肠吉安口服液对肝脾不和腹泻型肠易激综合征患者痛觉功能区激活信号变化幅度的影响

Effect of Changji’an Oral Liquid on Activated Signal Alterative Intensity in Algesthesia Domain in Patients with Diarrhea Type Irritable Bowel Syndrome due to Gan-Pi Disharmony

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DOI：

中文关键词: 肠吉安口服液肝脾不和腹泻型肠易激综合征功能性磁共振成像痛觉功能区激活信号

英文关键词:Changji’an oral liquid diarrhea type due to Gan-Pi disharmony irritable bowel syndrome functional magnetic resonance imaging active signal in algesthesia domain

基金项目:

作者	单位
沈骏	上海第二医科大学附属瑞金医院上海200025
诸琦	上海第二医科大学附属瑞金医院上海200025
袁耀宗	上海第二医科大学附属瑞金医院上海200025
张仲伟	上海第二医科大学附属瑞金医院上海200025
陈克敏	上海第二医科大学附属瑞金医院上海200025

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中文摘要:

目的观察肝脾不和腹泻型肠易激综合征(IBS)患者用中药复方制剂肠吉安口服液治疗前后脑痛觉功能区激活信号幅度的变化。方法24例肝脾不和腹泻型IBS患者随机分为两组,分别服用肠吉安口服液(治疗组14例)和安慰剂(对照组10例)。对比分析直肠注气试验两组患者的感觉阈值和感觉评分,并应用功能性磁共振成像(f MRI)分析直肠注气30ml、60ml、90ml和120ml时脑痛觉功能区的激活信号变化幅度。结果初始感觉阈值对照组治疗后比治疗前显著下降(P<0·05);排便急迫感阈值、疼痛感阈值治疗组治疗前后比较差异有显著性(P<0·05),且优于对照组P<0·05)。两组治疗前后视觉模拟评分组间比较,在注气30ml时差异无显著性,大于30ml后部分时段差异有显著性(P<0·05);治疗组注气90ml、120ml时大脑痛觉功能区脑岛皮质和注气120ml丘脑激活信号变化幅度显著减少(P<0·05),而对照组治疗前后大脑痛觉功能区激活信号变化幅度未见显著改变。结论肠吉安口服液对肝脾不和腹泻型IBS的治疗作用可能是通过调节减少颅内痛觉功能区脑岛皮质和丘脑激活信号变化幅度产生。

英文摘要:

Objective To observe the effect of Changji’an (CJA) oral liquid on the activated signal alterative intensity (ASAI) in intracranial algesthesia domain in patients with diarrhea type irritable bowel syndrome (IBS) due to Gan-Pi disharmony. Methods Twenty-four patients were randomly divided into 2 groups, 14 in the treated group and 10 in the control group, they were administrated with CJA and placebo respectively. The sensory threshold and score in the two groups recorded by rectal inflation test were compared and analyzed. The change of ASAI in intracranial algesthesia domain was analyzed by functional magnetic resonance imagine (fMRI) during rectum being inflated with 30 ml, 60 ml, 90 ml and 120 ml of gas respectively. Results The initial sensory thresholds in the two groups were insignificantly different, but significant difference did show between the two groups in urgent defecation threshold and pain threshold after treatment (P<0.05). Comparison in visual simulative scores between the two groups after treatment at rectal inflated for 30 ml showed no significant difference, but it showed significant difference when the inflation was over 30 ml(P<0.05). In the treated group, the ASAI in insula cortex when rectal inflation being 90 ml or 120 ml and that in thalamus when rectal inflation being 120 ml were significantly decreased (P<0.05). But in the control group, it changed insignificantly after treatment. Conclusion The treatment of CJA on Gan-Pi disharmony caused diarrhea type IBS might be effected by regulating the ASAI in intracranial insula cortex and thalamus.

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