健脾和胃化瘀中药对慢性萎缩性胃炎患者胃黏膜热休克蛋白70表达的影响  

Effect of Chinese Drugs for Strengthening Pi,Harmonizing Wei,and Dispersing Blood Stasis on the Expression of Gastric Mucosal Heat Shock Protein 70 in Chronic Atrophic Gastritis Patients

作　　者：周嘉鹤[1] 傅志泉[1] 邓建平[2] 李春霞[1] 乔镇[1] 朱伟琴[1] 赵虹雯[1] 李珍[1] 

机构地区：[1]浙江省杭州市第三人民医院消化内科,杭州310009 [2]浙江省杭州市第三人民医院中医科,杭州310009

出　　处：《中国中西医结合杂志》2015年第4期406-410,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：浙江省中医药普通课题研究计划资助项目(No.2009CB061)

摘　　要：目的观察健脾和胃化瘀中药对慢性萎缩性胃炎(chronic atrophic gastritis,CAG)患者胃黏膜热休克蛋白70(HSP70)表达的影响。方法将100例CAG患者按随机数字表法分为治疗组(50例)和对照组(50例)。治疗组给予口服健脾和胃化瘀中药治疗,每日1次;对照组给予口服叶酸片治疗,10 mg/次,每日3次,两组疗程均为6个月。观察两组治疗前后主要中医症状体征、胃镜和病理组织学的变化。采用SP免疫组化法测定治疗前后胃黏膜HSP70的表达,利用HPIAS-1 000病理图文分析系统采集图像,半定量分析表达情况。结果治疗组中医症状体征有效率为88.0%(44/50),对照组有效率为56.0%(28/50),两组差异有统计学意义(P<0.01)。胃镜检查治疗组对胃黏膜充血水肿、糜烂、胆汁反流、黏膜白相、血管显露和颗粒增生的改善率明显优于对照组(均P<0.05)。病理检查治疗组治疗萎缩总有效率为80.0%(40/50),对照组总有效率54.0%(27/50),两组差异有统计学意义(P<0.01)。治疗组治疗肠化有效率75.0%(12/16),对照组有效率33.3%(5/15),治疗组优于对照组(P<0.05)。与本组治疗前比较,两组治疗后胃黏膜HSP70积分光密度值均明显升高,差异有统计学意义(均P<0.01);与对照组比较,治疗组治疗后胃黏膜HSP70积分光密度值亦明显升高,差异有统计学意义(P<0.01)。结论健脾和胃化瘀中药治疗CAG有明显的效果,对胃癌前病变有改善作用,并可能通过影响CAG患者胃黏膜HSP70的表达而起到治疗作用。Objective To observe the effect of Chinese drugs for strengthening Pi, harmonizing Wei, and dispersing blood stasis （CDSPHWDBS） on the expression of gastric mucosal heat shock pro- tein 70 （HSP70） in chronic atrophic gastritis （CAG） patients. Methods A total of 100 CAG patients were assigned to the control group and the treatment group by random digit table, 50 in each group. Patients in the control group took Folic Acid Tablet 10 mg each time, 3 times per day. Those in the treatment group took CDSPHWDBS, 100 mL each time, once per day. The treatment course was 6 months for all. Clinical symptoms and signs, endoscopic and histopathological changes were observed before and after treat- ment in the two groups. The expression of gastric mucosal HSP70 in CAG patients was determined using SP immunohistochemistry. Data were collected by HPIAS-1 000 pathological graphic analysis system, and its expression semi-quantitatively analyzed. Results The total effective rate of clinical Chinese med-ical symptoms and signs was 88.0% （44/50 cases） in the treatment group and 56.0% （28/50 cases） in the control group, with significant difference between the two groups （P 〈0.01 ）. The improvement rate of endoscopic manifestations such as congestion and edema, erosion, bile regurgitation, pale gastric mu- cosa, exposed blood vessels, particles proliferation in the treatment group were superior to those in the control group （P 〈0.05）. The total effective rate of atrophy was 80.0% （40/50 cases） in the treatment group and 54.0% （27/50 cases） in the control group, with significant difference between the two groups （P 〈0.01 ）. The effective rate of intestinal metaplasia was 75.0% （12/16 cases） in the treatment group and 33.3% （5/15 cases） in the control group, with significant difference between the two groups （P 〈 0.05 ）. The optical density value of gastric mucosal HSP70 was significantly elevated in the two groups af- ter treatment （both P 〈0.05）. It was higher in the tre

关 键 词：慢性萎缩性胃炎 健脾和胃化瘀 热休克蛋白 

分 类 号：R259[医药卫生—中西医结合]