Effects of Hypericum perforatum extract on rat irritable bowel syndrome

Effects of Huangshu enema on serum levels of TNF-α in patients with irritable bowel syndrome

AIM: To investigate the effects of Chinese medicine Huangshu enema (HSE) on the level of tumor necrosis factor-α (TNF-α) in serum of patients with irritable bowel syndrome (IBS) and to explore the underlying mechanism.

METHODS: Sixty IBS patients were randomly divided into an observation group and a control group. The observation group was given Huangshu enema for 10 d, and the control group was given pinaverium bromide tablets for 10 d. The observation group included 18 patients with IBS-D (IBS with diarrhea), 12 patients with IBS-C (IBS with constipation), while the control group included 17 patients with IBS-D and 13 patients with IBS-C. Serum levels of TNF-α and symptom score were measured before and after treatment.

RESULTS: For patients with IBS-D, diarrhea score, abdominal pain score, abdominal distention score, total symptom score and serum level of TNF-α after treatment were significantly lower than those before treatment in the observation group (1.44 ± 0.70 vs 2.17 ± 0.79; 1.00 ± 0.77 vs 2.22 ± 0.55; 0.73 ± 0.67 vs 1.22 ± 0.72; 3.12 ± 1.34 vs 5.61 ± 1.42; 42.73 ± 11.45 vs 53.06 ± 6.49, all P < 0.05); abdominal pain score after treatment was lower than that before treatment in the control group (1.53 ± 0.62 vs 2.24 ± 0.56, P < 0.05), but the diarrhea score, abdominal distension score, total symptom score and serum level of TNF-α did not differ significantly between before and after treatment (2.17 ± 0.73 vs 2.24 ± 0.75; 1.35 ± 0.49 vs 1.29 ± 0.69; 5.00 ± 1.71 vs 5.76 ± 1.30; 44.34 ± 10.25 vs 50.00 ± 6.75, all P > 0.05). For patients with IBS-C, constipation score, abdominal pain score, abdominal distention score and total symptom score after treatment were significantly lower than those before treatment in the observation group (1.42 ± 0.52 vs 2.08 ± 0.79; 1.17 ± 0.71 vs 2.17 ± 0.58; 0.72 ± 0.52 vs 1.17 ± 0.50; 1.08 ± 1.00 vs 5.42 ± 3.08, all P < 0.05), but serum level of TNF-α showed no significant difference between after and before treatment (23.89 ± 5.92 vs 23.94 ± 4.62, P > 0.05); abdominal pain score after treatment was lower than that before treatment in the control group (1.46 ± 0.66 vs 2.23 ± 0.60, P < 0.05), but the constipation score, abdominal distension score, total symptom score and the level of TNF-α showed no significant differences between after and before treatment (2.08 ± 0.76 vs 2.15 ± 0.80; 1.30 ± 0.48 vs 1.23 ± 0.73; 4.77 ± 1.09 vs 5.62 ± 1.26; 22.87 ± 1.64 vs 23.53 ± 4.53, all P > 0.05).

CONCLUSION: Huangshu enema can effectively improve the symptoms of IBS, which is possibly associated with changing serum levels of TNF-α.