• 동의생리병리학회지
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• 제35권5호
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• pp.199-209
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• 2021

The purpose of this study was to explore objective indicators(outcomes) which are used to evaluate clinical efficacy and figure out the mechanisms of herbal medicine, acupuncture and moxibustion treatment for Irritable bowel syndrome(IBS). We searched randomized controlled trials(RCTs) that mediated with herbal medicine, acupuncture and moxibustion treatment for IBS and used objective indicators for outcome from November 1, 2020 to December 31, 2020. The RCTs that were published in Korean, English and Chinese were included in this study. The selected literatures were analyzed about methods of result measurement and assessed by Cochrane's risk of bias(RoB). Total 18 RCTs were included in this study. There were lots of objective indicators for result measurement; the concentration of hormones in blood and neurotransmitters, the sensitivity of rectum, the functional assessment of central nerve and autonomic nerve system, the change of intestinal flora, the concentration of serum cytokines. Various objective indicators can be used to evaluate the clinical efficacy of with herbal medicine, acupuncture and moxibustion treatment for IBS, but due to the limitations of the quality of the included studies, systematic review and meta-analysis will be needed.

• Journal of Neurogastroenterology and Motility
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• 제24권4호
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• pp.656-668
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• 2018

Background/Aims MicroRNAs (miRNAs) were reported to be responsible for intestinal permeability in diarrhea-predominant irritable bowel syndrome (IBS-D) rats in our previous study. However, whether and how miRNAs regulate visceral hypersensitivity in IBS-D remains largely unknown. Methods We established the IBS-D rat model and evaluated it using the nociceptive visceral hypersensitivity test, myeloperoxidase activity assay, restraint stress-induced defecation, and electromyographic (EMG) activity. The distal colon was subjected to miRNA microarray analysis followed by isolation and culture of colonic epithelial cells (CECs). Bioinformatic analysis and further experiments, including dual luciferase assays, quantitative real-time polymerase chain reaction, western blot, and enzyme-linked immunosorbent assay, were used to detect the expression of miRNAs and how it regulates visceral hypersensitivity in IBS-D rats. Results The IBS-D rat model was successfully established. A total of 24 miRNAs were differentially expressed in the distal colon of IBS-D rats; 9 were upregulated and 15 were downregulated. Among them, the most significant upregulation was miR-200a, accompanied by downregulation of cannabinoid receptor 1 (CNR1) and serotonin transporter (SERT). MiR-200a mimic markedly inhibited the expression of CNR1/SERT. Bioinformatic analysis and luciferase assay confirmed that CNR1/SERT are direct targets of miR-200a. Rescue experiments that overexpressed CNR1/SERT significantly abolished the inhibitory effect of miR-200a on the IBS-D rats CECs. Conclusions This study suggests that miR-200a could induce visceral hyperalgesia by targeting the downregulation of CNR1 and SERT, aggravating or leading to the development and progression of IBS-D. MiR-200a may be a regulator of visceral hypersensitivity, which provides potential targets for the treatment of IBS-D.

• 동의생리병리학회지
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• 제18권6호
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• pp.1913-1917
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• 2004

This study was designed to report the clinical effects of oriental medical therapy on a patient whose irritable bowel syndrome did not improved under western medical therapy, Herbal medication, acupuncture and moxibustion therapy were applied to the patient for 12 days. The status and frequency of feces were checked and self-recognized symptoms (abdominal pain and bowel sounds) were checked to evaluate improvement. According to the above evaluation items, the treatment was beneficial. The status and frequency of feces became normal. Abdominal pain and bowel sounds ceased. The above results suggest that oriental medical therapy is beneficial for the patients with irritable bowel syndrome.

• Journal of Preventive Medicine and Public Health
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• 제30권4호
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• pp.791-804
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• 1997

Irritable bowel syndrome(IBS) is one of the common health problem that has been considered as stress-induced. This study was conducted to investigate the relationship between life style and the level of stress and IBS by structured questionnaire which included questions on life style, the self-esteemed gastrointestinal symptoms, and Psychosocial Well-being Index(PWI). Subjects were 1,498 male white collars who get the regular health check and participated in survey at Inje University Health Promotion Center from January to ,December, 1996. The overall prevalence of IBS was 37.5%(561 cases), and the level of stress by PWI score was higher in IBS group$(41.8{\pm}14.2)$ than symptom-free group$(34.6{\pm}12.6)$. As the result of comparison between the two groups, heavier smoking (adjusted O.R=2.48, 95% C.I 1.81-3.41), longer daily working time (adjusted O.R=5.19, 95% C.I 3.59-7.56), stimulatory food materials-mainly hot or salty (adjusted O.R=1.87, 95% C.I 1.44-2.45), higher body mass index (adjusted O.R=1.80, 95% C.I 1.27-2.57), and higher level of stress (adjusted O.R=2.81, 95% C.I 1.80-4.43) were estimated as risk factors of IBS. On the contrary, 6-8 hours sleeping per day (adjusted O.R=0.38 95% C.I 0.21-0.70), 3-4 times exercise per week (adjusted O.R=0.57 95% C.I 0.39-0.83), and tenure more than 20 years (adjusted O.R=0.25 95% C.I 0.16-0.35) were considered as protective factors to IBS. In summary, the assessment of the stress level might be placed in the first priority to control IBS, at least by some degree, which suggested that IBS could be controlled by avoiding such risk factors and by encouraging such protective factors.

• Journal of Neurogastroenterology and Motility
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• 제25권3호
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• pp.343-362
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• 2019

Background/Aims There has been major progress in our understanding of the irritable bowel syndrome (IBS), and novel treatment classes have emerged. The Rome IV guidelines were published in 2016 and together with the growing body of Asian data on IBS, we felt it is timely to update the Asian IBS Consensus. Methods Key opinion leaders from Asian countries were organized into 4 teams to review 4 themes: symptoms and epidemiology, pathophysiology, diagnosis and investigations, and lifestyle modifications and treatments. The consensus development process was carried out by using a modified Delphi method. Results Thirty-seven statements were developed. Asian data substantiate the current global viewpoint that IBS is a disorder of gut-brain interaction. Socio-cultural and environmental factors in Asia appear to influence the greater overlap between IBS and upper gastrointestinal symptoms. New classes of treatments comprising low fermentable oligo-, di-, monosacharides, and polyols diet, probiotics, non-absorbable antibiotics, and secretagogues have good evidence base for their efficacy. Conclusions Our consensus is that all patients with functional gastrointestinal disorders should be evaluated comprehensively with a view to holistic management. Physicians should be encouraged to take a positive attitude to the treatment outcomes for IBS patients.

• Journal of Ginseng Research
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• 제29권2호
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• pp.94-99
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• 2005

In the previous study, we reported that the in viかo inhibitory effect of ginsenosides, active ingredient of Panax ginseng, on $5-HT_{3A}$ receptor channel activity is coupled to in vivo anti-vomiting and anti-nausea effect. In the present study, we further investigated that the inhibitory effect of ginsenosides, active ingredient of Panax ginseng, on 5-HT3A receptor channel activity is also coupled to attenuation of irritable bowel syndrome (IBS), which is induced by colorectal distention (CRD) and $0.6\%$ acetic acid treatment. The CRD-induced visceral pains induced by CRD and acetic acid treatment are measured by frequency of contractions of the external oblique muscle in conscious rats. Treatment of GTS significantly inhibited CRD-induced visceral pain with dose-dependent manner. The $EC_{50}$ was $5.5{\pm}4.7$ mg/kg ($95\%$ confidence intervals: 1.2-15.7) and the antinociceptive effect of GTS on visceral pain was persistent for 4 h. We also compared the effects of protopanaxadiol (PD) ginsenosides and protopanaxatriol (PT) ginsenosides with saline on acetic acid-and CRD-induced visceral pain, and found that protopanaxatriol (PT) ginsenosides was much more potent than PD ginsenosides in attenuating CRD-induced visceral pain. These results indicate that U ginsenosides of Panax ginseng are components far attenuation of experimentally CRD-induced visceral pains.

• 대한한의학회지
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• 제25권1호
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• pp.198-204
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• 2004

Backgrounds & Methods : Asthma is considered to be chronic inflammatory disease characterized by airway hyperresponsiveness and pulmonary eosinophilia. Recently, there has been many researches about asthma. IBS(Irritable Bowel Syndrome), PUD(peptic Ulcer disease) and GERD(gastroesophageal reflux disease) are the most common diseases of the gastrointestinal tract. Recent studies suggest that IBS, PUD and GERD are associated with bronchial hyper-responsiveness and bronchial asthma might be more prevalent in IBS and GERD patients than in control subjects. In addition, there are many comments about the interrelationship between the gastrointestinal problem and asthma in the oriental medical books. Actually, many oriental medical doctors don$^{\circ}$Øt consider the gastrointestinal condition when they deal with the asthmatic patients these days. So, we assessed the prevalence of gastrointestinal symptoms and histories in a cohort of patients with asthmatic symptoms. We evaluated 128 outpatients with asthmatic symptoms(60 males and 68 females, aged 13-75). All subjects enrolled completed the GSRS(Gastrointestinal Symptom Rating Scale). GSRS is an interview based rating scale consisting of 15 items for assessment of gastrointestinal symptoms in IBS and PUD developed by Jan Svedlund. Results : The limit of total score of GSRS in asthmatic patients is zero to 30. The number of patients with no GI symptoms is 66(51.5%). The number of patients with GSRS>5 is 62(48.4%), GSRS>10 is 24(18.8%), GSRS>15 is 8(6.25%). The number of patients with history of gastritis is 54(42.2%), gastric ulcer is 13(10.2%), gastroptosis is 8(6.25%), IBS is 6(4.68%), others is 6(4.68%). Conclusions : This study suggests that patients with bronchial asthma have an significant prevalence of gastrointestinal symptoms. Additional studies are needed to find the mechanism of the association between gastrointestinal symptoms and asthma.

• Journal of Veterinary Science
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• 제24권3호
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• pp.23.1-23.16
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• 2023

Background: Irritable bowel syndrome (IBS) is a functional bowel disorder (FBD). Objectives: To assess the therapeutic effects of paeoniflorin (PF) on IBS in rats. Method: Sixty male Sprague-Dawley rats were randomly divided into normal, model, positive drug, low-dose PF, medium-dose PF and high-dose PF groups (n = 10). After gavage for 2 consecutive weeks, the effect of PF on abdominal pain symptoms was assessed based on the abdominal withdrawal reflex (AWR) score, fecal water content and pathological changes in colon tissues. D-lactate, interleukin-1β (IL-1β), transforming growth factor-β (TGF-β) and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay, and phosphorylated nuclear factor kappa B (p-NF-κB) p65 was detected by Western blotting. The abundance and diversity changes of intestinal flora were explored using 16S ribosomal RNA sequencing. Result: In PF groups, the mucosal morphology of colon tissues was intact, and the glands were arranged neatly and structured clearly, without obvious inflammatory cell infiltration. Compared with the model group, PF groups had significantly elevated pain threshold, and mRNA and protein levels of zonula occludens-1 (ZO-1) and occludin, decreased AWR score at 20 mmHg pressure, fecal water content, mRNA levels of IL-1β, TGF-β, and TNF-α, protein level of p-NF-κB p65 and level of serum D-lactate, and reduced levels of serum IL-1β, TGF-β, and TNF-α (p < 0.05, p < 0.01). PF groups had higher abundance of Lactobacillus, Akkermansia, Alistipes, and Bacteroides, but lower abundance of Desulfovibrio, Parasutterella, and Enterococcus than those of the model group. Conclusions: PF exerts therapeutic effects on IBS in rats probably by regulating the intestinal flora, and then up-regulating the expressions of ZO-1 and occludin in colon tissue while down-regulating the levels of IL-1β, TGF-β, TNF-α, D-lactate and p-NF-κB p65.

• Journal of Neurogastroenterology and Motility
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• 제24권4호
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• pp.628-642
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• 2018

Background/Aims A Subset of patients with irritable bowel syndrome (IBS) may have mild inflammation due to immune activation. Toll-like receptors (TLRs) and cytokines may cause intestinal inflammation. We studied their expression in relation to gut microbiota. Methods Expression of TLRs and cytokines was assessed in 47 IBS patients (Rome III) and 25 controls using quantitative real-time polymerase chain reaction. Immunohistochemistry was further performed to confirm the expression of TLR-4 and TLR-5. Results Of 47 patients with IBS, 20 had constipation (IBS-C), 20 diarrhea (IBS-D), and 7 unclassified (IBS-U). The mRNA levels of TLR-4 and TLR-5 were up-regulated in IBS patients than controls (P = 0.013 and P < 0.001, respectively). Expression of TLR-4 and TLR-5 at protein level was 4.2-folds and 6.6-folds higher in IBS-D than controls. The mRNA levels of IL-6 (P = 0.003), C-X-C motif chemokine ligand 11 (CXCL-11) (P < 0.001) and C-X-C motif chemokine receptor 3 (CXCR-3) (P < 0.001) were higher among IBS patients than controls. Expression of IL-6 (P = 0.002), CXCL-11 (P < 0.001), and CXCR-3 (P < 0.001) were up-regulated and IL-10 (P = 0.012) was down-regulated in IBS-D patients than controls. Positive correlation was seen between TLR-4 and IL-6 (P = 0.043), CXCR-3, and CXCL-11 (P = 0.047), and IL-6 and CXCR-3 (P = 0.003). Stool frequency per week showed positive correlation with mRNA levels of TLR-4 (P = 0.016) and CXCR-3 (P = 0.005), but inversely correlated with IL-10 (P = 0.002). Copy number of Lactobacillus (P = 0.045) and Bifidobacterium (P = 0.011) showed correlation with IL-10 in IBS-C, while Gram-positive (P = 0.031) and Gram-negative bacteria (P = 0.010) showed correlation with CXCL-11 in IBS-D patients. Conclusions Altered immune activation in response to dysbiotic microbiota may promote intestinal inflammation in a subset of patients with IBS.

• 치위생과학회지
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• 제14권1호
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• pp.22-28
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• 2014

본 연구는 일부 지역 치위생과 학생을 대상으로 IBS와 수면의 질의 관련성을 파악하기 위하여 수행하였다. 연구대상은 전북지역 4개 대학 치위생과 344명을 대상으로 구조화된 설문지를 이용하여 2013년 5월부터 9월까지 수행하였으며 결과는 다음과 같다. 대상자의 IBS의 배변양상유형은 혼합형이 57.6%로 가장 많았고, 변비형 10.5%, 미분류형 7.1%, 설사형 6.1%로 나타났다. 대상자의 일반적 특성에 따른 수면의 질은 3학년 11.45점, 2학년 10.90점, 1학년 9.53점으로 학년이 높을수록 수면의 질이 통계적으로 유의하게 낮았으며, IBS일 경우에서도 수면의 질이 낮아 통계적으로 유의한 차이를 나타냈다. IBS 유무에 따른 수면의 질 차이는 습관적 수면효율성, 수면제 복용, 낮 시간 기능장애가 통계적으로 유의한 차이를 나타내 대조군에 비해 수면의 질이 낮았다. IBS 배변양상유형에 따른 수면의 질 차이는 수면방해에서 혼합형이 6.86점으로 가장 높았고, 습관적 수면효율성은 변비형이 1.00점, 주관적 수면의 질은 변비형이 1.42점, 수면제 복용은 미분류형이 0.15점으로 가장 높았으나 통계적으로 유의하지는 않았지만, 낮 시간 기능장애에서는 변비형이 2.61점으로 가장 높아 통계적으로 유의한 차이를 보였다(p=0.012). 수면의 질 하위요인간의 상관관계는 양의 상관관계가 있는 것으로 나타났다. 이상의 연구결과를 바탕으로 IBS의 경우와 학년이 높을수록 수면의 질이 낮다는 것을 알 수 있었고, IBS의 경우 낮은 수면의 질로 인하여 낮 시간 동안의 기능장애가 있는 것으로 나타나, 과민성장증후군의 증상에 대해 교육하고 증상을 완화시킬 수 있는 적절한 스트레스 관리법과 올바른 식습관에 관한 교육 및 예방프로그램 개발을 통해 수면의 질을 높일 수 있도록 해야 할 것이다.