Physiologic Characteristics of Traditional Chinese Medicine Based IBS Subgroups

中医IBS亚群的生理特征

• 批准号: 7295756
• 负责人: BRUCE D NALIBOFF
• 金额: $ 22.5万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7295756
• 关键词: Abdominal Pain; Acupuncture procedure; Affect; Affective; Anger; Anxiety; Autonomic nervous system; Awareness; Characteristics; Chinese People; Chinese Traditional Medicine; Chronic; Chronic Fatigue Syndrome; Classification; Clinical; Complementary and alternative medicine; Complex; Condition; Cutaneous; Data; Diagnosis; Diagnostic; Disease; Elements; Employee Strikes; Fatigue; Feasibility Studies; Female; Functional disorder; Habits; Heart Rate; Herb; Herbal Medicine; Hostility; Hydrocortisone; Hyperalgesia; Intestines; Irritable Bowel Syndrome; Measures; Medical; Medicine; Methods; Mind; Moods; Morbidity - disease rate; Nature; Neurobiology; Neurosecretory Systems; Output; Pain; Pain Threshold; Patient Self-Report; Patients; Pattern; Physical Examination; Physiological; Population; Population Heterogeneity; Psychometrics; Questionnaires; Rate; Recording of previous events; Recurrence; Reporting; Research Personnel; Role; Salivary; Standards of Weights and Measures; Stimulus; Stress; Subgroup; Sympathetic Nervous System; Symptoms; Testing; Therapeutic; Therapeutic Intervention; Traditional Medicine; Validation; Visceral; Visceral pain; allostasis; allostatic load; base; concept; gastrointestinal; hypothalamic-pituitary-adrenal axis; insight; mind body interaction; novel diagnostics; programs; response

DESCRIPTION (provided by applicant): Background: Irritable Bowel Syndrome (IBS) is a common chronic gastrointestinal (Gl) disorder defined by recurrent symptoms of abdominal pain or discomfort associated with alterations in bowel habits, in the absence of a detectable organic cause. Though many IBS patients have extraintestinal symptoms, these are generally not considered under the conventional paradigm. Partly from the lack of effective therapies, 30- 40% of IBS patients turn to complementary and alternative medical (CAM) therapies instead of, or in addition to, conventional treatment. Unlike the western approach, Traditional Chinese Medicine (TCM) views IBS patients as a heterogeneous population whose Gl symptoms are one of many manifestations resulting from a broader underlying multisystemic dysregulation. In TCM patterns of dysregulation, patients are classified into subgroups incorporating both Gl and extraintestinal symptoms. TCM therapies like acupuncture and herbs target these specific patterns. Further, TCM patterns show striking similarity to common presentations of IBS and to emerging concepts of stress neurobiology, particularly allostasis and allostatic load. Despite its core role in the TCM paradigm, few studies explore the nature of patterns of dysregulation. Aims: Building on extensive preliminary data, this proposal seeks to scientifically validate TCM patterns by testing the following hypotheses: 1) TCM patterns can be characterized by distinct pathophysiologic patterns related to specific alterations in stress responsiveness, and 2) TCM patterns can be distinguished by select symptom items. Methods: In Aim 1, we will assess affective, pain, autonomic and neuroendocrine responses to visceral and somatic pain stimuli to identify two distinct patterns (EXCESS and DEFICIENCY) reflecting altered stress responsiveness (allostasis and allostatic load, respectively). In Aim 2, we will assess correlation between patient self-report of select symptom items and TCM expert diagnosis of patients to specific TCM patterns. Conclusions: If these hypotheses are correct, it strongly validates the existence of TCM patterns of dysregulation in IBS, supports that IBS is a heterogeneous, multisystemic disorder contrary to current characterizations, and provides the basis for novel diagnostic and treatment approaches. Given the disappointing results with conventional approaches to multisystemic functional disorders like IBS, this may provide exciting insights and contributions to the classification and treatment of these challenging disorders.

描述（由申请人提供）：背景：肠易激综合征（IBS）是一种常见的慢性胃肠道（Gl）疾病，在没有可检测到的器质性病因的情况下，以腹痛或不适的复发症状与排便习惯的改变相关。虽然许多IBS患者有肠外症状，但这些症状通常不被传统范式所考虑。部分由于缺乏有效的治疗方法，30% - 40%的肠易激综合征患者转向补充和替代医学（CAM）疗法，而不是常规治疗，或在常规治疗之外。与西方的方法不同，中医（TCM）认为肠易激综合征患者是一个异质性人群，其Gl症状是由更广泛的潜在多系统失调引起的许多表现之一。在中医失调模式中，患者被划分为包括Gl和肠外症状的亚组。针灸和草药等中医疗法针对这些特定的模式。此外，中医模式与肠易激综合征的常见表现和新兴的应激神经生物学概念，特别是适应和适应负荷，显示出惊人的相似性。尽管它在中医范式中具有核心作用，但很少有研究探索失调模式的本质。目的：基于广泛的初步数据，本研究旨在通过验证以下假设来科学地验证中医模式：1)中医模式可以通过与应激反应特异性改变相关的不同病理生理模式来表征；2)中医模式可以通过选择的症状项来区分。方法：在目标1中，我们将评估对内脏和躯体疼痛刺激的情感、疼痛、自主神经和神经内分泌反应，以确定两种不同的模式（过量和不足），反映应激反应的改变（分别是适应负荷和适应负荷）。在Aim 2中，我们将评估患者自我报告的选择症状项目与中医专家对患者特定中医模式的诊断之间的相关性。结论：如果这些假设是正确的，它有力地验证了肠易激综合征中失调的中医模式的存在，支持肠易激综合征是一种与当前特征相反的异质性、多系统疾病，并为新的诊断和治疗方法提供了基础。鉴于IBS等多系统功能障碍的传统治疗方法令人失望的结果，这可能为这些具有挑战性的疾病的分类和治疗提供令人兴奋的见解和贡献。