健脾清化散瘀饮对隆起糜烂性胃炎患者CyclinD1、CDK4、P21表达的影响

发布时间：2018-09-11 18:12

【摘要】：目的:前期研究运用健脾清化散瘀饮治疗隆起糜烂性胃炎(raised erosive gastritis,R EG)取得较好的临床疗效,本课题拟采用免疫组化检测技术,通过体内实验探究健脾清化散瘀饮对REG患者细胞周期蛋白D1(CyclinD1)、细胞周期蛋白依赖性激酶4(CDK4)及P21蛋白表达的影响,以期明确健脾清化散瘀饮治疗REG的药理机制,丰富REG的临床研究。方法:纳入福建中医药大学附属第二人民医院门诊及病房被确诊为REG并符合纳入/排除标准的患者36例,予自拟方"健脾清化散瘀饮"加减治疗3个月,其中2例资料不完全、2例失访脱落,最终纳入REG患者32例。对比治疗前后REG患者临床表现、胃镜下隆起形态、病理组织学改变及CyclinD1、CDK4、P21表达情况,另选取我院体检中心体检健康者20例作空白对照组。结果:1.中医证候疗效:通过症状量化统计中医证候疗效指数,(1)符合方案集:其中痊愈13例(40.62%),显效8例(25%),有效8例(25%);总有效率90.62%。(2)全分析集:治愈13例(38.24%),显效8例(23.53%),有效8例(23.53%),总有效率85.29%。2.胃镜疗效:(1)符合方案集:治愈16例(50%),显效4例(12.5%),有效5例(15.62%),总有效率78.12%。(2)全分析集:治愈16例(47.06%),显效4例(11.76%),有效5例(14.71%),总有效率73.53%。3.病理疗效:(1)符合方案集:治愈11例(34.37%),显效7例(21.85%),有效9例(28.18%),总有效率81.25%。(2)全分析集:治愈11例(32.35%),显效7例(20.59%),有效9例(26.47%),总有效率79.41%。4.CyclinD1表达情况:(1)正常对照组 CyclinD1 IHS 值为 0.1515±0.02390,REG 组治疗前 CyclinD1 IHS值为1.2713±0.08055,REG组明显高于对照组(P0.05);(2)REG 组治疗后 CyclinD1 IHS 值为 0.5653±0.21831,较治疗前 CyclinD1 IHS 值明显下降(P0.05);(3)REG组治疗后CyclinD1 IHS值高于对照组(P0.05)。5.CDK4表达情况:(1)正常对照组 CDK4IHS 值为 0.1580±0.03037,REG 组治疗前 CDK4 IHS 值为 1.2525±0.10280,REG组明显高于对照组(P0.05);(2)REG组治疗后CDK4 IHS值为0.5747±0.213,较治疗前CDK4 IHS值显著降低(P0.05);(3)REG组治疗后CDK4 IHS值高于对照组(P0.05)。6.P21表达情况:(1)正常对照组P21 IHS值为0.1585±0.02581,REG组治疗前P21 IHS值为1.2713±0.09540,REG组明显高于对照组(P0.05);(2)REG组治疗后P21 IHS值为0.5625±0.23113,较治疗前P21 IHS值显著降低(P0.05);(3)REG组治疗后P21 IHS值高于对照组(P0.05)。7.不良反应:入组的REG患者治疗过程未见不良事件发生。结论:1.健脾清化散瘀饮治疗REG安全且临床疗效显著。2.CyclinD1、CDK4、P21在REG患者胃粘膜呈高表达,经健脾清化散瘀饮治疗后CyclinD1、CDK4、P21的表达均显著下调。3.健脾清化散瘀饮可能是通过下调CyclinD1、CDK4、P21的表达来治疗REG。
[Abstract]:Objective: to obtain a better clinical effect of Jianpi Qinghua Sanyu Yin in treating protruding erosive gastritis (raised erosive gastritis,R EG). To investigate the effects of Jianpi Qinghua Sanyu decoction on the expression of cyclin D1 (CyclinD1), cyclin dependent kinase 4 (CDK4) and P21 protein in patients with REG, in order to clarify the pharmacological mechanism of Jianpi Qinghua Sanyu Yin in the treatment of REG, and to enrich the clinical study of REG. Methods: Thirty-six patients who were diagnosed as REG in outpatient and ward of the second people's Hospital affiliated to Fujian University of traditional Chinese Medicine were treated with "Jianpi Qinghua Sanyu Yin" for 3 months. Among them, 2 cases were incomplete and 2 cases lost their visit, and 32 cases were included in REG. The clinical manifestations, histopathological changes and CyclinD1,CDK4,P21 expression of REG patients before and after treatment were compared, and 20 healthy subjects from physical examination center of our hospital were selected as blank control group. The result is 1: 1. The curative effect of TCM syndromes: (1) according to the program set, 13 cases were cured (40.62%), 8 cases were effective (25%), 8 cases were effective (25%), and the total effective rate was 90.622.The total effective rate was 90.62%. (2) the total effective rate was 90.62 2%. (2) the total effective rate was 90.62% (38.24%), 8 cases (23.53%), 8 cases (23.53%), 85.29.2%. The total effective rate was 78.12%. (2) the total effective rate was 78.12% (47.06%), 4 cases (11.76%) were cured, 5 cases (14.71%) were effective, and the total effective rate was 73.53%. Pathological efficacy: (1) according to the protocol set, 11 cases (34.37%) were cured, 7 cases (21.85%) were cured, 9 cases (28.18%) were effective, and the total effective rate was 81.25%. (2) Total analysis set: 11 cases (32.35%) were cured, 7 cases (20.59%) were effective, 9 cases (26.47%) were effective. The expression of total effective 79.41%.4.CyclinD1: (1) CyclinD1 IHS value of normal control group. The CyclinD1 IHS value before treatment in the 0.1515 卤0.02390 REG group was 1.2713 卤0.08055, significantly higher than that in the control group (P0.05); (2). The CyclinD1 IHS value in the REG group was 0.5653 卤0.21831 after treatment, which was significantly lower than that in the REG group before treatment (P0.05); (3) and the CyclinD1 IHS value in the REG group was higher than that in the control group (P0.05). 5. CDK4 expression: (1) the normal control group had higher CyclinD1 IHS value than the control group (P0.05). 5. CDK4 expression in the REG group was significantly higher than that in the control group (P0.05). The CDK4IHS value was 0.1580 卤0.03037 CDK4 IHS before treatment in the CDK4 IHS group (1.2525 卤0.10280) and 0.5747 卤0.213 in the REG group (P0.05); (2), which was significantly lower than that before treatment (P0.05); (3) CDK4 IHS value in REG group was significantly higher than that in control group (P0.05) .6.P21 expression: (1) P21 expression in normal control group was significantly lower than that before treatment (P0.05); (3) in REG group: (1) P21 expression in normal control group was significantly lower than that in control group (P0.05). 6. P21 expression in REG group was significantly lower than that in control group (P0.05). The P21 IHS of the IHS group before treatment was 1.2713 卤0.09540 IHS significantly higher than that of the control group (P0.05); (2), the P21 IHS value of the REG group was 0.5625 卤0.23113, which was significantly lower than that of the pre-treatment P21 IHS group (P0.05); (3) and the P21 IHS value of the REG group was higher than that of the control group (P0.05. 7). Adverse reactions: there were no adverse events in REG patients. Conclusion 1. Jianpi Qinghua Sanyu Yin was safe in the treatment of REG. 2. Cyclin D1 + CDK4P21 was highly expressed in gastric mucosa of REG patients, and the expression of CyclinD1,CDK4,P21 was significantly down-regulated by Jianpi Qinghua Sanyu Yin. Jianpi Qinghua Sanyu Yin may treat REG. by down-regulating the expression of CyclinD1,CDK4,P21
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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