胃安除幽汤对Hp阳性慢性胃炎的影响及机制研究  

Effect of Weian Chuyou Decoction(胃安除幽汤)on Chronic Gastritis of Helicobacter Pylori Positive and Involved Mechanism

作　　者：胡俊强 程佳 李兴瑜 许双朝 刘玉龄 王玲玲 HU Junqiang;CHENG Jia;LI Xingyu;XU Shuangchao;LIU Yuling;WANG Lingling(Gastroenterology Department,The Second Affiliated Hospital,Xingtai Medical College,Xingtai 054000,China;Drug Analysis Department,Center for ADR Monitoring of Xiangtai,Xingtai 054000,China)

机构地区：[1]邢台医学高等专科学校第二附属医院消化内科,河北邢台054000 [2]邢台市药品不良反应和药物滥用监测中心药物分析科,河北邢台054000

出　　处：《山东中医杂志》2022年第7期738-743,781,共7页Shandong Journal of Traditional Chinese Medicine

基　　金：邢台市科技计划重点研发项目(编号:2020ZC224)。

摘　　要：目的:观察胃安除幽汤对幽门螺杆菌(Hp)阳性慢性胃炎患者免疫水平及肠道菌群的影响,并探讨其作用机制。方法:选择Hp阳性慢性胃炎患者180例,随机分为对照组和胃安除幽汤组各90例。两组患者均接受四联疗法,胃安除幽汤组在此基础上联合应用胃安除幽汤治疗,比较两组的症状缓解情况、Hp清除情况、肠道菌群组成、CD4+和CD8+细胞变化情况以及胃黏膜中的髓样分化因子88(MyD88)/白细胞介素受体相关激酶(I-RAK)/核因子-κB(NF-κB)通路转录和翻译水平。结果:治疗后两组的临床症状均有明显缓解(P<0.05),胃安除幽汤组各症状评分均低于对照组(P<0.05);胃安除幽汤组Hp清除率(86.67%)高于对照组(71.67%)(P<0.05);治疗后两组的有益菌(乳酸杆菌和双歧杆菌)含量均升高(P<0.05),且胃安除幽汤组高于对照组(P<0.05);有害菌(大肠杆菌、梭菌、拟杆菌和柔嫩梭菌)水平均降低(P<0.05),且胃安除幽汤组低于对照组(P<0.05);治疗后两组患者的CD4+细胞比例以及CD4+/CD8+比值均升高(P<0.05),且胃安除幽汤组高于对照组(P<0.05);治疗后两组患者胃黏膜中MyD88、I-RAK和NF-κB的mRNA和蛋白表达水平均降低,且胃安除幽汤组低于对照组(P<0.05)。结论:在四联疗法基础上联合胃安除幽汤可改善Hp阳性慢性胃炎患者临床症状,提高Hp清除率,改善机体免疫水平与肠道菌群失衡,其机制可能与抑制MyD88/I-RAK/NF-κB信号通路有关。Objective:To observe the effect of Weian Chuyou Decoction(胃安除幽汤)on the immunity and intestinal flora of patients with chronic gastritis of helicobacter pylori(Hp)positive and explore the mechanism.Methods:A total of 180 patients with chronic gastritis of Hp positive were included and randomly divided into the control group and Weian Chuyou Decoction group,90 patients in each group.Both groups were given quadruple therapy.Besides,Weian Chuyou Decoction group was also given Weian Chuyou Decoction.The symptom relief,Hp clearance,intestinal flora composition,changes of CD4+and CD8+,and the transcription and translation levels of MyD88/I-RAK/NFκB pathway in gastric mucosa were compared between the two groups.Results:The clinical symptoms of the two groups were significantly relieved after treatment(P<0.05).The syndrome scores in the Weian Chuyou Decoction group were lower than those in the control group(P<0.05).The Hp clearance rate of Weian Chuyou Decoction group(86.67%)was significantly higher than that of the control group(71.67%)(P<0.05).After treatment,the contents of beneficial bacteria(lactobacillus and bifidobacterium)in both groups increased(P<0.05),and those in the Weian Chuyou Decoction group were higher than those in the control group(P<0.05).After treatment,the levels of harmful bacteria(escherichia coli,clostridium,bacteroides and clostridium tenuiflora)in both groups decreased(P<0.05),and the levels of harmful bacteria in the Weian Chuyou Decoction group were lower than those in the control group(P<0.05).After treatment,the percentage of CD4+and the ratio of CD4+/CD8+in both groups were increased(P<0.05),and the percentage of CD4+and ratio of CD4+/CD8+in the Weian Chuyou Decoction group were higher than those in the control group(P<0.05).After the treatment,the expression levels of MyD88,I-RAK and NF-κB mRNA and protein in the gastric mucosa of both groups were reduced,and the expression levels of MyD88,I-RAK and NF-κB mRNA and protein of the Weian Chuyou Decoction group were significantly

关 键 词：幽门螺杆菌 胃炎 胃安除幽汤 免疫 肠道菌群 髓样分化因子88/白细胞介素受体相关激酶/核因子-κB通路 

分 类 号：R256.4[医药卫生—中医内科学]