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[Identification and determination of marker substances in niuhuang jiedu pian by three dimensional HPLC].
The Chinese traditional patent medicine Niuhuang Jiedu Pian was analyzed by three dimensional HPLC. The results show that some of the Chinese herbal drugs contained in Niuhuang Jiedu Pian can be identified and the content of the marker substances can be determined. According to the results of determination, the content of baicalin, sennoside A and glycyrrhizin in Niuhuang Jiedu Pian was 4.21, 0.59 and 1.03 (mg/tablet), respectively. The RSD was 1.6, 2.8 and 1.4%, respectively.
Pre-radiographic bowel preparation: a comprehensive reappraisal of factors.
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[Comparative study of the efficacy and tolerance of 2 types of colon cleansing].
OBJECTIVE: To examine if (hypothesis): orally administered colon cleansing with 3 liters of balanced electrolyte/polyethylene glycol solution is superior to the standard method of bowel preparation with senna laxatives and sodium phosphate enemas. STUDY FACTORS: 1st) Quality of colon cleansing estimated by the attending endoscopist. 2nd) Patient tolerance. METHODS DESIGN: prospective randomized trial, blind to the endoscopist, comparing two methods of bowel preparation: group A received 3 L of the balanced electrolyte/polyethylene glycol solution the night before the procedure and group B was instructed to ingest 75 ml of a senna laxative the day before the colonoscopy and sodium phosphate enemas per rectum b.i.d. starting 2 days before the examination and again the morning of the procedure. Assessing criteria: 1st) Questionnaire filled by the attending endoscopist immediately after the completion of the colonoscopy. 2nd) Questionnaire filled by the patient the day after the procedure. PATIENTS INCLUSION CRITERIA: all the patients addressed to our Unit for colonoscopy (18 patients refused to participate). EXCLUSION CRITERIA: severe cardiovascular disease, decompensated diabetes mellitus and severe disease or neurological derangement that prevented collaboration (35 patients). Two hundred and sixteen patients were initially included, 110 in group A and 106 in group B; in 39 patients (18 in group A and 21 in group B) colonoscopy could not be completed for causes others than bowel preparation and were excluded for further evaluation by the endoscopist, thus, quality of bowel preparation was evaluated in 92 patients in group A and in 85 patients in group B; 83 patients (43 in group A and 40 in group B) did not answer the questionnaire, or did it incorrectly, thus, tolerance was evaluated in 67 patients in group A and in 66 patients in group B. RESULTS: In 2 patients in group A (2.2%) and in 9 patients in group B (10.6%) colonoscopy could not be completed because of solid stool (p = 0.045). Mucosal visualization was better in group A than in group B (p = 0.0108). A total of 11.9% of the patients in group A and 25.8% of the patients in group B found the preparation hard or very hard to tolerate (p = 0.0001), patients in this latter group presented more frequently abdominal cramps (p = 0.0004), and distress (p < 0.00001), and dizziness (p = 0.0031). Bad tolerance in group B was primarily due to the rectal enemas (p < 0.0001). CONCLUSIONS: Bowel preparation for colonoscopy with 3 L of orally administer balanced electrolyte/polyethylene glycol solution (PEG) results in a better colon cleansing and is better tolerated than the classical preparation consisting in oral purge and rectal enemas.
[Mechanism of action of sennosides].
A review of the recent progress in the study of the mode of action of the sennosides, the active constituents of the senna drug, is presented. An interaction between rhein anthrone, the active metabolite of the sennosides, and the immune cells of the colon is suggested as a base for laxative activity.
[The mechanism of action of sennosides].
A review of the recent progress in the study of the mode of action of the sennosides, the active constituents of the senna drug, is presented. An interaction between rhein anthrone, the active metabolite of the sennosides, and the immune cells of the colon is suggested as a base for laxative activity.
Lack of influence of intestinal transit on oxidative status in premenopausal women.
OBJECTIVE: There are reasons for believing that diet can alter the risk of malignancy by alteration of the body's oxidative status. Intestinal contents and enterohepatically recirculated substances are influenced by intestinal transit rate. A low fibre diet has been linked to the increase in constipation seen in countries consuming a westernized diet, as well as to the aetiology of many diseases. We studied the effects of altering intestinal transit rates and of wheat bran on oxidative status. DESIGN: 40 premenopausal women were randomized to receive dietary supplements of wheat bran, senna or loperamide for the length of two menstrual cycles. Dietary records, whole gut transit time (WGTT) and plasma lipid peroxides, measured as TBARS (specifically malondialdehyde) were determined at the beginning and end of each intervention. SETTING: University department of Medicine, Bristol Royal Infirmary. RESULTS: 36 volunteers completed the study. WGTT increased in those receiving loperamide and decreased in those receiving senna. The decrease in WGTT was not significant in those receiving wheat bran. Diets did not change. There were no changes in TBARS, cholesterol, triglyceride or TBARS adjusted for cholesterol and triglyceride, during any intervention. CONCLUSIONS: Dietary supplementation with wheat bran and pharmacological alteration of intestinal transit had no influence on oxidative status or on plasma cholesterol or triglycerides.
Correction of outflow obstruction with the use of sennosides in CAPD patients.
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[Drug therapy of the varicose syndrome using Evilettes].
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[Use of sennosides A + B in the preparation of the colon for endoscopy].
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[Sennosides Reference Standard (Control 951) of the National Institute of Health Sciences].
The "Sennosides Reference Standard (Control 951)" was prepared, which is intended to be used for the fluorophotometric assay of sennosides content in the preparation of "Sennosides". In this assay hydroxylated mono- and dianthraquinone glucosides are chelated with boric acid, and the fluorescence intensity of the chelate is determined against that of the Reference Standard (RS). In the establishment of this RS, sennosides content in the candidate material must be determined accurately by fluorophotometry. The Sennoside AB for assay, prepared as an equimolar mixture of the purified sennoside A and Sennoside B, was used as the RS for the fluorophotometry. Based on the above concept, sennosides content in the candidate was determined as calcium salts to be 60.1 +/- 1.6% by the fluorophotometry. Thus the sennosides content of this Sennosides RS was certified to be 60%. Separately, contents of Sennoside A (SA) and Sennoside B (SB) in this candidate were determined by using HPLC. As a result, the sum of SA and SB was estimated to be 38% as free acids. Thus it was suggested that about 20% of dianthraquinone glucosides other than SA and SB and anthraquinone glucosides may be included in this Sennoside RS as free acids. Analytical results on the USP Sennosides RS were also shown and discussed, compared with the present Sennosides RS.
Randomized comparison of two preoperative methods for preparation of the colon: oral administration of a solution of polyethylene glycol plus electrolytes and total parenteral nutrition.
BACKGROUNDS/AIMS: Two colon preparation methods were compared for their efficacy. The comparison was carried out between whole bowel irrigation using polyethylene glycol-electrolyte lavage solution (PEG-ELS) and total parenteral nutrition (TPN). METHODOLOGY: Twenty-six consecutive patients suffering from colorectal cancer without apparent obstruction were randomly divided into two groups. Twelve patients received 2 litres of PEG-ELS one day before the operation following two tablets of sennoside (24 mg) two days before the operation without restriction of food until PEG-ELS. Fourteen patients received magnesium citrate (34 g) and sennoside (24 mg) on the day before the operation with 7 days' TPN and fasting. RESULTS: The average time of defecation was 9 in the PEG-ELS group and 5 in the TPN group (p < 0.001), with little difference between the necessary times to complete defecation (PEG-ELS: 280 min. vs. TPN: 260 min.). However, although half of the PEG-ELS group complained of side effects of abdominal fullness the overall incidence of side effects in both groups were the same of 50%. There were no significant changes between the data of blood test and routine chemistry before and after the bowel preparation in both groups. The purity of the colorectum judged at operation in both groups were excellent, no residue at all, except in one patient of the TPN group. The total bacterial counts of the rectal samples obtained at operation of PEG-ELS group were fewer than that of TPN group but not statistically significant. CONCLUSION: Colon preparation using PEG-ELS is just as good as the 7-days' TPN treatment and fasting, and exceeds from the standpoint of saving time.
The effect of sennosides on colonic mucosal histology and bowel preparation.
INTRODUCTION: A single high dose of sennosides is often used to optimize bowel preparation for diagnostic procedures. From previous studies it is suspected that sennosides in such a dose cause acute damage to the colonic mucosa. This study was designed to determine any effects of sennosides on histology of colonic mucosa and on bowel preparation. RESULTS: In a prospective study 171 patients were randomized for bowel preparation. 84 patients received 1 ml/kg (maximal 75 ml) of a syrup containing 2.0 mg/ml sennoside A and B and 3-5 l of a lavage solution (Sen), 87 patients only received 3-5 l lavage solution (NSen). All patients completed a questionnaire on which patient tolerance was scored. Another questionnaire was completed by the endoscopist, recording quality of the preparation. From the 40 patients with a normal colon (19 Sen, 21 NSen) a biopsy was taken from the sigmoid colon and analyzed for morphological abnormalities. No difference could be demonstrated in tolerance or quality of bowel preparation between the two groups. A marked increase of mononuclear infiltrate in the lamina propria was observed in Sen compared to NSen: in 10/19 vs. 2/21 patients respectively, p < 0.0005. CONCLUSION: As these microscopic effects could hamper the interpretation of colonic biopsies, bowel preparation without sennosides is to be recommended.
Cassia senna inhibits mutagenic activities of benzo[a]-pyrene, aflatoxin B1, shamma and methyl methanesulfonate.
Ethanol extract of Senokot tablets (Cassia senna concentrate used as vegetable laxative), was found to be non-mutagenic while it inhibited the mutagenicity of benzo[a]pyrene, shamma, aflatoxin B1 and methyl methanesulfonate in the Ames histidine reversion assay using the Salmonella typhimurium tester strain TA98. While the Senokot extract completely inhibited the mutagenicity of promutagens (i.e. metabolic activation dependent) like benzo[a]pyrene and shamma, it reduced the mutagenic activity of the direct acting mutagen methyl methanesulfonate by only 58%. The mutagen aflatoxin B1 showed a 25-fold increase in the number of histidine revertants per plate at low concentrations (1.0-4.0 micrograms/plate) in the presence of metabolic activation system while at high concentrations (10.0-30.0 micrograms/plate) it proved to be weakly mutagenic (with a 5-fold increase in the number of histidine revertants/plate) without metabolic activation. The Senokot extract completely inhibited the mutagenic effect of low concentrations of aflatoxin B1 in the presence of metabolic activation but not that resulting from higher concentrations without metabolic activation. The results obtained with benzo[a]pyrene, shamma and aflatoxin B1 indicated that the antimutagenic effects of Senokot extract could be largely due to an interaction with the metabolic process involved in the activation of procarcinogens. However, the results obtained with methyl methanesulfonate suggested that factors in Senokot may also interact with direct mutagens to produce some antimutagenic effects. An ethanol extract of crude senna leaves found to be weakly mutagenic also inhibited (though less than Senokot) the mutagenic effect of benzo[a]pyrene suggesting that the antimutagenic principle is present in the complex plant material itself.
[Quantitative determination of sennosides in senna pods and senna leaves. I. Method (author's transl)].
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Safety and efficacy of a bulk laxative containing senna versus lactulose in the treatment of chronic constipation in geriatric patients.
Thirty geriatric long-stay patients aged 65-94 years (mean 81.8) participated in the trial the aim of which was to examine bulk laxative plus senna (Agiolax) in the treatment of chronic constipation using lactulose (Levolac) as a reference medicine. Bulk laxative plus senna (daily doses 14.8 g) produced more frequent (p < 0.05) bowel habits (4.5 vs. 2.2-1.9/week) than lactulose (daily doses 20.1 g). Both laxatives proved to be safe to use. Our study indicated bulk laxative plus senna to be more efficient in treating constipation in geriatric long-stay patients.
A comparison of Agiolax and lactulose in elderly patients with chronic constipation.
In a double-blind crossover study the efficacies of Agiolax, a combination of fibre and senna pod, and lactulose were compared in 77 long-stay elderly patients with chronic constipation. Mean daily bowel frequency, stool consistency and ease of evacuation were significantly greater with Agiolax than lactulose. The recommended dose was exceeded more frequently with lactulose than Agiolax (chi 2 = 8.38, p < 0.01). Adverse effects were not different for the 2 treatments. In long-stay elderly patients with chronic constipation Agiolax and lactulose were well tolerated, but Agiolax proved a more effective treatment.