[Effect of Zhizhuwan on gastrointestinal peptide concentrations in plasma of diabetic gastroenteropathy with constipation patients].
OBJECTIVE
To determine the therapeutic efficacy and elucidate the probable pharmacological mechanism of Zhizhuwan (ZZ), a known formula for GI/Dysmotility and constipation in Traditional Chinese medicine, in managing constipating diabetes mellitus (DM).


METHODS
Subjects, composed of both males and females, ranged from 55 to 76 years of age, and had constipating DM. Subjects with severe colon, rectum, heart, renal, or hepatic disease, obesity and those on medications known to alter gastrointestinal motility were excluded. 28 healthy subjects were also recruited. The study group (n = 28) received 90 g per day of ZZ and the control group (n = 28) received 30 mg per day of cisapride for a 1 month period. Conservative therapy was similar in both groups and administered by a person blinded to randomization code. Patients were assessed pre-treatment and post-treatment by a blinded interviewer. A constipation visual analogue scale (CVAS) was constructed to evaluate the patients' constipation status. To analyze neuropeptides motilin (MTL), vasoactive intestinal polypeptide (VIP), substance P (SP) levels in plasma, a radioimmunoassay technique was adopted. Data were analyzed for treatment effects using the "t" test.


RESULTS
Base line characteristics were similar in both treatment groups. There were significant effects on symptom relief, increases in serum SP level, and decreases in VIP level in both groups (P < 0.05). ZZ was significantly more effective than cisapride in ameliorating patients' subjective symptoms of defecating and stool frequency, and increasing serum SP level (P < 0.05).


CONCLUSIONS
ZZ is beneficial in constipating DM via increasing SP levels and decreasing VIP levels of serum.
Liu
Yi
Y
The First affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
Zhao
Xiao-Rui
XR
Wang
Rui
R
Qiu
Gen-Quan
GQ
Zhang
Mei
M
D000368:Aged; D003248:Constipation / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D005767:Gastrointestinal Diseases / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D005768:Gastrointestinal Hormones / Q000097:blood*; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D013373:Substance P / Q000097:blood
D004365:Drugs, Chinese Herbal; D005768:Gastrointestinal Hormones; D013373:Substance P