参芪消痞汤对慢性萎缩性胃炎癌前期病变患者肿瘤标志物及血清p53蛋白、MDA、GSH-Px的影响  

Effect of Shenqi Xiaopi Decoction on Tumor Markers and Serum p53 Protein,MDA,GSH-Px in Patients with Precancerous Lesions of Chronic Atrophic Gastritis

作　　者：刘宇[1] 杜小龙 王钢[1] LIU Yu;DU Xiaolong;WANG Gang(Chongqing Hospital of Chinese Medicine,Chongqing China 400021)

机构地区：[1]重庆市中医院,重庆400021

出　　处：《中医学报》2021年第1期182-186,共5页Acta Chinese Medicine

基　　金：重庆市中医药科研专项项目(2018QN053)。

摘　　要：目的:观察参芪消痞汤对慢性萎缩性胃炎(chronic atrophic gastritis,CAG)癌前期病变患者肿瘤标志物及血清p53蛋白、丙二醛(monochrome display adapter,MDA)、谷胱甘肽过氧化物酶(glutathion peroxidase,GSH-Px)的影响。方法:78例CAG患者按照随机数字表法随机分为试验组39例与对照组39例。对照组给予阿莫西林、呋喃唑酮、奥美拉唑、枸橼酸铋钾四联疗法治疗幽门螺杆菌感染;试验组在对照组治疗基础上给予参芪消痞汤(黄芪20 g,党参15 g,半夏、白术、厚朴、枳实、木香、柴胡、白花蛇舌草各10 g,草豆蔻仁、甘草各6 g),每日2次口服。治疗3个月后观察两组临床患者临床疗效,并在治疗前后分别采用酶联免疫吸附法检测两组患者血清p53蛋白的水平,电化学发光法检测人癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原(carbohydrate antigen,CA)72-4、白细胞介素-8(interleukin-8,IL-8)水平,比色法检测血清GSH-Px水平,硫代巴比妥酸法检测血清MDA水平。结果:试验组中医证候有效率为92.31%,对照组中医证候有效率为87.18%,两组比较,差异有统计学意义(Z=2.176,P=0.032)。试验组临床疗效有效率为89.74%,对照组临床疗效有效率为74.36%,两组比较,差异有统计学意义(Z=2.259,P=0.026)。治疗后两组患者血清CEA、CA72-4、IL-8、p53、MDA水平明显降低,GSH-Px水平明显升高,差异有统计学意义(P<0.05),且试验组CEA低于对照组(t=2.916,P=0.002),CA72-4低于对照组(t=3.945,P=0.000),IL-8低于对照组(t=2.896,P=0.002),p53低于对照组(t=0.652,P=0.005),MDA低于对照组(t=4.041,P=0.000),GSH-Px高于对照组(t=2.749,P=0.004),中医证候积分低于对照组(t=3.667,P=0.000)。结论:参芪消痞汤治疗CAG癌前病变患者临床疗效显著,能纠正氧化损伤,提高临床疗效,且能显著降低肿瘤标志物和p53蛋白的水平。Objective:To investigate the effect of Shenqi Xiaopi Decoction on tumor markers,serum p53 protein,monochrome display adapter(MDA),glutathione peroxidase(GSH-Px)in patients with precancerous lesions of chronic atrophic gastritis(CAG).Methods:78 CAG patients were randomly divided into experimental group 39 cases and control group 39 cases according to the random number table method.The control group was given amoxicillin,furazolidone,omeprazole,and bismuth potassium citrate quadruple therapy to treat Helicobacter pylori infection;the experimental group was given Shenqi Xiaopi Decoction[Huang qi(Astragalus membranaceus)20 g,Dangshen(Codonopsis)15 g,Banxia(Pinellia ternata),Baizhu(Atractylodes macrocephala),Houpu(Magnolia trifoliata),Zhishi(Fructus aurantii),Muxiang(Radix Aucklandiae),Chaihu(Radix Bupleuri),Baihuashe Shecao(Hedyotis diffusa)10 g,Caodoukou Ren(Fructus Amomi),Gancao(Licorice)6 g)],taken orally twice a day.After 3 months of treatment,the clinical efficacy of the two groups of clinical patients was observed,and the serum p53 levels of the two groups of patients were detected by enzyme-linked immunosorbent assay before and after treatment,and the levels of human carcinoembryonic antigen(CEA),carbohydrate antigen(CA)72-4 and interleukin-8(IL-8)were detected by electrochemiluminescence(ECL).The serum GSH-Px level was detected by colorimetry,and the MDA level was detected by thiobarbituric acid method.Results:The effective rate of TCM syndromes in the experimental group was 92.31%,while that in the control group was 87.18%.The difference between the two groups was statistically significant(Z=2.176,P=0.032).The clinical effective rate of the experimental group was 89.74%,and that of the control group was 74.36%(7 cases were cured,10 cases were markedly effective,12 cases were ineffective),and the difference between the two groups was statistically significant(Z=2.259,P=0.026).After treatment,the levels of serum CEA,CA72-4,IL-8,p53 and MDA in the two groups were significantly decreased,and GSH-Px was significa

关 键 词：参芪消痞汤 慢性萎缩性胃炎 胃癌前病变 肿瘤标志物 p53蛋白 丙二醛 谷胱甘肽过氧化物酶 

分 类 号：R259.733[医药卫生—中西医结合]