中蒙药对幽门螺杆菌的体外抑菌作用研究  

Antibacterial effects of Chinese and Mongolian medicines on Helicobacter pylori in vitro

作　　者：刘畅[1] 孟宪梅[2] 年媛媛 白敏 LIU Chang;MENG Xianmei;NIAN Yuanyuan;BAI Min(Baotou Medical College of Inner Mongolia University of Science&Technology,Baotou 014040,Inner Mongolia,China;The Second Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science&Technology,Baotou 014030,Inner Mongolia,China)

机构地区：[1]内蒙古科技大学包头医学院,内蒙古包头014040 [2]内蒙古科技大学包头医学院第二附属医院,内蒙古包头014030

出　　处：《现代中西医结合杂志》2024年第16期2244-2249,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：2022年“草原英才”工程专项资金项目(CYYC230425);内蒙古自治区科技计划项目(2021GG0232);内蒙古自治区科技创新引导项目。

摘　　要：目的筛选对幽门螺杆菌(H.pylori)具有抑菌作用的中蒙单药,构建新型抑菌方剂,探索中蒙药对H.pylori的治疗价值。方法取H.pylori标准菌株,常规体外培养;临床分离并培养H.pylori现症感染患者的H.pylori菌株,采用生化反应、H.pylori特异性基因检测进行鉴定。选取黄连、黄芩、大黄、丁香、鱼腥草、黄芪、茯苓、三七、生姜、苦参、诃子、蒲公英分别对H.pylori标准和临床菌株进行药敏试验,采用十字测量法测量抑菌圈直径,直径15~20 mm为高敏、直径10~14 mm为中敏。根据上述药敏试验,选取敏感药物构建新型组方,然后采用药敏试验、浓度梯度试验、尿素酶浓度测定试验评估新型组方的抑菌作用。选取阿莫西林、克拉霉素、甲硝唑、左氧氟沙星、利福平、四环素、庆大霉素、呋喃唑酮对H.pylori临床菌株进行药敏试验,分析耐药情况及耐药患者H.pylori菌株对新型组方的敏感性。结果H.pylori标准菌株对蒲公英、诃子高敏,对丁香、大黄中敏;H.pylori临床菌株对蒲公英高敏,对鱼腥草、三七、苦参、黄芩、黄连、黄芪、诃子、丁香、大黄、生姜中敏。其中蒲公英、诃子、丁香、大黄对H.pylori标准和临床菌株均具有较好抑菌作用,且蒲公英作用最强。构建的新型组方命名为半夏益胃颗粒,包括清半夏15 g、黄连6 g、黄芩10 g、干姜10 g、党参10 g、炙甘草6 g、大枣15 g、诃子10 g、丁香6 g、三七粉6 g、蒲公英30 g、百合30 g、乌药10 g、鱼腥草10 g、海螵蛸15 g。有6例H.pylori临床菌株对半夏益胃颗粒高敏,3例H.pylori临床菌株及标准菌株对半夏益胃颗粒中敏。半夏益胃颗粒最小抑菌浓度为0.5 g/mL,此浓度半夏益胃颗粒应用后,H.pylori标准和临床菌株分泌的尿素酶浓度较应用前明显降低(P均<0.05)。H.pylori临床菌株抗生素耐药情况:甲硝唑7例、左氧氟沙星4例、克拉霉素3例、呋喃唑酮1例、阿莫西林1例;Objective It is to screen the single Chinese and Mongolian medicines with antibacterial effects on Helicobacter pylori(H.pylori),to construct new antibacterial prescriptions,and to explore the therapeutic value of Chinese and Mongolian medicines on H.pylori.Methods The standard strain of H.pylori was cultured in vitro,and the H.pylori strains of the patients with current H.pylori infection were isolated and cultured in clinic.At the same time,biochemical reactions and H.pylori specific gene detection were used for identification.The sensitivity tests of standard and clinical H.pylori strains were carried out on Coptis chinensis,Scutellariae radix,Rheum palmatum,Clove,Houttuynia cordata,Astragalus membranaceus,Poria cocos,Panax notoginseng,ginger,Sophora flavescens,Chebulae Fruit and Dandelion were respectively carried out.The antibacterial diameter was measured by cross measurement method.The diameter of 15—20 mm was highly sensitive,and the diameter of 10—14 mm was moderately sensitive.According to the above experiments,the sensitive drugs were selected to construct a new prescription,and its antibacterial effect was further detected by drug sensitivity test,concentration gradient analysis and urease concentration measurement.Amoxicillin,clarithromycin,metronidazole,levofloxacin,rifampicin,tetracycline,gentamicin,and furazolidone were selected for drug sensitivity testing of H.pylori clinical strains to analyze the drug resistance and the susceptibility of H.pylori strains from drug-resistant patients to the new prescription.Results The standard strain of H.pylori is highly sensitive to Chebulae Fruit and Dandelion,moderately sensitive to Clove and Rheum palmatum.The clinical strain of H.pylori is highly sensitive to Dandelion,moderately sensitive to Houttuynia cordata,Panax notoginseng,Sophora flavescens,Scutellariae radix,Coptis chinensis,Astragalus membranaceus,Chebulae Fruit,Clove,Rheum palmatum and ginger.Dandelion,Chebulae Fruit,Clove,Rheum palmatum all had good antibacterial effects on standard strain

关 键 词：幽门螺杆菌 耐药 蒲公英 诃子 丁香 大黄 半夏益胃颗粒 

分 类 号：R-33[医药卫生]