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Zhen Ci Yan Jiu = Acupuncture Research Jan 2023To observe the clinical efficacy of shuanggu yitong acupuncture therapy (the therapy for both replenishment and unblocking) combined with domperidone on diabetic...
OBJECTIVE
To observe the clinical efficacy of shuanggu yitong acupuncture therapy (the therapy for both replenishment and unblocking) combined with domperidone on diabetic gastroparesis (DGP) of liver stagnation and spleen deficiency pattern and explore its effect mechanism.
METHODS
DGP patients differentiated as liver stagnation and spleen deficiency pattern were divided into a control group (=42) and an observation group (=42) according to the random number table. The patients in the control group took domperidone tablets orally, 10 mg each time, 3 times a day for 28 days. In the observation group, on the base of the treatment as the control group, acupuncture therapy was applied to Baihui (GV20), Shenting (GV24), Zhongwan (CV12), bilateral Zusanli (ST36), Hegu (LI4)and Taichong (LR3), stimulated for 30 min in each treatment. Acupuncture was given once daily, 3 times a weeks for 28 days consecutively. Fasting blood glucose (FBG), 2-hour postprandial blood glucose (2 h PBG) and glycosylated hemoglobin (HbA1c) were detected before and after treatment in the patients of two groups separately. The score of symptom severity index of gastroparesis (GCSI), traditional Chinese medicine (TCM) syndrome score and gastric emptying rate were assessed in the patients of two groups. Using ELISA, radioimmunoassay and colorimentry methods, the contents of motilin in plasma, gastrin, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β) and interferon-gamma (INF-γ) in serum, as well as the activity of superoxide dismutase (SOD), reactive oxygen species (ROS) and malondialdehyde (MDA) in the serum were determined in the two groups. The clinical curative effect was evaluated.
RESULTS
After treatment, the levels of FBG, 2 h PBG and HbA1c, the scores of GCSI and TCM syndrome, the contents of motilin in plasma, gastrin, TNF-α and MDA, as well as the activity of ROS in serum were all reduced when compared with those before treatment in each group (<0.05, <0.01), while gastric emptying rate and SOD activity in the serum were higher than those before treatment (<0.05, <0.01). After treatment, the serological content of INF-γ was lower than that before treatment in the control group (<0.05), and the contents of IL-6 and IL-1β were reduced than those before treatment in the observation group (<0.05). Compared with the control group, the levels of FBG, 2 h PBG and HbA1c, the scores of GCSI and TCM symptoms, the contents of motilin in plasma, gastrin, TNF-α, MDA, IL-6 and IL-1β, and the activity of ROS in serum in the observation group were all lower significantly (<0.05, <0.01), while the SOD activity and gastric emptying rate in the observation group were higher than those in the control group (<0.05, <0.01). The total effective rate was 90.5% (38/42) in the observation group, better than the control group (73.8%, 31/42, <0.05).
CONCLUSION
acupuncture therapy combined with domperidone remarkably relieves the clinical symptoms and improves the gastric emptying rate, effectively reduces motilin and gastrin and regulates oxidative stress and inflammatory responses in the patients with DGP of liver stagnation and spleen deficiency.
Topics: Humans; Gastroparesis; Spleen; Domperidone; Gastrins; Motilin; Reactive Oxygen Species; Tumor Necrosis Factor-alpha; Interleukin-6; Blood Glucose; Glycated Hemoglobin; Acupuncture Therapy; Liver; Superoxide Dismutase; Acupuncture Points; Diabetes Mellitus
PubMed: 36734504
DOI: 10.13702/j.1000-0607.20211215 -
Pharmaceutical Biology Dec 2023L (Rutaceae) (Au) and Blanco (Rutaceae) (Ci) are commonly used as couplet prokinetics and DC. (Umbelliferae) (Bup) is an herbal antidepressant in traditional Chinese...
CONTEXT
L (Rutaceae) (Au) and Blanco (Rutaceae) (Ci) are commonly used as couplet prokinetics and DC. (Umbelliferae) (Bup) is an herbal antidepressant in traditional Chinese medicine.
OBJECTIVE
This study evaluates the synergistic prokinetic effects of Bup with Au and Ci in mice suffering from multistress-induced delayed gastric emptying (DGE).
MATERIALS AND METHODS
Kunming mice were divided into four groups: control, DGE, AuCi and AuCiBup. Mice were gavaged with AuCi (14.25 g/kg) or AuCiBup (22.13 g/kg) extract for 12 days. Gastric reminder rate, intestinal driving ratio, sucrose preference and open field test were examined, and serotonin (5-HT), motilin (MTL), substance P (SP), 5-HTR and c-kit were assayed. Intracellular Ca levels in primary cultured gastric smooth muscle cells (GSMCs) were determined.
RESULTS
Both AuCi and AuCiBup treatment significantly reduced gastric residual rate (39.5% and 67.7%, < 0.01). Higher serum levels of 5-HT, MTL and SP were observed in treatment groups (AuCi: 0.060 mg/L, AuCiBup: 0.089 mg/L, DGE: 0.025 mg/L, < 0.01). The expression of 5-HTR and c-kit in the antrum and duodenum was upregulated after treatment (AuCi and AuCiBup, 4.3-times, 2.8-times to DGE, < 0.01). Medicated serums of AuCi and AuCiBup effectively increased the influx of Ca into GSMCs (1.8-times, < 0.01). In terms of 5-HTR expression, circulatory contents of 5-HT and SP and Ca influx, AuCiBup demonstrated better prokinetic effects than AuCi.
CONCLUSIONS
These findings indicate the potential for developing combination therapy with antidepressants and prokinetics in gastrointestinal dysmotility management.
Topics: Mice; Animals; Serotonin; Citrus; Gastroparesis; Drugs, Chinese Herbal; Antidepressive Agents; Gastric Emptying
PubMed: 36728913
DOI: 10.1080/13880209.2023.2173249 -
The Cochrane Database of Systematic... Feb 2023Upper endoscopy is the definitive treatment for upper gastrointestinal haemorrhage (UGIH). However, up to 13% of people who undergo upper endoscopy will have incomplete... (Review)
Review
BACKGROUND
Upper endoscopy is the definitive treatment for upper gastrointestinal haemorrhage (UGIH). However, up to 13% of people who undergo upper endoscopy will have incomplete visualisation of the gastric mucosa at presentation. Erythromycin acts as a motilin receptor agonist in the upper gastrointestinal (GI) tract and increases gastric emptying, which may lead to better quality of visualisation and improved treatment effectiveness. However, there is uncertainty about the benefits and harms of erythromycin in UGIH.
OBJECTIVES
To evaluate the benefits and harms of erythromycin before endoscopy in adults with acute upper gastrointestinal haemorrhage, compared with any other treatment or no treatment/placebo.
SEARCH METHODS
We used standard, extensive Cochrane search methods. The latest search date was 15 October 2021.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) that investigated erythromycin before endoscopy compared to any other treatment or no treatment/placebo before endoscopy in adults with acute UGIH.
DATA COLLECTION AND ANALYSIS
We used standard Cochrane methods. Our primary outcomes were 1. UGIH-related mortality and 2. serious adverse events. Our secondary outcomes were 1. all-cause mortality, 2. visualisation of gastric mucosa, 3. non-serious adverse events, 4. rebleeding, 5. blood transfusion, and 5. rescue invasive intervention. We used GRADE criteria to assess the certainty of the evidence for each outcome. MAIN RESULTS: We included 11 RCTs with 878 participants. The mean age ranged from 53.13 years to 64.5 years, and most participants were men (72.3%). One RCT included only non-variceal haemorrhage, one included only variceal haemorrhage, and eight included both aetiologies. We defined short-term outcomes as those occurring within one week of initial endoscopy. Erythromycin versus placebo Three RCTs (255 participants) compared erythromycin with placebo. There were no UGIH-related deaths. The evidence is very uncertain about the short-term effects of erythromycin compared with placebo on serious adverse events (risk difference (RD) -0.01, 95% confidence interval (CI) -0.04 to 0.02; 3 studies, 255 participants; very low certainty), all-cause mortality (RD 0.00, 95% CI -0.03 to 0.03; 3 studies, 255 participants; very low certainty), non-serious adverse events (RD 0.01, 95% CI -0.03 to 0.05; 3 studies, 255 participants; very low certainty), and rebleeding (risk ratio (RR) 0.63, 95% CI 0.13 to 2.90; 2 studies, 195 participants; very low certainty). Erythromycin may improve gastric mucosa visualisation (mean difference (MD) 3.63 points on 16-point ordinal scale, 95% CI 2.20 to 5.05; higher MD means better visualisation; 2 studies, 195 participants; low certainty). Erythromycin may also result in a slight reduction in blood transfusion (MD -0.44 standard units of blood, 95% CI -0.86 to -0.01; 3 studies, 255 participants; low certainty). Erythromycin plus nasogastric tube lavage versus no intervention/placebo plus nasogastric tube lavage Six RCTs (408 participants) compared erythromycin plus nasogastric tube lavage with no intervention/placebo plus nasogastric tube lavage. There were no UGIH-related deaths and no serious adverse events. The evidence is very uncertain about the short-term effects of erythromycin plus nasogastric tube lavage compared with no intervention/placebo plus nasogastric tube lavage on all-cause mortality (RD -0.02, 95% CI -0.08 to 0.03; 3 studies, 238 participants; very low certainty), visualisation of the gastric mucosa (standardised mean difference (SMD) 0.48 points on 10-point ordinal scale, 95% CI 0.10 to 0.85; higher SMD means better visualisation; 3 studies, 170 participants; very low certainty), non-serious adverse events (RD 0.00, 95% CI -0.05 to 0.05; 6 studies, 408 participants; very low certainty), rebleeding (RR 1.13, 95% CI 0.63 to 2.02; 1 study, 169 participants; very low certainty), and blood transfusion (MD -1.85 standard units of blood, 95% CI -4.34 to 0.64; 3 studies, 180 participants; very low certainty). Erythromycin versus nasogastric tube lavage Four RCTs (287 participants) compared erythromycin with nasogastric tube lavage. There were no UGIH-related deaths and no serious adverse events. The evidence is very uncertain about the short-term effects of erythromycin compared with nasogastric tube lavage on all-cause mortality (RD 0.02, 95% CI -0.05 to 0.08; 3 studies, 213 participants; very low certainty), visualisation of the gastric mucosa (RR 1.19, 95% CI 0.79 to 1.79; 2 studies, 198 participants; very low certainty), non-serious adverse events (RD -0.10, 95% CI -0.34 to 0.13; 3 studies, 213 participants; very low certainty), rebleeding (RR 0.77, 95% CI 0.40 to 1.49; 1 study, 169 participants; very low certainty), and blood transfusion (median 2 standard units of blood, interquartile range 0 to 4 in both groups; 1 study, 169 participants; very low certainty). Erythromycin plus nasogastric tube lavage versus metoclopramide plus nasogastric tube lavage One RCT (30 participants) compared erythromycin plus nasogastric tube lavage with metoclopramide plus nasogastric tube lavage. The evidence is very uncertain about the effects of erythromycin plus nasogastric tube lavage on all the reported outcomes (serious adverse events, visualisation of gastric mucosa, non-serious adverse events, and blood transfusion).
AUTHORS' CONCLUSIONS
We are unsure if erythromycin before endoscopy in people with UGIH has any clinical benefits or harms. However, erythromycin compared with placebo may improve gastric mucosa visualisation and result in a slight reduction in blood transfusion.
Topics: Female; Humans; Male; Middle Aged; Endoscopy; Erythromycin; Gastrointestinal Hemorrhage; Metoclopramide; Treatment Outcome
PubMed: 36723439
DOI: 10.1002/14651858.CD013176.pub2 -
Pakistan Journal of Medical Sciences 2023To investigate the effect of different treatment methods of the left colic artery (LCA) on postoperative rehabilitation of patients undergoing laparoscopic radical...
OBJECTIVE
To investigate the effect of different treatment methods of the left colic artery (LCA) on postoperative rehabilitation of patients undergoing laparoscopic radical resection of rectal cancer.
METHODS
Retrospective analysis was performed on 70 patients undergoing laparoscopic radical resection of rectal cancer who were admitted to The Affiliated Suqian Hospital of Xuzhou Medical University from January, 2020 to December, 2022 were selected and divided into two groups according to different treatment methods of LCA. The preservation group (LCA group) (n=34 cases) and the non-preservation group (NLCA group) (n=36 cases). Both groups were treated with laparoscopic radical resection of rectal cancer. IMA was preserved in the LCA group, but not in the NLCA group. The efficacy indicators, surgical treatment and rehabilitation-related indicators, gastrointestinal hormone indicators (motilin (MTL), gastrin (GAS)), and postoperative complications risk were compared between the two groups before and after surgery.
RESULTS
No statistically significant difference was observed between the two groups in terms of efficacy indicators (total number of lymph nodes dissected and number of lymph nodes at the root of the IMA), operation time, intraoperative blood loss, and postoperative drainage tube placement time (p>0.05). However, postoperative anal flatus and hospital stay in the LCA group were considerably shorter than those in the NLCA group (p<0.05). Postoperatively, the levels of MTL and GAS in the two groups were significantly decreased, and the LCA group decreased slightly compared with the NLCA group (p<0.05). Moreover, the incidence of complications in the LCA group (5.88%) was significantly lower than that in the NLCA group (27.78%) (p<0.05).
CONCLUSION
Preservation of LCA and no-preservation of LCA in laparoscopic radical resection of rectal cancer are comparable in terms of therapeutic effect, and the surgery with preservation of LCA is worthy of clinical promotion due to its various benefits such as less impact on gastrointestinal hormone indicators, lower risk of complications, and faster postoperative recovery.
PubMed: 36694757
DOI: 10.12669/pjms.39.1.6366 -
Frontiers in Nutrition 2022Slow transit constipation (STC) is a common disorder in the digestive system. This study aimed to evaluate the effects of stachyose (ST) and Furu 2019 () alone or...
INTRODUCTION
Slow transit constipation (STC) is a common disorder in the digestive system. This study aimed to evaluate the effects of stachyose (ST) and Furu 2019 () alone or combined on diphenoxylate-induced constipation and explore the underlying mechanisms using a mouse model.
METHODS
ICR mice were randomly divided into five groups. The normal and constipation model groups were intragastrically administrated with PBS. The ST, , and synbiotic groups were intragastrically administrated with ST (1.5 g/kg body weight), alive (3 × 10 CFU/mouse), or ST + (1.5 g/kg plus 3 × 10 CFU/mouse), respectively. After 21 days of intervention, all mice except the normal mice were intragastrically administrated with diphenoxylate (10 mg/kg body weight). Defecation indexes, constipation-related intestinal factors, serum neurotransmitters, hormone levels, short-chain fatty acids (SCFAs), and intestinal microbiota were measured.
RESULTS
Our results showed that three interventions with ST, , and synbiotic combination (ST + . sakei) all alleviated constipation, and synbiotic intervention was superior to ST or alone in some defecation indicators. The RT-PCR and immunohistochemical experiment showed that all three interventions relieved constipation by affecting aquaporins (AQP4 and AQP8), interstitial cells of Cajal (SCF and c-Kit), glial cell-derived neurotrophic factor (GDNF), and Nitric Oxide Synthase (NOS). The three interventions exhibited a different ability to increase the serum excitatory neurotransmitters and hormones (5-hydroxytryptamine, substance P, motilin), and reduce the serum inhibitory neurotransmitters (vasoactive intestinal peptide, endothelin). The result of 16S rDNA sequencing of feces showed that synbiotic intervention significantly increased the relative abundance of beneficial bacteria such as , and regulated the gut microbes of STC mice. In conclusion, oral administration of ST or alone or combined are all effective to relieve constipation and the symbiotic use may have a promising preventive effect on STC.
PubMed: 36687730
DOI: 10.3389/fnut.2022.1039403 -
Pharmaceutical Biology Dec 2023Linnaeus (Bombacaceae) is known as silk cotton tree, the flowers of which are used in many medicinal applications.
CONTEXT
Linnaeus (Bombacaceae) is known as silk cotton tree, the flowers of which are used in many medicinal applications.
OBJECTIVE
To investigate the therapeutic effect of flower aqueous extracts (BCE) against loperamide-induced constipation and characterize the chemical composition of BCE.
MATERIALS AND METHODS
Sixty male Kunming mice were divided into control (saline), model (10 mg/kg loperamide + saline), phenolphthalein (10 mg/kg loperamide + 10 mg/kg phenolphthalein) and different dosage of BCE (10 mg/kg loperamide + 40, 80 and 160 mg/kg BCE, respectively) groups, and received intragastric administrations for eight days. Faecal water content, number of faeces, first black-stool defecation time and gastrointestinal transit rates were evaluated. Various biochemical and molecular biomarkers were assessed in blood and colon. UPLC-ESI-QTOF-MS/MS was used to tentatively identify the composition of the BCE.
RESULTS
BCE treatment (160 mg/kg) could increase faecal water (15.75%), faeces number (11.65%), gastrointestinal transit rate (25.37%) and decrease first black-stool defecation time (24.04%). The BCE (80 mg/kg) increased the serum level of motilin (30.62%), gastrin (54.46%) and substance P (18.99%), and decreased somatostatin (19.47%). Additionally, the BCE (160 mg/kg) reduced the mucosal damage, restored colonic goblet cell function, down-regulated the protein expression of AQP (33.60%) and increased c-kit protein expression (11.63%). Twelve known compounds, including protocatechuic acid, chlorogenic acid and rutin, previously reported in were identified in the BCE.
DISCUSSION AND CONCLUSIONS
This study suggested that BCE is a promising agent for the treatment of constipation.
Topics: Mice; Animals; Loperamide; Bombax; Tandem Mass Spectrometry; Constipation; Flowers; Water; Phenolphthaleins
PubMed: 36582187
DOI: 10.1080/13880209.2022.2157841 -
Frontiers in Microbiology 2022The aim of this study was to investigate the effects of subsp VHProbi YB11 (YB11) on attenuating sucralfate-induced constipation in BALB/c mice. The strain of YB11...
INTRODUCTION
The aim of this study was to investigate the effects of subsp VHProbi YB11 (YB11) on attenuating sucralfate-induced constipation in BALB/c mice. The strain of YB11 exhibited favorable tolerance of simulated gastrointestinal (GI) juice. Only 0.42 Log value declined when the live cells of YB11 were co-incubated with simulated GI juice. Meanwhile, this strain also displayed perfect ability to adhere the intestinal epithelium Caco-2 cells with adhesion index of 18.5. 24 of female mice were randomized into four groups.
METHODS
The normal group (NOR) was fed with a normal diet, whereas the placebo group (PLA), positive group (POS), and probiotic group (PRO) were fed with sucralfate to induce constipation. After first successfully establishing the constipation model, groups NOR and PLA received the oral administration of saline solutions. Meanwhile, the POS and PRO groups were orally administered phenolphthalein and YB11 suspensions, respectively. Several indices, including fecal water content, GI transit time, short-chain fatty acids (SCFAs), intestinal neuropeptides level, and histopathology of colonic tissues, were investigated.
RESULTS AND DISCUSSION
Compared with PLA, YB11 had a positive effect in increasing the fecal water content and intestinal peristalsis. Some positive trends, including the acetic and total acids level of fecal samples, and the colonic tissue histopathology, were also observed. Furthermore, YB11 had an ability to upregulate the levels of gut excitatory neuropeptides including motilin, gastrin, and substance P, whereas it downregulated the levels of inhibitory neuropeptides including endothelin-1, somatostatin, and vasoactive intestinal peptide. We conclude that the strain YB11 has a positive impact on improving gastrointestinal mobility and reducing the severity of constipation.
PubMed: 36532450
DOI: 10.3389/fmicb.2022.1040371 -
Microbial Pathogenesis Jan 2023Massa Medicata Fermentata (MMF) is one of the most commonly used traditional fermented Chinese medicines. MMF is widely used for the treatment of digestive diseases such...
BACKGROUND
Massa Medicata Fermentata (MMF) is one of the most commonly used traditional fermented Chinese medicines. MMF is widely used for the treatment of digestive diseases such as dyspepsia and flatulence in traditional Chinese medicine (TCM). However, the therapeutic mechanism of MMF is not well understood.
METHOD
In this study, SD rats received 0.1% iodoacetamide either alone or in combination with water platform sleep deprivation to induce functional dyspepsia and were administered MMF (1 or 3 g/kg/d, ig), mosapride citrate (Mosa., 2 mg/kg/d, ig) or saline for 21 days. After treatment, the sucrose preferences and gastric emptying rates of the rats were assessed; HE staining was used to detect the pathological changes in the rat duodenum; ELISA kits were used to detect motilin (MTL) in the rat duodenum and the serum contents of Interferon-λ (IFN-λ), Interleukin 6 (IL-6), and Tumor Necrosis Factor-α (TNF-α). An approach based on 16S rDNA amplicon sequencing was utilized to explore the intestinal microflora in the colon contents of rats and the metabolism of the microflora to assess the potential mechanisms of MMF in ameliorating functional dyspepsia (FD). In addition, gas chromatography-mass spectrometry (GC/MS) was used to detect changes in short fatty acids (SCFAs) in the colon contents of rats.
RESULTS
MMF reduced the serum levels of TNF-α, and IFN-λ, improved the morphology of duodenal intestinal villi and ameliorated intestinal mucosal lamina propria injury in FD rats, and the sucrose preference increased and the gastric emptying rate decreased in FD rats. MMF alleviated intestinal microflora disturbance and exerted a regulatory effect on Bacteroidetes, Proteobacteria, and Firmicutes, reduced total SCAFs, Butyric Acid, Propionic acid-2-methyl, Butanoic Acid-3-methyl, and Hexanoic acid.
CONCLUSIONS
These results showed that the effect of MMF on the intestinal flora and its metabolites may provide a new treatment strategy for FD.
Topics: Rats; Animals; Dyspepsia; Gastrointestinal Microbiome; Tumor Necrosis Factor-alpha; Rats, Sprague-Dawley
PubMed: 36529285
DOI: 10.1016/j.micpath.2022.105927 -
Peptides Feb 2023Motilin is a gastrointestinal hormone secreted by the duodenum. This peptide regulates a characteristic gastrointestinal contraction pattern, called the migrating motor... (Review)
Review
Motilin is a gastrointestinal hormone secreted by the duodenum. This peptide regulates a characteristic gastrointestinal contraction pattern, called the migrating motor complex, during the fasting state. Motilin also affects the pressure of the lower esophageal sphincter, gastric motility and gastric accommodation in the gastrointestinal tract. Furthermore, motilin induces bile discharge into the duodenum by promoting gallbladder contraction, pepsin secretion in the stomach, pancreatic juice and insulin secretion from the pancreas. In recent years, it has been shown that motilin is associated with appetite, and clinical applications are expected for diseases affected by food intake, e.g. obesity, by regulating motilin levels. Gastric acid and bile are the two major physiological regulators for motilin release. Caloric foods have varying effects on motilin levels, depending on their composition. Among non-caloric foods, bitter substances reduce motilin levels and are therefore expected to have an appetite-suppressing effect. Various motilin receptor agonists and antagonists have been developed but have yet to reach clinical use.
Topics: Motilin; Gastrointestinal Motility; Stomach; Gastrointestinal Hormones; Myoelectric Complex, Migrating; Duodenum
PubMed: 36436612
DOI: 10.1016/j.peptides.2022.170905 -
Complementary Medicine Research 2023Postoperative gastrointestinal tract dysfunction is considered a common complication affecting patients undergoing intestinal surgery. This research aims to provide... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Postoperative gastrointestinal tract dysfunction is considered a common complication affecting patients undergoing intestinal surgery. This research aims to provide evidence to assess the efficacy and safety of Baizhu Shaoyao San (BSS) or modified BSS in treating postoperative diarrhea of colorectal cancer patients.
METHODS
Eighty patients with colorectal cancer were randomized within 2 weeks after surgery to receive either modified BSS or Loperamide combined with the respective dummy. The curative effect was evaluated with the traditional Chinese medicine (TCM) syndrome score. Determination of motilin and gastrin in plasma was conducted utilizing ELISA.
RESULTS
Compared with Loperamide therapy, the efficacy of modified BSS was statistically significant, the TCM syndrome score decreased, and the total effective rate increased. Levels of motilin and gastrin in plasma decreased.
CONCLUSION
The curative effect and safety of modified BSS were statistically significant.
Topics: Humans; Gastrins; Loperamide; Motilin; Single-Blind Method; Gastrointestinal Diseases; Diarrhea; Colorectal Neoplasms
PubMed: 36349756
DOI: 10.1159/000527706