The Effect of Tong Xie Yao Fang on IBS-D Patients and the Association with Level of5-HT and5-HT3Receptors Mrna in Colonic Mucosa
|Keywords||Diarrhea-predominant of irritable bowel syndrome(IBS-D) Tong Xie Yao Fang 5-hydroxy tryptamine(5-HT) 5-hydroxy tryptamine3receptors Pinaverium Bromide|
Objective：1.To evaluate the role of5-HT and5-HT3receptors mRNA incolonic mucosa in the pathogenesis of diarrhea-predominant irritablebowel syndrome(IBS-D) patient.2.To observe both the clinical effects ofTong Xie Yao Fang on threating IBS-D patient and the possible mechanism.Method：We chose70cases as the treatment group，who were diagnosed IBS-D.These patients were randomly divided into Group A (n=35,receiving10gTong Xie Yao Fang granul2times daily for4weeks)and group B(n=35,receiving50mg Pinaverium Bromide3times daily for4weeks).Symptom-scores were evaluated according to the symptoms of quantifiedstandard ratings before and after treatment.Group C(the healthy controlgroup) were35persons.All subjects (before and after treatments)acceptedendoscopy and mucosa samples were taken at sigmoid-rectum junction.Theexpression of5-HT was detected by immunohistochemical staining, and themRNA expression of5-HT3receptor was detected by RT-PCR (reversetranscription-PCR).Results：The expression (the quantity and the staining intensity) of5-HT-positive cells in the group IBS-D were both significantly more thanthose in group C.The mRNA expression of5-HT3receptor in group IBS-D weresignificantly more than that of group C. The relationshiop between singlesymptom score, total symptom score and the expression of5-HT and5-HT3receptors mRNA in colonic mucosa of IBS-D patients were significantlypositive, respectively. The cure-markedly effective rate(62.86%)andthe total effective rate(80.00%) of group A had no statistic differencefrom those of group B（51.43%,77.14%）.The expression of5-HT-positive cells in group A after treatment were markedly less compared with thosebefore treatment,but there was no significant difference between groupA and group B.The mRNA expression of5-HT3receptors of group A aftertreatment were significantly less compared with that before treatment,butthere was no significant difference between group A and group B.Conclusion： The expressions of5-HT and5-HT3receptors mRNA in colonicmucosa may be involved in the pathogenesis of IBS-D, and there is anassociation between the expression of5-HT and5-HT3receptors. Tong XieYao Fang is effective to treat IBS-D patients,and the effect may owe toits regulation of the expression of5-HT and5-HT3receptors mRNA incolonic mucosa.