根除Hp与疗胃煎剂对Hp相关CAG治疗作用  

Effects of Helicobacter pylori eradication and decoction of Liaowei therapy on Helicobacter pylori associated chronic atrophic gastritis

作　　者：姚希贤[1] 姚金锋[1] 崔东来[1] 郭昱[1] 白文元[1] 

机构地区：[1]河北医科大学第二医院消化内科,河北省石家庄市050000

出　　处：《世界华人消化杂志》2000年第7期741-745,共5页World Chinese Journal of Digestology

摘　　要：目的研究根除 Hp 与疗胃煎剂对 Hp 相关 CAG 的治疗作用方法实验研究,90g-110g,二级 Wistar 大鼠70只,随机分为疗胃煎剂治疗组(三种不同剂量)、三九胃泰对照组、单纯根除 Hp 组、自然恢复组与正常组(各10只).采用灌胃接种 SS1Hp 菌株,灌胃水畅酸钠溶液,交替自由饮用50mL/L 乙醇与5 mmool/L 去氧胆酸钠溶液的综合方法制备 Hp 相关 CAG 动物模型.模型制备成功后均先根除 Hp.以三九胃泰为对照进行疗胃煎剂治疗,12 wk 疗程结束后,处死动物进行 Hp 感染,病理组织学检查与粘膜氮基已糖含量检测.临床研究,34例经内镜、病理证实的 Hp 阳性 CAG 患者随机分为疗胃煎剂治疗组和硫糖铝对照组,治疗前后分别进行病理组织学及化验指标检测.结果实验研究结果显示,疗胃煎剂中、高剂量组大鼠粘膜萎缩程度较三九胃泰组,自然恢复组及单纯根除 Hp 组明显减轻[粘膜上皮层厚度(μm)分别为97±14,96±13,73±11,66±12,74±10,P<0.05],中剂量组粘膜氨基己糖增加,与自然恢复组比较(22.53±4.37)mg/g vs(12.21±2.40)mg/gP<0.05.自然恢复组 Hp 均为阳性,粘膜固有层有较明显炎症细胞浸润.其他各实验组 Hp 阴性,粘膜固有层无明显炎症反应.临床研究结果显示,疗胃煎剂对萎缩病变治疗有效率75%(15/20)明显高于硫糖铝组29%(4/14)(P<0.01),粘膜氨基己糖含量增加(41.21±7.73,49.72±12.61,P<0.05).硫糖铝对照组治疗前后无明显变化.结论疗胃煎剂具有增强胃粘膜屏障功能作用,可增加氨基己糖含量,能增加粘膜固有层厚度,是治疗 CAG 的有效药物.AIM To investigate the effect of successful Hp eradication and Chinese herbal decoction of Liao-wei therapy on Hp associated chronic atrophic gastritis in human and rats. METHODS In experimental study,70 grade two male rats,weighing 90g-110g,were randomly divided into decoction of Liao-wei,Wei-tai999 granule ( control group),simple Hp eradication,and natural restoring group.The Hp associated chronic atrophic gastritis models were induced with sodium deoxycholate,sodium salicylate,ethanol,and culture broth of Hp that were orally administered.The therapeutic effects of Hp eradication,medicinal herb decoction of Liao-wei,and Wei-tai999 granule (control group) on atrophic gastritis were observed quantitatively,and gastric mucosal hexosamine level were measured.In clinical study,34 patients with gastric Hp infection and histological evidence of CAG were treated with decoction of Liao-wei and sucralfate.Both treated patients underwent the same investigations performed pre-and post-treatment. RESULTS In experimental study,a significant (P<0.01) improvement was found for grading of glandular atrophy in decoction of Liao-wei at moderate (the thickness of lamina epithelium 97 μm±14 μm) and high dosage (96±13)μm compared with Wei-tai999 granule (73±11)μm and simple Hp eradication groups (74±10)μm.The content of gastric mucosal hexosamine was significantly increased in decoction of Liao-wei group at moderate dosage (compared with natural recovering group (22.5±4.4) mg/g vs (12.2±2.4)mg/g,P<0.01,Hp was positive and mild to moderate chronic active gastritis was observed in natural recovering group.In contrast,no Hp infection and remarkable inflammation were found in other groups,In patients treated with decoction of Liao-wei,a significant reduction was also detected for grading of glandular atrophy (the mean values from 1.55±0.60 to 0.60±0.68 P<0.01).The therapeutic effect on gastric atrophy was better than sucralfate group (75% vs 29% P<0.01).The concentration of hexosamine also increased (P<0.05). CONCLUSION Dec

关 键 词：幽门螺杆菌 萎缩性胃炎 治疗 胃粘膜 

分 类 号：R573.3[医药卫生—消化系统]