化浊解毒活血方对慢性萎缩性胃炎伴随肠上皮化生患者PG、PGR、LI-CD的影响  

Influence of decoction for resolving turbidity,removing toxin and activating blood on PG,PGR,and LI-CD in patients with chronic atrophic gastritis and intestinal metaplasia

作　　者：赵源[1,2,3] 郎晓猛 要翠翠[4] 康欣 杨倩 刘建平[1,2,3] ZHAO Yuan;LANG Xiaomeng;YAO Cuicui;KANG Xin;YANG Qian;LIU Jianping(Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,Hebei,China;Hebei Key Laboratory of Turbidity Toxin Syndrome,Shijiazhuang 050000,Hebei,China;Hebei Key Laboratory of Integrated Chinese and Western Medicine for Gastroenterology Research,Shijiazhuang 050000,Hebei,China;The Affiliated Hospital of Hebei Academy of Chinese Medicine,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北省中医院,河北石家庄050000 [2]河北省浊毒证重点实验室,河北石家庄050000 [3]河北省中西医结合胃肠病研究重点实验室,河北石家庄050000 [4]河北省中医药科学院附属医院,河北石家庄050000

出　　处：《现代中西医结合杂志》2024年第18期2511-2515,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家中医临床研究基地建设项目(国中医药科技函[2018]131号);河北省名中医传承工作室建设项目(河北省中医药管理局冀中医药函[2019]86号)。

摘　　要：目的探讨化浊解毒活血方对慢性萎缩性胃炎(CAG)伴肠上皮化生患者血清胃蛋白酶原(PG)、胃蛋白酶原比值(PGR)及胃黏膜中肝肠钙黏连蛋白(LI-CD)表达的影响。方法采用随机数字表法,将2016年1月—2017年12月在河北省中医院脾胃病科诊治的120例CAG伴肠上皮化生患者分为中药组和中成药组,每组60例。中药组口服化浊解毒活血方(1剂/d,分2次温服),中成药组口服摩罗丹(每次8丸,3次/d),2组疗程均为6个月。比较2组患者治疗前后胃镜像病情程度、病理(炎症、腺体萎缩、肠上皮化生)变化程度、血清PG水平、PGR和胃黏膜肠化生组织中LI-CD阳性表达情况。结果治疗后,2组胃镜像和炎症、腺体萎缩、肠上皮化生程度均较治疗前明显改善(P均<0.05),且中药组的改善情况均明显优于中成药组(P均<0.05)。治疗后,2组血清PGⅠ水平和中药组PGR均较治疗前明显升高(P均<0.05),2组血清PGⅡ水平和中成药组PGR与治疗前比较差异均无统计学意义(P均>0.05);治疗后中药组血清PGⅠ和PGⅡ水平均明显高于中成药组(P均<0.05)。治疗后,2组胃黏膜肠化生组织中LI-CD阳性表达平均光密度值均较治疗前明显降低(P均<0.05),且中药组明显低于中成药组(P<0.05)。结论化浊解毒活血方能有效改善CAG伴肠上皮化生患者的病理表现,可能与其提升血清PGI水平,下调LI-CD在胃黏膜的表达有关。Objective It is to investigate the effects of decoction for resolving turbidity,removing toxin and activating blood on serum pepsinogen(PG),pepsinogenⅠ/Ⅱratio(PGR),and expression of liver intestinal cadherin(LI-CD)in gastric mucosa of patients with chronic atrophic gastritis(CAG)complicated with intestinal metaplasia(IM).Methods One hundred and twenty patients with CAG with IM diagnosed and treated in the Department of Splenology and Gastroenterology of Hebei Provincial Hospital of Traditional Chinese Medicine(TCM)from January 2016 to December 2017 were divided into traditional Chinese medicine group and Chinese patent medicine group by a random number method,with 60 cases in each group.The TCM group was treated with decoction for resolving turbidity,removing toxin and activating blood for oral administration(one dose daily,divided into two warm administrations),the Chinese patent medicine group was treated with Moluo Dan for oral administration(8 pills each time,3 times per day),both groups were treated for 6 months.The degree of condition of gastroscopic image,degree of pathological(inflammation,glandular atrophy,intestinal epithelial hyperplasia)changes,serum level of PG,PGR and positive expression of LI-CD in intestinal hyperplasia tissues of gastric mucosa of patients in the two groups were compared before and after treatment.Results After treatment,the gastroscopic image and the degree of inflammation,glandular atrophy,and intestinal epithelial hyperplasia of the two groups were significantly improved compared with those before treatment(all P<0.05),and the improvements in the TCM group were significantly better than those in the Chinese patent medicine group(all P<0.05).After treatment,the serum levels of PGⅠin the two groups and PGR in the TCM group were significantly higher than those before treatment(all P<0.05),and the differences in serum PGⅡlevel in the two groups and PGR in the Chinese patent medicine group were not statistically significant compared with those before treatment(all P>0.05);t

关 键 词：慢性萎缩性胃炎 化浊解毒活血方 肠上皮化生 胃蛋白酶原 胃蛋白酶原比值 肝肠钙黏连蛋白 

分 类 号：R573.32[医药卫生—消化系统]