整肠宁治疗肠易激综合征86例临床研究

目的 :观察整肠宁治疗肠易激综合征的临床疗效。方法 :应用整肠宁治疗肠易激综合征 86例 ,并与 5 2例应用补脾益肠丸治疗者作对照。结果 :总有效率分别为 94.16 %、73.0 8% ,对腹泻、腹痛、腹胀、肠鸣、纳呆、乏力、失眠等症状的有效率分别为 93.0 2 %、73.0 8% ;89.88%、74.47% ;92 .86 %、6 5 .85 % ;92 .31%、 72 .2 7% ;98.11%、 80 .77% ;84.0 9、45 .83% ;73.91%、35 .71%。结论 :整肠宁对肠易激综合征有较好疗效     

肠道微生态与肠道疾病

人类肠道微生态是一个包含大量肠道微生物的复杂生态系统,近年来研究发现肠道细菌过度繁殖可导致胃肠道动力失调及内脏神经敏感性改变,最终导致肠易激综合征的发生,而肠道菌群引起的肠粘膜异常免疫应答损伤被认为是炎症性肠病发病机制的关键所在,另外,肠道微生态还可过参与炎症性肠病的病理生理过程或直接代谢产生致癌物质影响肠道肿瘤的发生发展。由此我们发现,肠道微生态不仅参与了消化吸收、物质代谢等胃肠道基本生理过程,还直接关系到肠道疾病的发生。本文将就目前肠道微生态与肠道疾病的研究进展进行简单综述。     

Inhibitory effects of Geijigajakyak-Tang on trinitrobenzene sulfonic acid-induced colitis

Aim of the study

Water extract of Geijigajakyak-Tang (GJT) consisting of five crude drugs [dried root of P. lactiflora Peony (Paeoniaceae), dried trunk bark of C. cassia Blume (Lauraceae), seed of Z. jujube var. inermis Mill (Rhamnaceae), fresh root of Z. officinale Rocoe (Zingiberaceae) and dried trunk bark of G. uralensis Fish (Leguminosae)] is a folk medicine used for the treatment of chronic colitis. This study was designed to further elucidate the effect of GJT on 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis in rats.

Materials and methods

GJT orally given to mice before and after TNBS intoxication, and their clinical and morphological changes, myeloperoxidase (MPO) activity and malondialdehyde (MDA) levels in colon tissues, were evaluated on Day 8 post-TNBS. Furthermore, the effect of six major constituents of individual herbs on ileum smooth muscle contraction and neutrophil chemotaxis was studied.

Results

GJT had a significant anti-inflammatory effect based on clinical and morphologic changes, MPO activity and MDA levels in colon tissues as compared with sham control. GJT and 5 major active constituents of individual herbs, paeoniflorin, cinnamaldehyde, jujuboside A, jujubogenin, and diammonium glycyrhhizinate significantly inhibited neutrophil chemotaxis. GJT significantly inhibited muscle contraction (IC₅₀; 2.10 ± 0.11 mg/ml), and 1,8-cineol has the most spasmolytic activity (IC₅₀; 0.10 ± 0.03 mg/ml).

Conclusion

GJT has significant anti-inflammatory effects on TNBS-induced colitis via inhibitions of smooth muscle contraction and neutrophil chemotaxis.     

Efficacy of FODMAP Elimination and Subsequent Blinded Placebo-Controlled Provocations in a Randomised Controlled Study in Patients with Ulcerative Colitis in Remission and Symptoms of Irritable Bowel Syndrome: A Feasibility Study

Background: Patients with inflammatory bowel disease (IBD) and symptoms of irritable bowel syndrome (IBS) may be intolerant to fermentable carbohydrates (FODMAPs). The aim of this study was to test the feasibility of eliminating and subsequently reintroducing FODMAPs in patients with IBS symptoms as part of the IBD manifestation and to compare the severity of IBS symptoms and pain, bloating and quality of life (QoL). Methods: An eight-week randomised open-label FODMAP elimination with double-blinded, crossover provocations of FODMAP and placebo. Diet patients were on a low-FODMAP diet for eight weeks with blinded two-week provocations after two and six weeks. Questionnaires, blood and stool samples were collected. Results: Patient enrolment was challenging. Nineteen participants were included in the study. Eliminating low FODMAP for two weeks resulted in significant decreases in pain and bloating scores (p < 0.003), whereas there were no statistical differences in pain scores between diet patients and controls. Pain and bloating scores increased, returning to baseline levels after two weeks of double-blinded provocations with placebo, (p > 0.05). Conclusions: The results document the possibility of performing a randomised controlled study following the gold standard for testing food intolerance with blinding of the Low FODMAP diet. Recruitment of participants was challenging.