思连康联合艾司奥美拉唑钠治疗幽门螺杆菌相关性胃炎疗效及对NF-κB炎症信号通路的影响  

Siliankang combined with esomeprazole sodium for treatment of Helicobacter pylori-associated gastritis:Efficacy and influence on NF-κB signaling pathway

作　　者：黄龙武[1] 李雷[1] Long-Wu Huang;Lei Li(Endoscopy Center,Huzhou Third People’s Hospital,Huzhou 313000,Zhejiang Province,China)

机构地区：[1]湖州市第三人民医院内镜中心,浙江省湖州市313000

出　　处：《世界华人消化杂志》2021年第3期131-137,共7页World Chinese Journal of Digestology

摘　　要：背景基于药理学和药物遗传学,质子泵抑制剂-阿莫西林的优化二联疗法开始运用于临床.近期共识报告指出益生菌对于幽门螺杆菌(Helicobacter pylori,H.pylori)根除治疗亦有显著效果.但目前临床关于两者治疗H.pylori相关性胃炎治疗效果及可能作用机制的研究鲜有报告,值得进一步研究.目的思连康(双歧杆菌四联活菌片)联合艾司奥美拉唑钠治疗H.pylori相关性胃炎疗效及对核因子κB(nuclear factorκB,NF-κB)炎症信号通路的影响.方法选取2018-11/2019-12于我院接受治疗的64例H.pylori相关性胃炎患者临床资料,按照随机数字表法将纳入对象分为治疗组(32例)与对照组(32例).两组入院后均接受优化二联疗法,即艾司奥美拉唑钠肠溶片20 mg+阿莫西林胶囊1000 mg,均为bid,在此基础上,治疗组加用思连康进行治疗,两组均连续治疗14 d.比较两组临床疗效、胃黏膜改变情况、H.pylori根除率及药物相关不良反应情况,同时于治疗前后通过胃镜下病理活检后采用蛋白质定量(BCA)法进行NF-κB P50、P65蛋白定量,采用荧光定量聚合酶链式反应(polymerase chain reaction,PCR)法检测NF-κB P50、P65 mRNA,采用免疫组化检测白细胞介素(interleukin,IL)-1β、IL-8、肿瘤坏死因子(tumor necrosis factor,TNF)-α水平.结果治疗后,两组NF-κB P50、P65 mRNA和蛋白均呈下降趋势,同时治疗组较对照组更低(1.42±0.33 vs 1.10±0.24,1.27±0.26 vs 0.87±0.17,2.51±0.52 vs 1.94±0.28,2.33±0.37 vs 1.77±0.23)(P<0.01);两组IL-1β、IL-8、TNF-α均呈下降趋势,同时治疗组较对照组更低(11.50±3.40 vs 7.30±2.16,237.70±27.72 vs 193.68±19.88,19.30±3.41 vs 10.87±2.18)(P<0.01);此外,治疗组胃黏膜充血、水肿、糜烂和出血点好转例数均明显多于对照组(P<0.05),治疗组总有效率高于对照组(96.88%vs 78.13%,P<0.05),H.pylori根除率亦高于对照组(93.75%vs 75.00%,P<0.05).结论思连康联合优化二联疗法治疗可显著缓解H.pylori相关�BACKGROUND Based on pharmacology and pharmacogenetics,the optimized dual therapy of proton pump inhibitorsamoxicillin has began to be used in clinical practice.A recent consensus report pointed out that probiotics also have a significant effect on Helicobacter pylori(H.pylori)eradication.However,there are few clinical reports on the therapeutic effect and possible mechanism of the two treatments for H.pylori-related gastritis.AIM To evaluate the efficacy of Siliankang(bifidobacterium quadruple viable bacteria tablets)combined with esomeprazole sodium in the treatment of H.pylori-associated gastritis and its effect on the nuclear factor kappa B(NF-κB)signaling pathway.METHODS The clinical data of 64 patients with H.pylori-related gastritis who were treated at our hospital from November 2018 to December 2019 were analyzed.The included subjects were randomly divided into either a treatment group(32 cases)or a control group(32 cases)using the random number table method.Both groups received optimized dual therapy after admission,that is,esomeprazole sodium enteric-coated tablets 20 mg+amoxicillin capsules 1000 mg,both bid.On this basis,the treatment group was additionally treated with Siliankang.Both groups were treated continuously for 14 d.The clinical efficacy,gastric mucosal changes,HP eradication rate,and drug-related adverse reactions were compared between the two groups.The NF-κB p50 and p65 proteins were quantified after pathological biopsy under gastroscopy before and after treatment.Quantitative polymerase chain reaction(PCR)was used to detect NF-κB p50 and p65 mRNA,and immunohistochemistry was used to detect the levels of interleukin(IL)-1β,IL-8,and tumor necrosis factor(TNF)-α.RESULTS After treatment,NF-κB p50 and p65 mRNA and protein showed a downward trend in both groups,and the decrease was significantly greater in the treatment group than in the control group(1.42±0.33 vs 1.10±0.24,1.27±0.26 vs 0.87±0.17,2.51±0.52 vs 1.94±0.28,and 2.33±0.37 vs 1.77±0.23,respectively;P<0.01).IL-1β,IL-8,an

关 键 词：思连康 优化二联疗法 幽门螺杆菌 相关性胃炎 临床疗效 NF-κB炎症信号通路 

分 类 号：R573.3[医药卫生—消化系统]