理干预有利于缓解功能性消化不良患者的焦虑、抑郁情绪,能有效增强患者胃肠动力及活力,提高患者生活质量。

调中健脾汤对脾虚气滞型功能性消化不良患者胃排空功能及脑肠轴相关因子的影响

目的探讨调中健脾汤对脾虚气滞型功能性消化不良(FD)患者胃排空功能及脑肠轴相关因子的影响。方法选择2021年1月至2022年12月收治的84例脾虚气滞型FD患者,根据随机数字表法将其分为对照组和研究组,各42例。对照组口服多潘立酮片治疗,研究组联合应用调中健脾汤治疗。比较两组的治疗效果。结果研究组的治疗总有效率明显高于对照组(P<0.05)。治疗后,两组的餐后1 h胃排空率、餐后2 h胃排空率及胃窦收缩率均明显高于治疗前,胃半排空时间明显短于治疗前,且研究组优于对照组(P<0.05)。治疗后,两组的神经肽S受体1(NPSR1)、胃促生长素(Ghrelin)与胃动素(MTL)水平明显高于治疗前,降钙素基因相关肽(CGRP)、P物质(SP)、血管活性肠肽(VIP)及八肽胆囊收缩素(CCK8)水平明显低于治疗前,且研究组优于对照组(P<0.05)。研究组的复发率显著低于对照组(P<0.05);治疗后,两组的生活质量评分均明显低于治疗前,且研究组低于对照组(P<0.05)。结论调中健脾汤可有效缓解脾虚气滞型FD患者的临床症状,调节脑肠轴相关因子水平,改善胃排空功能及生活质量,并降低复发率。

四磨汤对肝脾气滞型功能性消化不良大鼠胃肠动力的影响

目的观察四磨汤对肝脾气滞型功能性消化不良(FD)大鼠血管活性肠肽(VIP)及其受体2(VIPR2)表达的影响,探讨其调节胃肠动力的作用机制。方法60只SD大鼠随机分为空白组、模型组、莫沙必利组(0.305mg/kg)和四磨汤高、中、低剂量组(5.62、2.81、1.40g/kg),采用多因素造模法制备肝脾气滞型FD大鼠模型,各给药组分别予相应药物灌胃14d。观察大鼠一般情况,测定体质量、胃排空率和小肠推进率,HE染色观察胃窦和十二指肠组织形态,免疫组化染色检测十二指肠组织VIP、VIPR2阳性表达,Westernblot、RT-PCR分别检测十二指肠组织VIP、VIPR2蛋白和mRNA表达。结果与空白组比较,模型组大鼠一般状况较差,体质量、胃排空率和小肠推进率均显著降低(P<0.01),十二指肠组织VIP、VIPR2蛋白和mRNA表达均显著升高(P<0.05,P<0.01);与模型组比较,四磨汤高、中剂量组和莫沙必利组大鼠体质量、胃排空率和小肠推进率均显著升高(P<0.05,P<0.01),十二指肠组织VIP、VIPR2蛋白和mRNA表达均显著降低(P<0.05,P<0.01)。HE染色显示,胃窦和十二指肠组织形态未发生明显改变。结论四磨汤可能通过抑制肝脾气滞型FD大鼠十二指肠组织VIP、VIPR2表达促进胃肠动力,从而改善FD。

半夏泻心汤对功能性消化不良大鼠抑郁状态及促肾上腺皮质激素释放因子相关通路的影响

目的:观察半夏泻心汤对功能性消化不良(FD)大鼠抑郁样行为、下丘脑促肾上腺皮质激素释放因子(CRF)及其受体CRF-R1、CRF-R2的影响。方法:48只SPF级Wistar大鼠随机分为空白组、模型组、氟西汀组、半夏泻心汤低、中、高剂量组,共六组,每组各8只。空白组正常饲养,其余五组采用不规则喂养+夹尾激惹刺激法造模,造模成功后半夏泻心汤低、中、高各剂量组分别给予0.62、1.24、2.48 g/ml剂量灌胃,氟西汀组给予2 mg/kg氟西汀,空白组及模型组均给予同等容积的蒸馏水,各组连续灌胃14 d。干预结束后采用糖水偏好实验和旷场实验测试各组抑郁样行为;HE染色观察大鼠胃窦组织基本形态;RT-qPCR和Western blot检测大鼠下丘脑中CRF、CRF-R1和CRF-R2 mRNA和蛋白的表达。结果:与空白组比较,模型组大鼠体重、糖水偏好度、旷场实验移动总距离和直立次数均明显下降(P<0.05);下丘脑中CRF、CRF-R1 mRNA和蛋白表达均明显升高(P<0.01),CRF-R2 mRNA和蛋白的表达均明显降低(P<0.01)。与模型组比较,半夏泻心汤各剂量组大鼠的体重、糖水偏好度、旷场实验移动总距离和直立次数均明显增加(P<0.05);半夏泻心汤各剂量组FD大鼠下丘脑中CRF、CRF-R1 mRNA的表达量均明显降低(P<0.01),CRF-R2 mRNA的表达明显升高;半夏泻心汤高剂量组FD大鼠下丘脑中CRF蛋白表达均明显降低(P<0.01),半夏泻心汤各剂量组FD大鼠下丘脑中CRF-R1蛋白表达明显降低(P<0.01),CRF-R2蛋白表达升高(P<0.05)。结论:半夏泻心汤可通过调控CRF通路,恢复CRF-R1和CRF-R2的平衡状态,发挥抗抑郁的作用。

基于下丘脑-垂体-肾上腺轴探讨电针对功能性消化不良大鼠的作用机制

目的探讨电针印堂、内关、足三里对FD大鼠下丘脑-垂体-肾上腺轴的可能作用机制。方法40只SD大鼠随机分为空白组、模型组和电针组。采用夹尾、不规律饮食以及冰生理盐水灌胃法复制FD模型。造模后,电针组行针刺干预,每天1次,每次30 min,连续14天。记录大鼠的一般状态;旷场实验检测大鼠的自主行为及紧张度;HE染色法观察大鼠胃黏膜形态及炎症反应;实时荧光定量PCR法检测大鼠下丘脑5-羟色胺3受体(5-HT3R)、促肾上腺皮质激素释放激素(CRH)的表达;蛋白免疫印迹法检测大鼠十二指肠促肾上腺皮质激素释放激素受体2(CRHR2)、NOD样受体蛋白6(NLRP6)蛋白表达;阿利新蓝染色观察大鼠十二指肠黏膜上皮形态及杯状细胞的阳性表达。结果与空白组相比,模型组大鼠一般状态、旷场自主运动距离、运动速度、十二指肠CRHR2、NLRP6蛋白均大幅下降(P<0.05),下丘脑5-HT3R、CRH mRNA明显升高(P<0.05)。与模型组相比,电针组大鼠一般状态、旷场自主运动距离、运动速度、十二指肠CRHR2、NLRP6蛋白及杯状细胞的表达均明显提高(P<0.05),下丘脑5-HT3R、CRH mRNA大幅下降(P<0.05)。模型组大鼠胃黏膜可见疏松的结缔组织,黏膜下层轻度水肿,淋巴细胞增生;空白组和电针组大鼠胃黏膜结缔组织排列紧密,胃腺间质无明显增生,未见炎症细胞。结论电针印堂、内关、足三里可能是通过提升十二指肠CRHR2、NLRP6蛋白和杯状细胞表达,抑制下丘脑5-HT3R、CRH的表达,来提高FD大鼠自主运动水平,缓解焦虑,修复缺损的肠道黏膜屏障,恢复下丘脑-垂体-肾上腺轴的正常功能。

保和丸配合针刺治疗功能性消化不良疗效观察

目的:观察保和丸配合针刺治疗功能性消化不良的疗效。方法:60例随机分成观察组和对照组。对照组用枸橼酸莫沙必利片治疗,观察组用保和丸及针刺治疗。结果:总有效率观察组高于对照组(P<0.05)。结论:保和丸配合针刺治疗功能性消化不良效果较好。