逆萎康对慢性萎缩性胃炎病人TNF-α、IL-6和CDX2表达的影响

发布时间：2018-06-24 11:16

本文选题：慢性萎缩性胃炎 + 逆萎康　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:研究逆萎康对慢性萎缩性胃炎患者肿瘤坏死因子(INF-a)、白细胞介素-6(interleukin-6,IL-6)和尾型同源盒转录因子2(CDX2)表达的影响。方法:选取2014年6月至2015年10月在我院消化内科门诊就诊的中度及中度以下的慢性萎缩性胃炎患者220例。先进行碳13呼气试验检测,如果是阳性,要先进行杀菌,直至测试为阴性再入组;如果是阴性,则可以入组。将其随机分为两组,逆萎康治疗组(118例),胃复春对照组(102例),两组均治疗5个月,并选择30例健康的人作为对照组。三组性别、年龄、病程比较差异无统计学意义(P0.05),具有可比性。三组实验者治疗前后均进行胃镜检查和抽血化验,并均签署知情同意书。观察比较三组实验者治疗前后的临床症状改变、胃镜下及病理改变,放射免疫法检测血清中TNF-a及IL-6的含量,免疫组化方法检测胃粘膜组织中CDX2表达。结果:(1)逆萎康组治疗后的胃镜结果和病理结果以及症状体征根据国际疗效标准评测均较治疗前明显好转(P0.05),其治疗效果与胃复春对照组未见明显差异(P0.05);(2)治疗前逆萎康组及胃复春对照组血清TNF-a、IL-6水平均高于健康对照组(P0.01),逆萎康组及胃复春组治疗后血清TNF-a、IL-6含量较治疗前均明显降低(P0.05),而两组比较差异没有统计学意义(P0.05)。(3)治疗后逆萎康组和胃复春组患者的胃粘膜组织中CDX2含量均较治疗前明显下降(P0.05),而两组比较差异没有统计学意义(P0.05)。结论:1.治疗前逆萎康组和胃复春组血液中的TNF-a、IL-6的含量都高于健康对照组(P0.01),说明这两项指标可能是慢性萎缩性胃炎的内在因素。2.逆萎康组和胃复春组治疗后血液中TNF-a、IL-6的含量较治疗前均明显下降(P0.05),而两组之间比较差异没有统计学意义(P0.05),说明逆萎康与胃复春相似也具有治疗慢性萎缩性胃炎的作用,其作用是因为降低了TNF-a、IL-6含量。3.逆萎康组和胃复春组治疗后体内CDX2水平比治疗前明显下降(P0.05),而两组比较差异没有统计学意义(P0.05),这说明逆萎康和胃复春相似也具有治疗慢性萎缩性胃炎的作用,其作用机制可能与其抗炎及降低胃粘膜CDX2表达有关。4.逆萎康组及胃复春组患者胃粘膜组织中TNF-a、IL-6和CDX2的表达水平治疗后与治疗前相比差异没有统计学意义,说明逆萎康治疗慢性萎缩性胃炎具有理想的临床疗效,治疗效果与胃复春相当。
[Abstract]:Aim: to study the effects of Nishiweikang on the expression of tumor necrosis factor (INF-a), interleukin-6 (IL-6) and tail homeobox transcription factor 2 (CDX2) in patients with chronic atrophic gastritis. Methods: 220 patients with chronic atrophic gastritis were selected from June 2014 to October 2015. The carbon-13 breath test was performed first, and if positive, sterilization was performed first until the test was negative and re-entered; if it was negative, it could be added to the group. They were randomly divided into two groups: the treatment group (n = 118) and the control group (n = 102). The two groups were treated for 5 months and 30 healthy persons were selected as the control group. There was no significant difference in sex, age and course of disease among the three groups (P0.05). Before and after treatment, the three groups were examined by gastroscopy and blood samples, and informed consent was signed. The changes of clinical symptoms, pathological changes under gastroscopy, the levels of TNF-a and IL-6 in serum and the expression of CDX2 in gastric mucosa were detected by radioimmunoassay before and after treatment. Results: (1) the results of gastroscopy, pathology and symptoms and signs in the treatment group were significantly better than those before treatment (P0.05), and there was no significant difference between the treatment effect and Weifuchun control group (P0.05) before treatment (P0.05). The serum levels of TNF-afir IL-6 in the Kang group and Weifuchun control group were higher than those in the healthy control group (P0.01). The serum TNF-afir IL-6 level in the Nishiweikang group and Weifuchun group was significantly lower than that before treatment (P0.05), but there was no significant difference between the two groups (P0.05). (3). The content of CDX2 in gastric mucosa of patients in Kang group and Weifuchun group was significantly lower than that before treatment (P0.05), but there was no significant difference between the two groups (P0.05). Conclusion 1. Before treatment, the levels of TNF-afir IL-6 in the blood of both the NW group and Weifuchun group were higher than those in the healthy control group (P0.01), indicating that these two indexes may be the internal factors of chronic atrophic gastritis. 2. After treatment, the levels of TNF-afir IL-6 in blood of the two groups decreased significantly (P0.05), but there was no significant difference between the two groups (P0.05), which indicated that Nishiweikang and Weifuchun also had the effect of treating chronic atrophic gastritis. Its effect is due to the decrease of TNF-ahl6 content. 3. After treatment, the levels of CDX2 in both groups were significantly lower than those before treatment (P0.05), but there was no significant difference between the two groups (P0.05), which indicated that Nishiweikang and Weifuchun also had the effect of treating chronic atrophic gastritis. Its mechanism may be related to its anti-inflammation and the decrease of CDX 2 expression in gastric mucosa. 4. There was no significant difference in the expression levels of TNF-ahl6 and CDX2 in gastric mucosa of patients with chronic atrophic gastritis after treatment with Nishihuikang and Weifuchun, which indicated that the treatment of chronic atrophic gastritis with Nishiweikang had an ideal clinical effect. The therapeutic effect was equivalent to that of Weifu Chun.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R573.32

【参考文献】