益气护膜方对ESD术后胃黏膜修复的作用:基于Foxo3a调控上皮细胞凋亡的机制研究  

Mechanistic Study on the Effect of Yiqi Humo Formula on Gastric Mucosa Repair After Endoscopic Submucosal Dissection:Based on the Regulation of Foxo3a-Mediated Epithelial Cell Apoptosis

作　　者：吴大鹏[1] 刘真真 孙仁虎[1] WU Dapeng;LIU Zhenzhen;SUN Renhu(Jiangsu Provincial Hospital of Traditional Chinese Medicine,China)

机构地区：[1]江苏省中医院消化内镜中心,南京210000

出　　处：《药学与临床研究》2024年第6期513-516,共4页Pharmaceutical and Clinical Research

摘　　要：目的:探讨益气护膜方治疗内镜下黏膜剥离术(ESD)后胃溃疡的疗效及相关机制。方法:收集本院ESD术后患者60例,分为常规西药组和联合中药组各30例。术后6周根据其临床症状和胃黏膜修复情况分析两组患者的溃疡恢复情况;收集患者术中和术后胃黏膜标本,通过TUNEL免疫荧光法检测胃黏膜上皮细胞的凋亡情况,并通过荧光定量PCR检测Foxo3a/FasL/Caspase-8信号通路的激活情况。结果:联合中药组临床症状得分和总得分在术后6周时均低于术后当天,差异有统计学意义(P<0.05);定量分析显示,接受常规西药治疗6周后,胃黏膜上皮细胞凋亡减少至(22.7±6.9)%,而接受联合中药治疗6周后,胃黏膜上皮细胞凋亡减少至(10.3±4.1)%,联合中药治疗具有明显优势(P<0.05)。治疗6周后,两组患者Foxo3a、FasL和Caspase-8 mRNA的表达均显著下降,其中联合中药组中3种mRNA下降幅度明显更大,差异有统计学意义(P<0.05)。结论:益气护膜方可以通过抑制Foxo3a/FasL/Caspase-8信号通路的表达减少胃黏膜上皮细胞的凋亡,从而促进ESD术后胃溃疡的修复。Objective:To investigate the efficacy and related mechanism of Yiqi Humo Recipe in the treatment of gastric ulcer after endoscopic submucosal dissection(ESD).Methods:Sixty patients after ESD in our hospital were collected and divided into a conventional Western medicine group and a combined traditional Chinese medicine group,with 30 cases in each group.Six weeks after the operation,the ulcer recovery of the two groups of patients was analyzed according to their clinical symptoms and gastric mucosal repair conditions;the gastric mucosal specimens of the patients during and after the operation were collected,and the apoptosis of gastric mucosal epithelial cells was detected by a TUNEL immunofluorescence method,and the activation of Foxo3a/FasL/Caspase-8 signaling pathway was detected by fluorescence quantitative PCR.Results:At 6 weeks after the operation,the clinical symptom scores and total scores of the combined traditional Chinese medicine group were lower than those on the day of operation,and lower than those of the conventional Western medicine group(P<0.05);quantitative analysis showed that after 6 weeks of conventional Western medicine treatment,the apoptosis of gastric mucosal epithelial cells decreased to(22.7±6.9)%,while after 6 weeks of combined traditional Chinese medicine treatment,the apoptosis of gastric mucosal epithelial cells decreased to(10.3±4.1)%,and the combined traditional Chinese medicine treatment had an obvious advantage(P<0.05).After 6 weeks of treatment,the expressions of Foxo3a,FasL and Caspase-8 mRNA in the two groups of patients were significantly decreased,and the decrease amplitudes of the three mRNAs in the combined traditional Chinese medicine group were significantly larger(P<0.05).Conclusion:Yiqi Humo Recipe can reduce the apoptosis of gastric mucosal epithelial cells by inhibiting the expression of Foxo3a/FasL/Caspase-8 signaling pathway,thereby promoting the repair of gastric ulcer after ESD.

关 键 词：益气护膜方 FOXO3A 早期胃癌:ESD术后:胃黏膜 凋亡 

分 类 号：R285[医药卫生—中药学]