助阳通便汤治疗功能性便秘临床观察及对便秘模型小鼠结肠组织VIP的影响  

Clinical Study of Zhuyang Tongbian Decoction(助阳通便汤)on Constipation Patients and Its Effect on VIP of Colon Tissue in Constipation Model Mice

作　　者：王璐[1] 隋楠[1,2] WANG Lu;SUI Nan(The Third Afflicted Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110003,Liaoning,China;Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)

机构地区：[1]辽宁中医药大学附属第三医院,辽宁沈阳110003 [2]辽宁中医药大学,辽宁沈阳110847

出　　处：《中华中医药学刊》2025年第4期66-71,I0016,共7页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82174370);国家中医药管理局青年岐黄学者培养项目(国中医药办人教函[2022]256号);辽宁省自然科学基金项目(2020-MS-229);辽宁省中医药(临床)优秀人才项目(辽卫办发[2021]29号)。

摘　　要：目的观察助阳通便汤对功能性便秘(脾肾阳虚证)患者的临床疗效和患者血清P物质(substance P,SP)、血管活性肠肽(vasoactive intestinal peptide,VIP)含量的影响,以及其对便秘模型小鼠结肠组织病理及VIP表达的影响。方法(1)将66例符合功能性便秘诊断,且中医证型为脾肾阳虚证的患者,用随机数字表法进行分组,其中治疗组(33例)、对照组(33例),治疗组助阳通便汤130 mL日2次口服,对照组乳果糖15 mL日2次口服,均治疗2周。比较两组患者用药前后便秘症状评分、粪便性状评分、中医证候评分及血清SP、VIP含量。(2)将18只雄性BALB/c小鼠依据随机数字表法分为KB组(空白对照组)、MX组(模型组)、ZY组(助阳通便汤组)3组,每组6只,以复方地芬诺酯片混悬液80 mg/kg灌胃的方法进行造模。ZY组给予助阳通便汤0.2 mL/10 g连续2周灌胃,结束后取材,观察各组小鼠结肠组织病理及VIP免疫组化表达。结果(1)治疗后两组患者便秘症状及粪便性状的评分均比治疗前显著提高(P<0.05);治疗组中医证候评分差异有统计学意义(P<0.05);治疗组患者血清SP含量高于对照组(P<0.05),血清VIP含量低于对照组(P<0.05)。治疗组有效率90.0%,对照组有效率73.3%(P<0.05)。(2)与模型组(MX组)小鼠比较,助阳通便汤组(ZY组)小鼠结肠组织中VIP阳性表达细胞分布相对较密集,阳性细胞数量较多(P<0.05)。结论助阳通便汤对功能性便秘(脾肾阳虚证)患者的临床症状及中医证候有较好地改善,并且对患者血清SP、VIP含量有干预作用;助阳通便汤调控便秘模型小鼠结肠组织VIP含量是其治疗功能性便秘的作用机制之一。Objective To observe the clinical efficacy of Zhuyang Tongbian Decoction(助阳通便汤)on patients with functional constipation(spleen and kidney Yang deficiency)and the effects of serum substance P(SP)and vasoactive intestinal peptide(VIP)as well as its effects on the histopathology of the colon and the expression of VIP in the constipation model mice.Methods(1)Sixty-six patients who met the diagnosis of functional constipation and whose TCM syndrome was spleen and kidney Yang deficiency were grouped by randomized numerical table method,including the treatment group(33 cases)and the control group(33 cases).The treatment group was given Zhuyang Tongbian Decoction(130 mL)orally twice a day,and the control group was given Lactulose(15 mL)orally twice a day.Both groups were treated for 2 weeks.The constipation symptom scores,fecal character score,traditional Chinese medicine symptom scores and contents of serum SP and VIP before and after the use of drugs in the two groups were compared.(2)Eighteen BALB/c mice were divided into KB group(blank control group),MX group(model group)and ZY group(Zhuyang Tongbian Decoction group)according to the randomized numerical table method,6 mice in each group were modeled by gavage with 80 mg/kg of diphenoxylate tablets suspension,and ZY group was given Zhuyang Tongbian Decoction(0.2 mL/10 g)for two weeks,and then samples were taken out to observe the histopathology of colon and VIP immunohistochemical expressions of each group.Colonic histopathology and VIP immunohistochemical expressions were observed in each group.Results(1)The scores of constipation symptoms and fecal character of patients in both groups after treatment were significantly higher than those before treatment(P<0.05).There was a significant difference in TCM symptom scores in the treatment group(P<0.05).The serum SP content of patients in the treatment group was higher than that of the control group(P<0.05),and the serum VIP content was lower than that of the control group(P<0.05).The effective rate was 90.0%in

关 键 词：助阳通便汤 功能性便秘 脾肾阳虚型 SP VIP 

分 类 号：R256.35[医药卫生—中医内科学] R289.5[医药卫生—中医学]