胃复春治疗胃黏膜肠上皮化生的临床观察及机制研究  

Clinical observation and mechanism of Weifuchun in treating gastric intestinal metaplasia

作　　者：刘先勇[1] 刘雪梅[2] 杨振斌 LIU Xian-yong LIU Xue-mei YANG Zhen-bin(Department of Integrated Traditional Chinese and Western Medicine, Jiangning Hospital Affiliated to Nanjing Medical University, Nanjing, 211100 Clinical Laboratory, Hospital Affiliated to Xinyang Vocational and Technical College, Xinyang, 464000 Department of Spleen and Stomach, Yangzhou Municipal Hospital of Traditional Chinese Medicine, Yangzhou, 225002)

机构地区：[1]南京医科大学附属江宁医院中西医结合科,江苏南京211100 [2]信阳职业技术学院附属医院检验科,河南信阳464000 [3]江苏省扬州市中医医院脾胃病科,江苏扬州225002

出　　处：《上海中医药杂志》2017年第2期44-47,共4页Shanghai Journal of Traditional Chinese Medicine

摘　　要：目的观察胃复春治疗慢性萎缩性胃炎肠上皮化生的病理疗效、中医症状疗效及作用机制。方法将48例慢性浅表性胃炎(CSG)病例及110例胃黏膜肠上皮化生(GIM)病例先分为CSG组与GIM总组,比较两组音猬因子(Shh)/Wnt信号通路蛋白(Wnt3A)表达的不同后,将GIM总组病例随机分为对照组与治疗组,每组55例。对照组口服叶酸片,治疗组在此基础上口服胃复春。两组疗程均为6个月,比较两组GIM病理分级、中医症状疗效和Shh/Wnt3A表达的变化情况。结果 1试验期间,CSG组无脱落;GIM总组脱落21例,最终完成试验者89例。2干预前Shh弱表达于GIM总组,而强表达于CSG组中,组间比较差异有统计学意义(P<0.05);而干预前GIM总组Wnt3A表达明显高于CSG组,组间比较差异有统计学意义(P<0.05)。3组间治疗后比较,GIM分级治疗组较对照组明显改善(P<0.05)。4治疗组、对照组中医症状的总有效率分别为85.42%、36.59%;组间中医症状疗效比较,治疗组明显优于对照组(P<0.05)。组间治疗后比较,中医症状总积分治疗组明显低于对照组(P<0.05)。5组间治疗后比较,Shh表达治疗组明显高于对照组,而Wnt3A表达明显低于对照组(P<0.05)。结论胃复春能较好改善GIM患者中医症状、减轻其病理分级,其机制可能是通过调控Hh-Wnt基因信号通路环来实现的。Objective To observe the pathological effect,the traditional Chinese medicine（ TCM） syndrome efficacy and the mechanism of Weifuchun in treating gastric intestinal metaplasia of chronic atrophic gastritis. Methods 48 patients with chronic superficial gastritis（ CSG） and 110 patients with gastric intestinal metaplasia（ GIM） were divided into the CSG and GIM group respectively. Then the patients in the GIM group were randomly divided into the GIM-control and GIMtreatment group according to the different expression of sonic hedgehog（ Shh） and Wnt signaling pathway protein（ Wnt3A）,55 cases in each group. The GIMcontrol group was orally treated with folic acid tablets,and the GIM-treatment group was orally treated with Weifuchun and folic acid tablets,with a course of 6months. The pathological grade of GIM,TCM syndrome efficacy and expression of Shh and Wnt3 A in the two groups were compared. Results 1During the trial,21 cases fell off in the GIM group and no case fell off in the CSG group,a total of 89 cases finally completed the test. 2Before the intervention,the Shh was weakly expressed in the GIM group,but strongly expressed in the CSG group,with statistically significant difference（ P 〈0. 05）. Before the intervention,the Wnt3 A expression in the GIM group was obviously higher than that in the CSG group,with statistically significant difference（ P 〈0. 05）. 3For the comparison between groups after treatment,the GIM grade of the GIM-treatment group was obviously improved compared with the GIM-control group（ P〈 0. 05）. 4The total effective rate of TCM syndrome was 85. 42% in the GIM-treatment group and 36. 59% in the GIM-control group. For the comparison of the TCM syndrome efficacy between groups,the effects of the GIM-treatment group were significantly better than those of the GIM-control group（ P 〈0. 05）. For the comparison between groups after treatment,the total score of TCM syndrome in the GIM-treatment group was obviously lower than that in the GIM-control group（ P

关 键 词：胃黏膜肠上皮化生 胃复春 中医症状 Hedgehog/Wnt基因信号通路 音猬因子 

分 类 号：R259[医药卫生—中西医结合]