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Constipation-predominant irritable bowel syndrome: A review of current and emerging drug therapies

World Journal of Gastroenterology 2014年第27期20卷 8898-8909页

作者： Khaled A Jadallah Susan M Kullab David S Sanders Department of InternalMedicine King Abdullah University Hospital Faculty of Medicine Jordan University of Science and Technology Department of Gastroenterology and Liver Unit Royal Hallamshire Hospital Sheffield South Yorkshire S102JF United Kingdom

Irritable bowel syndrome(IBS) is a highly prevalent medical condition that adversely affects patient quality of life and constitutes a significant economic burden on healthcare resources. A large proportion of patients suffer from the constipation subtype of IBS(IBS-C), most commonly afflicting older individuals and those with a lower socioeconomic status. Conventional pharmacologic and nonpharmacologic treatment options have limited efficacies and/or significant adverse events, which lead to increased long-term health care expenditures. Failure to effectively treat IBS-C patients over the past decades has largely been due to a poor understanding of disease pathophysiology, lack of a global view of the patient, and an inappropriate selection of patients and treatment endpoints in clinical trials. In recent years, however, more effective and safer drugs have been developed for the treatment of IBS-C. The advancement in the area of pharmacologic treatment is based on new knowledge of the pathophysiologic basis of IBS-C and the development of drugs with increased selectivity within pharmacologic classes with recognized efficacies. This narrative review covers the spectrum of available drugs and their mechanisms of action, as well as the efficacy and safety profiles of each as determined in relevant clinical trials that have investigated treatment options for IBS-C and chronic constipation. A brief summary of laxative-based treatment options is presented, followed by up-to-date assessments for three classes of drugs: prokinetics, prosecretory agents, and bile acid modulators.

关键词： Constipation Irritable bowel syndrome Drug therapy Serotonergic agents Prokinetics 5-hydroxytryptamine type 4 agonists secretagogues Prosecretory agents Bile acid modulators

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An overview on antidiabetic medicinal plants having insulin mimetic property

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Asian Pacific Journal of Tropical Biomedicine 2012年第4期2卷 320-330页

作者： Patel DK Prasad SK Kumar R Hemalatha S Pharmacognosy Research Laboratory Department of PharmaceuticsInstitute of TechnologyBanaras Hindu University

Diabetes mellitus is one of the common metabolic disorders acquiring around 2.8%of the world's population and is anticipated to cross 5.4%by the year *** long back herbal medicines have been the highly esteemed source of medicine therefore,they have become a growing part of modern,high-tech *** view of the above aspects the present review provides profiles of plants(65 species) with hypoglycaemic properties,available through literature source from various database with proper categorization according to the parts used,mode of reduction in blood glucose(insulinomimetic or insulin secretagugues activity) and active phyloconsliluents having insulin mimetics *** the review it was suggested that,plant showing hypoglycemic potential mainly belongs to the family Leguminoseae,Lamiaceae,Liliaceae,Cucurbitaceae, Asteraceae,Moraceae,Rosaceae and *** most active plants are Allium sativum. Gymnema sylvestre,Citrullus colocynthis,Trigonella foenum greacum,Momordica charantia and Ficuts *** review describes some new bioactive drugs and isolated compounds from plants such as roseoside,epigallocatechin gallate,beta-pyrazol-1-ylalanine,cinchonain Ib,leucocyandin 3-O-beta-d-galactosyl cellobioside,leucopelargonidin-3- O-alpha-L rhamuoside,glycyrrhetinic acid,dehydrotrametenolic acid,strictinin,isostrictinin,pedunculagin, epicatechin and christinin-A showing significant insulinomimetic and antidiabetic activity with more efficacy than conventional hypoglycaemic ***,from the review majorly,the antidiabetic activity of medicinal plants is attributed to the presence of polyphenols,flavonoida, terpenoids,coumarins and other constituents which show reduction in blood glucose *** review also discusses the management aspect of diabetes mellitus using these plants and their active principles.

关键词： Diabetes Insulin secretagogues Insulin mimetics Phytoconstituents Pancrease Blood glucose Insulin Beta cell Antidiabetic activity Medicinal plant Metabolic disorder Herbal medicine Diabetes mellitus Hypoglycaemic activity

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