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陈万群,黄玉兰,杨小军.运脾清热除湿方治疗幽门螺杆菌相关性胃炎消化不良的临床观察及可能机制[J].湖南中医药大学学报英文版,2019,39(5):635-639.[Click to copy
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| 运脾清热除湿方治疗幽门螺杆菌相关性胃炎消化不良的临床观察及可能机制 |
| 陈万群,黄玉兰,杨小军 |
| (重庆市中医院脾胃病科, 重庆 400021) |
| 摘要: |
| 目的 观察运脾清热除湿方治疗幽门螺杆菌（Helicobactor pylori，Hp）相关性胃炎消化不良的疗效及可能机制。方法 将符合纳入标准的90例门诊患者按照随机数字表法分为3组各30例，中药组单纯口服运脾清热除湿方，中药合并Hp根除组在口服运脾清热除湿方基础上加Hp根除四联疗法，单纯Hp根除组采用Hp根除四联疗法，3组疗程均为2周。观察3组治疗前后中医证候评分及Hp根除率，并通过胃镜下病理活检后免疫组化比较治疗前后白介素-12（IL-12）、干扰素-γ（IFN-γ）的表达。结果 中药合并Hp根除组Hp根除率为96.7%，高于中药组的43.3%（P<0.05），与单纯Hp根除组的90.0%之间差异无统计学意义（P>0.05）。第2月及第6月随访中，中药合并Hp根除组中医证候改善均优于中药组及单纯Hp根除组（P<0.05），中医证候疗效总有效率为90.0%，优于其余两组（P<0.05）。3组IL-12、IFN-γ表达较治疗前明显降低（P<0.05），中药合并Hp根除组二者下降较中药组及单纯Hp根除组更显著（P<0.05）。结论 运脾清热除湿方可有效缓解Hp相关性胃炎消化不良症状，联合Hp根除治疗远期疗效更佳，其机制可能为通过抑制IL-12、IFN-γ的表达起作用。 |
| 关键词: 幽门螺杆菌相关性胃炎 消化不良 运脾清热除湿方 白介素-12 干扰素 |
| DOI：10.3969/j.issn.1674-070X.2019.05.017 |
| Received:October 03, 2018 |
| 基金项目:重庆市科技计划项目（cstc2017jxj1130019，cstc2018jcyjAX0756）；重庆市卫计委项目（ZY201802063）；重庆市中医院院内培育课题（2016-1-8） |
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| Clinical Efficacy of Spleen-Activating, Heat-Clearing, and Dampness-Removing Prescription in Treatment of Dyspepsia and Helicobacter pylori-Associated Gastritis and Its Possible Mechanism |
| CHEN Wanqun,HUANG Yulan,YANG Xiaojun |
| (Department of Gastroenterology, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China) |
| Abstract: |
| Objective To investigate the clinical efficacy of spleen-activating, heat-clearing, and dampness-removing prescription (SHDP) in the treatment of dyspepsia and Helicobacter pylori (Hp)-associated gastritis and its possible mechanism. Methods A total of 90 outpatients who met the inclusion criteria were equally and randomly divided into three groups using a random number table:traditional Chinese medicine (TCM) group, TCM combined with Hp eradication (TCM+Hp) group, and Hp eradication group (Hp group). The TCM group was orally given SHDP alone, the TCM+Hp group received quadruple therapy for Hp eradication in addition to the oral administration of SHDP, and the Hp group received quadruple therapy for Hp eradication alone. The course of treatment was two weeks for all the three groups. The following indices were compared between the three groups:TCM syndrome score before and after treatment, Hp eradication rate after treatment, and the expression of interluekin-12 (IL-12) and interferon-γ (IFN-γ) before and after treatment, which was measured by immunohistochemistry after gastroscopic biopsy. Results The TCM+Hp group had a significantly higher Hp eradication rate than the TCM group (96.7% vs 43.3%, P<0.05). However, there was no significant difference in Hp eradication rate between the TCM+Hp group and the Hp group (96.7% vs 90.0%, P>0.05). The TCM+Hp group had significantly more improvements in TCM syndromes and a significantly higher overall response rate for TCM syndromes (90.0%) compared with the other two groups at 2-month and 6-month follow-up (all P<0.05). After treatment, all the three groups showed significantly reduced expression of IL-12 and IFN-γ (P<0.05), and the TCM+Hp group had significantly greater reductions in the expression of IL-12 and IFN-γ compared with the other two groups (P<0.05). Conclusion SHDP can effectively alleviate dyspepsia in Hp-associated gastritis. SHDP combined with Hp eradication therapy has better long-time efficacy, possibly by inhibiting the expression of IL-12 and IFN-γ. |
| Key words: Helicobacter pylori-associated gastritis dyspepsia spleen-activating, heat-clearing, and dampness-removing prescription interluekin-12 interferon-γ |
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