疏肝宁神降逆护膜方对非糜烂性反流病患者CGRP、SP含量的影响  

Influences of Method of Soothing Liver,Calming Nerves,Descending Adverse Qi and Protecting Membrane on CGRP and SP in Patients with Non-erosive Reflux Gastroesophageal Disease

作　　者：戴高中[1] 田秋实[1] 范先靖[1] 朱世楷[1] 诸静芬[1] 赵克学[1] 

机构地区：[1]无锡市中医医院消化内科,江苏无锡214071

出　　处：《南京中医药大学学报》2016年第6期519-523,共5页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：江苏省中医药局科技项目(LZ09101)

摘　　要：目的使用中药疏肝宁神降逆护膜方治疗非糜烂性反流病(NERD),观察其疗效及对降钙素基因相关肽(CGRP)、P物质(SP)表达的影响。方法将37例患者随机分为治疗组(20例)与对照组(17例)。对照组采用奥美拉唑肠溶胶囊和多潘立酮片治疗,治疗组在对照组的基础上加予中药疏肝宁神降逆护膜方。治疗前后进行反流性疾病问卷评估临床症状,胃镜下取食管下段组织2块送检,行免疫组化,检测黏膜组织中CGRP及P物质表达情况。结果 1反流性疾病问卷症状总积分:2组治疗前无明显差异(P>0.05),治疗后治疗组症状总积分及烧心、胸口痛、胃内容物上涌的症状积分低于对照组(P<0.05),口中酸/苦味的症状则没有显著差异(P>0.05);总有效率:治疗组(75%)高于对照组(47%)(P<0.05);2免疫组化显示治疗组治疗后的CGRP、P物质的表达均较治疗前减少(P<0.05),而对照组治疗前后则无明显差异(P>0.05)。结论疏肝宁神降逆护膜方配合现有西药疗法能更为有效地缓解NERD患者的症状,提高疗效,其可能的作用机制为抑制伤害性传导物质CGRP、P物质的表达,从而降低食管的高敏性,保护食管黏膜,提高其屏障功能。OBJECTIVE To observe the efficiency of the method of soothing liver,calming nerves,descending adverse qi and protecting membrane in treating patients with non-erosive reflux gastroesophageal disease（NERD）and its role in reducing the expression of CGRP and SP.METHODS 37 patients were randomly divided into treatment group（20cases）and control group（17cases）.Patients in the control group were treated with omeprazole and domperidone,whereas those in the treatment group were further added with Chinese formula.Questionnaire concerning reflux diseases was used to evaluate the symptoms before and after treatment.Two biopsy samples were taken from the lower esophageal for immunohistochemistry to evaluate the expression of CGRP and SP.RESULTS 1No evident differences were detected in the two groups when it came to the total scores of questionnaire concerning reflux diseases（P〉0.05）before treatment.Both the total symptom scores and the symptom scores of burning,chest pain and reflux of gastric contents in the treatment group were lower than those in the control group（P〈0.05）,with no evident differences being detected in sour taste/bitter taste in the mouth（P〉0.05）after treatment.The total curative rate of the treatment group was 75%,which was higher than 47% of the control group（P〈0.05）.2Immunohistochemical test showed that the expression of CGRP and substance P in the treatment group after treatment was lower than that before treatment（P〈0.05）,while no significant changes were noticed in the control group（P〉0.05）.CONCLUSION The method of soothing liver,calming nerves,descending adverse qi and protecting membrane combined with western medicine therapy can efficiently relieve the symptoms and enhance curative efficiency in patients with NERD,whose action mechanism might be related to the inhibition of CGRP and substance P expression,so as to decrease esophageal hypersensitivity,protect the esophageal mucosa and increase its barrier function.

关 键 词：疏肝宁神降逆护膜方 非糜烂性反流病 降钙素基因相关肽 P物质 

分 类 号：R256.3[医药卫生—中医内科学]