基于胃底黏膜组织Ghrelin水平变化探讨参赭培气汤治疗反流性食管炎的疗效及机制  

Based on the change of Ghrelin level in gastric fundus mucosa to explore the effect and mechanism of Shenzhe Peiqi Decoction in the treatment of reflux esophagitis

作　　者：苏冬梅[1] 李军祥[2] 刘新平[1] 孙忆婷 崔羽 SU Dongmei;LI Junxiang;LIU Xinping;SUN Yiting;CUI Yu(Department of Gastroenterology,Southern Branch of Guang'an Men Hospital,China Academy of Chinese Medical Sciences,Beijing,102618,China;Department of Gastroenterology,Dongfang Hospital,Subsidiary to Beijing University of Trditional Chinese Medicine)

机构地区：[1]中国中医科学院广安门医院南区消化科,北京102618 [2]北京中医药大学东方医院肝胆脾胃科

出　　处：《中国中西医结合消化杂志》2021年第9期665-668,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：北京市中医药科技项目(No:JJ2018-58)。

摘　　要：目的:观察参赭培气汤对中虚气逆型反流性食管炎患者生活质量改善情况以及对胃底黏膜组织Ghrelin表达的影响。方法:将100例中虚气逆型反流性食管炎患者按随机表法随机分成2组,每组50例。中药组采用参赭培气汤治疗,西药组采用雷贝拉唑肠溶胶囊治疗,疗程8周,随访3个月;观察治疗前后胃底黏膜组织Ghrelin的表达,治疗前后以及随访3个月时患者胃食管反流疾病问卷(Gerd Q)量表积分变化情况。结果:治疗后2组患者胃底不同部位(穹隆部、小弯侧)黏膜组织Ghrelin表达较治疗前均明显增加(P<0.001),Gerd Q量表积分均明显下降(P<0.001)。治疗后2组患者胃底黏膜组织Ghrelin表达及Gerd Q量表积分改善相当,均差异无统计学意义;随访3个月后,中药组的Gerd Q量表积分升高幅度小于西药组(P<0.001)。结论:中药参赭培气汤治疗反流性食管炎的临床疗效与西药雷贝拉唑相当,且中药组远期疗效优于西药组;中药参赭培气汤可能通过提高反流性食管炎患者胃底黏膜组织Ghrelin的表达起到治疗作用,且胃底穹隆部黏膜组织Ghrelin的表达明显高于小弯侧。Objective:To observe the effect of Shenzhe Peiqi Decoction on the improvement of the quality of life of patients with reflux esophagitis due to the deficiency of Qi and the expression of Ghrelin in the gastric fundus mucosa tissue. Methods:One hundred patients with reflux esophagitis of middle-deficiency-qi reverse type were randomly divided into 2 groups according to the computerized random table method, each with 50 cases. The Chinese Medicine group was treated with Shenzhe Peiqi Decoction, and the western medicine group was treated with rabeprazole enteric-coated capsules. Treatment course 8 weeks, follow-up 3 months;observe the expression of Ghrelin in gastric fundus mucosa before and after treatment, changes in the patient’s gastroesophageal reflux disease questionnaire(Gerd Q) scale score before and after treatment and 3 months follow-up. Results:Regardless of the treatment with Shenzhe Peiqi Decoction or Rabeprazole, the expression of Ghrelin in the mucosal tissues of different parts of the stomach fundus(fornix, side of minor curvature) was significantly increased compared with before treatment(P<0.001), and the score of the patient’s Gerd Q scale was significantly decreased(P<0.001). Among them, after treatment, the two groups of patients had the same improvement in Ghrelin expression and Gerd Q scale score in gastric fundus mucosa tissue, both of which were statistically different;and after 3 months of follow-up, the increase in Gerd Q scale score in the Traditional Chinese Medicine group was smaller than that in the western medicine group(P<0.001). Conclusion:The clinical efficacy of Shenzhe Peiqi Decoction in the treatment of reflux esophagitis is equivalent to that of the western medicine rabeprazole, and the long-term effect of the Chinese Medicine group is better than that of the western medicine group;the Traditional Chinese Medicine Shenzhe Peiqi Decoction may improve the Ghrelin of gastric fundus mucosa in patients with reflux esophagitis.The expression of Ghrelin plays a role in the treatme

关 键 词：反流性食管炎 中虚气逆型 参赭培气汤 脑肠肽 GHRELIN 

分 类 号：R573.3[医药卫生—消化系统]