DOI QR코드

DOI QR Code

Effect of an Aqueous Extract of Poncirus trifoliate (L.) Raf. in Stroke Patient with Constipation

뇌졸중환자의 변비에서 지실 열수 추출물의 효과

  • Received : 2016.03.24
  • Accepted : 2016.04.12
  • Published : 2016.04.30

Abstract

Objectives To evaluate the effects and safety of the aqueous extract of the dried, immature fruit of Poncirus trifoliate (L.) Raf. (Rutaceae) (PF) in stroke patients with constipation. Methods A total of 22 patients were recruited. Patients were interviewed about the clinical informations, constipation score and Bristol stool form scale at twice, before intake PF and after intake PF 2 weeks. The total and segmental colon transit time (CTT) were measured by using radio-opaque markers (Kolomark$^{(R)}$). The degree of stool retention was evaluated by the plain abdominal radiography and was scored by Leech score. Results Before intake PF, constipation scores ranged from 3 to 12, average $6.54{\pm}2.87$ and Bristol stool form scale ranged from 1 to 6, average $3.86{\pm}1.21$. CTTs were $9.05{\pm}6.89hours$, $14.29{\pm}10.68hours$, $12.11{\pm}7.19hours$ and $35.40{\pm}19.5hours$ in the right, left, rectosigmoid and total colon, respectively. Stool retention score was $2.45{\pm}0.61$, $2.3{\pm}0.86$, $1.9{\pm}0.85$, $6.65{\pm}1.56$ in the right, left, rectosigmoid and total colon, respectively. After 2 weeks, constipation scores ranged from 2 to 8, average $4.28{\pm}2.05$ and Bristol stool form scale ranged from 1 to 6, average $4.17{\pm}1.04$. CTTs were $7.41{\pm}8.86hours$, $11.12{\pm}9.12 hours$, $8.83{\pm}8.75hours$ and $27.3{\pm}20.2$ hours in the right, left, rectosigmoid and total colon, respectively. Stool retention score was $1.9{\pm}0.64$, $2.2{\pm}0.69$, $1.4{\pm}0.88$, $5.5{\pm}1.39$ in the right, left, rectosigmoid and total colon, respectively. There were statistically significant difference in the total and rectosigmoid colon CTT and constipation score, Stool retention score in right and rectosigmoid colon (p<0.05) after PF therapy. Conclusions These results suggest potential for PF therapy in stroke patient with constipation.

Keywords

Constipation;Stroke;Poncirus trifoliate

References

  1. Lim JH, Kim HS, Choi EJ, Shim CK, Park HJ, Effexts of Poncirus fructus on gastrointestinal motility in guinea pig : in vitro and in vivo study. Korean Journal of Gastrointestinal Motility. 2008;14:7-17
  2. Choi CW, Joo MC, Lee MY. Effect of Poncirus Trifoliata on colonic motility in spinal cord injured rats. Journal of Korean Medicine Rehabilitation. 2008;18(4):13-24
  3. Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Muller-Lissner SA. Functional bowel disorders and functional abdominal pain. Gut. 1999;45(Suppl II):S43-7
  4. Leech SC, McHugh K, Sullivan PB. Evaluation of a method of assessing faecal loading on plain abdominal radiographs in children. Pediatric Radiology. 1999;29:255-8 https://doi.org/10.1007/s002470050583
  5. Arhan P, Devroede G, Jehannin B, Lanza M, FaverdinC, Dornic C, Persoz B, Tetreault L, Perey B, Pellerin D. Segmental colonic transit time. Diseases of the Colon & Rectum. 1981;24:625-9 https://doi.org/10.1007/BF02605761
  6. Kim, HM, Kim, HJ, Park, ST, Inhibition of immunoglobulin E production by Poncirus trifoliata fruit extract. Journal of Ethnopharmacology. 1999;66:283-8 https://doi.org/10.1016/S0378-8741(99)00028-8
  7. Kim CM, Shin MK, Ahn DG, Lee KS. Chungyak Daesajun. 1997;vol.8:3969-76
  8. Jayaprakasha GK, Mandadi KK, Poulose SM, Jadegoud Y, Nagana GA, Patil BS. Inhibition of colon cancer cell growth and antioxidant activity of bioactive compounds from Poncirus trifoliata (L.) Raf. Bioorganic and Medicinal Chemistry. 2007;15:4923-32 https://doi.org/10.1016/j.bmc.2007.04.044
  9. Teng C.M, Li H.L, Wu T.S, Huang S.C, Huang T.F. Antiplatelet actions of some coumarin compounds isolated from plant sources. Thrombosis Research. 1992;66:549-57 https://doi.org/10.1016/0049-3848(92)90309-X
  10. Wong AL, Chan TY. Interaction between warfarin and the herbal product quilinggao. Annals of Pharmacotherapy. 2003;37:836-8 https://doi.org/10.1345/aph.1C503
  11. Kim DH, Bae EA, Han MJ. Anti-helicobacter pylori activity of the metabolites of poncirin from Poncirus trifoliata by human intestinal bacteria. Biological and Pharmaceutical Bulletin. 1999;22:422-4 https://doi.org/10.1248/bpb.22.422
  12. Ho TY, Wu SL, Lai IL, Cheng KS, Kao ST, Hsiang CY. An in vitro system combined with an in-house quantitation assay for screening hepatitis C virus inhibitors. Antiviral Research. 2003;58:199-208 https://doi.org/10.1016/S0166-3542(03)00004-4
  13. Lee YM, Kim DK, Kim SH, Shin TY, Kim HM. Antianaphylactic activity of Poncirus trifoliata fruit extract. Journal of Ethnopharmacology. 1996;54:77-84 https://doi.org/10.1016/S0378-8741(96)01451-1
  14. Ashraf W, Park F, Lof J, Quigley EM. An examination of the reliability of reported stool frequency in the diagnosis of idiopathic constipation. The American Jounal of Gastroenterology. 1996;91:26-32
  15. Shim WS, Back H, Jung SW, Kim JW, Jang Y, Lee B, Seo EK, Oh U, Shim CK. An aqueous extract of Poncirus fructus activates the prokinetic activity of 5-HT receptor subtype 4 without hERG interaction. Journal of Ethnopharmacology. 2010;132:328-33 https://doi.org/10.1016/j.jep.2010.08.042
  16. Choi KH, Jeong SI, Hwang BS, Lee JB, Ryoo HK, Lee S, Choi BK, Jung KY. Hexane extract of Poncirus trifoliate (L.) Raf. stimulates the motility of rat distal colon. Journal of Ethnopharmacology. 2010;127:718-24 https://doi.org/10.1016/j.jep.2009.11.032
  17. Scivoletto G, Fuoco U, Badiali D, Braccl F, Lucente LD, Patrelli A, Vona VU, Tnillo D, Castellano V, Corazzian E. Gastrointestinal dysfunction following stroke. Journal of the Neurological Sciences. 1997;150:S151
  18. Robain G, Chennevelle JM, Petit F, Piera JB. Incidence of constipation after recent vascular hemiplegia: a prospective cohort of 152 patients. Revue Neurologique. 2002;158:589-92
  19. Harari D, Norton C, Lockwood L, Swift C. Treatment of constipation and fecal incontinence in stroke patients: randomized controlled trial. Stroke. 2004;35:2549-55 https://doi.org/10.1161/01.STR.0000144684.46826.62
  20. Lim YH, Kim DH, Lee MY, Joo MC. Bowel dysfunction and colon transit time in brain-injured patients. Annals of Rehabilitation Medicine. 2012;36:371-8 https://doi.org/10.5535/arm.2012.36.3.371
  21. Yi JH, Chun MH, Kim BR, Han EY, Park JY. Bowel function in acute stroke patients. Journal of Korean Academy Rehabilitation Medicine. 2011;35:337-43
  22. O’Donnell LJ, Virhee J, Heaton KW. Detection of pseudodiarrhoea by simple clinical assessment of intestinal transit rate. British Medical Journal. 1990;300:439-40 https://doi.org/10.1136/bmj.300.6722.439
  23. Lee HT, Seo EK, Chung SJ, Shim CK. Effect of an aqueous extract of dried immature fruit of Poncirus trifoliata (L.) Raf. on intestinal transit in rodents with experimental gastrointestinal motility dysfunctions. Journal of Ethnopharmacology. 2005;102(2):302-6 https://doi.org/10.1016/j.jep.2005.08.015
  24. Kim BJ, Kim HW, Lee GS, Choi S, Jun JY, So I, Kim SJ. Poncirus trifoliate fruit modulates pacemaker activity in interstitial cells of Cajal from the murine small intestine. Journal of Ethnopharmacology. 2013;149:668-75 https://doi.org/10.1016/j.jep.2013.07.017
  25. Jang Y, Kim SW, Oh J, Hong GS, Seo EK, Oh U, Shim WS. Ghrelin receptor is activated by naringin and naringenin, constituents of a prokinetic agent Poncirus fructus. Journal of Ethnopharmacology. 2013;148:459-65 https://doi.org/10.1016/j.jep.2013.04.039
  26. Lee HT, Seo EK., Chung SJ, Shim CK, Prokinetic activity of an aqueous extract from dried immature fruit of Poncirus trifoliata (L.) Raf. Journal of Ethnopharmacology. 2005;102(2):131-6 https://doi.org/10.1016/j.jep.2005.05.052