化浊解毒中药对慢性萎缩性胃炎伴肠上皮化生患者CDX2、LI-CD表达的影响
发布时间：2018-07-24 15:00
【摘要】：目的:慢性萎缩性胃炎(Chronic Atrophic Gastritis,CAG)伴肠上皮化生(Intestinal Metaplasia,IM)是现在较为常见的消化系统疾病,癌变率高,缺乏有效的治疗方法。本研究通过选用化浊解毒中药与摩罗丹分别治疗CAG伴IM,比较患者治疗前后相应指标变化,以观察化浊解毒中药对CAG伴IM的治疗效果,并探索其作用机制。方法:将符合纳入标准的120例患者随机分为治疗组和对照组,每组60例,两组患者在性别、年龄、病程方面比较无统计学意义(P0.05),具有可比性。治疗组给予化浊解毒中药口服,150ml/袋,早、晚温服各1袋;对照组给予摩罗丹口服,8丸,3/日,疗程3个月。通过对比治疗前后患者症状积分、证候疗效、胃镜像、病理像、血清胃蛋白酶原(Pepsinogen,PG)水平、胃蛋白酶原比值(Ratio of serum pepsinogen I to pepsinogenII,PGR)、胃黏膜尾型同源盒转录因子2(Caudal type Homeobox Transcription Factor-2,CDX2)及肝肠钙黏连蛋白(Liver Intestinal Cadherin,LI-CD)表达变化,进行疗效性评价,探讨其作用机制。结果:1症状积分治疗前两组各症状积分及证候积分比较,无显著性差异(P0.05)。治疗组与治疗前相比,在胃胀积分、胃痛积分、嗳气反酸积分、饮食减少积分、证候积分五个方面,有显著性差异(P0.01),恶心呕吐积分有显著性差异(P0.05);对照组与治疗前相比,在胃胀积分、胃痛积分、饮食减少积分、证候积分四个方面,有显著性差异(P0.01),恶心呕吐积分有显著性差异(P0.05),嗳气反酸积分无显著性差异(P0.05)。治疗后,在胃胀积分、胃痛积分、嗳气反酸积分、证候积分四个方面,两组有显著性差异(P0.01),饮食减少积分有显著性差异(P0.05),恶心呕吐积分无显著性差异(P0.05)。经过治疗,两组证候疗效比较,治疗组痊愈17例,显效24例,有效14例,无效5例,有效率91.66%,对照组痊愈6例,显效13例,有效34例,无效7例,有效率88.33%,经统计学比较,有显著性差异(p0.01)。3胃镜像、炎症分级、腺体萎缩分级、肠上皮化生分级治疗前两组胃镜像、炎症分级、腺体萎缩分级、肠上皮化生分级比较无显著性差异(p0.05)。两组治疗后与治疗前比较,胃镜像、炎症分级、腺体萎缩分级、肠上皮化生分级有显著性差异(p0.01)。治疗后,两组胃镜像、炎症分级、腺体萎缩分级、肠上皮化生分级有显著性差异(p0.05)。4临床综合疗效治疗后,治疗组痊愈5例,显效10例,有效38例,无效7例,有效率为88.33%,对照组痊愈1例,显效6例,有效37例,无效16例,有效率为73.33%,治疗组优于对照组(p0.05)。5pg水平治疗前,两组pgi、pgii、pgr水平无显著性差异(p0.05)。经过治疗,治疗组与治疗前比较,pgi水平有显著差异(p0.01),pgii水平无显著性差异(p0.05),pgr有显著性差异(p0.05);对照组与治疗前比较,pgi水平有显著性差异(p0.05),pgii水平、pgr无显著性差异(p0.05)。治疗后两组比较,pgi、pgii水平有显著性差异(p0.05),pgr无显著性差异(p0.05)。6胃黏膜cdx2表达治疗前,两组cdx2表达相当(p0.05)。经过治疗,两组与治疗前比较,胃黏膜cdx2表达有显著性差异(p0.01)。治疗后,两组胃黏膜cdx2表达有显著性差异(p0.05)。7胃黏膜li-cd表达治疗前,两组胃黏膜li-cd表达比较无显著性差异(p0.05)。与治疗前比较,两组li-cd表达变化显著(p0.01)。治疗后两组胃黏膜li-cd表达有显著性差异(p0.01)。8两组治疗期间均无不良反应发生。结论:1化浊解毒方与摩罗丹治疗cag伴im均有效,化浊解毒中药优于摩罗丹。2化浊解毒方可明显减轻患者症状,改善胃镜像、病理像,其作用机制可能与提高胃黏膜PG水平,降低CDX2、LI-CD在胃黏膜的表达有关。3化浊解毒方治疗CAG伴IM,效果显著,不良反应少,值得进一步推广研究与应用。
[Abstract]:Objective: Chronic Atrophic Gastritis (Chronic Atrophic Gastritis, CAG) with intestinal metaplasia (Intestinal Metaplasia, IM) is a common digestive system disease, with high canceration rate and lack of effective treatment. This study was used to treat CAG with IM, respectively, by using Chinese traditional Chinese medicine for detoxification of turbidity and morrow, and to compare the corresponding indexes before and after treatment. To observe the therapeutic effect of traditional Chinese medicine on CAG with IM, and to explore the mechanism of action. Methods: 120 patients with the inclusion criteria were randomly divided into the treatment group and the control group, with 60 cases in each group. The two groups had no statistical significance (P0.05) in sex, age and course of disease. 150ml/ bags, 150ml/ bags, early and late warm clothes in each bag; the control group was given Mo Luo Dan oral, 8 pills, 3/ day for 3 months. The symptom score of the patients before and after the contrast treatment, the syndrome effect, the gastric image, the pathological image, the level of serum pepsinogen (Pepsinogen, PG), the ratio of the pepsinogen (Ratio of serum pepsinogen I to pepsinogenII, PGR), and the tail type of the gastric mucosa were the same. The expression changes of source box transcription factor 2 (Caudal type Homeobox Transcription Factor-2, CDX2) and liver intestinal calcium gluconin (Liver Intestinal Cadherin, LI-CD) were evaluated, and their mechanism of action was evaluated. Results: there was no significant difference (P0.05) between the two groups of symptom scores and syndrome scores in the two groups before the 1 symptom integral treatment. Compared with before, there were significant differences (P0.01) in five aspects of gastric distention score, gastric pain score, integral of belching and anti acid, integral of diet and syndrome score (P0.01), and significant difference in nausea and vomiting (P0.05). Compared with before treatment, there were significant differences in gastric distention, gastric pain score, diet reduction score and syndrome score (P0.01). There were significant differences in nausea and vomiting score (P0.05), and no significant difference in belching acid score (P0.05). After treatment, there were four significant differences in gastric distention score, stomach pain score, belching acid reacidity integral and syndrome score (P0.01), and there was significant difference in diet score (P0.05), and no significant difference between nausea and vomiting score (P0.05). Treatment, two groups of syndrome curative effect comparison, treatment group cured 17 cases, effective 24 cases, effective 14 cases, invalid 5 cases, effective 91.66%, 6 cases in the control group, 13 cases, 34 effective, 7 cases, 7 cases, effective 88.33%, statistically significant difference (P0.01).3 stomach mirror, inflammation classification, glandular atrophy classification, intestinal epithelial metaplasia grade two groups before treatment There was no significant difference in gastric image, inflammatory classification, glandular atrophy classification, and intestinal metaplasia grade (P0.05). After treatment, the two groups were compared with before treatment, gastric image, inflammatory classification, glandular atrophy classification, and intestinal metaplasia grade (P0.01). After treatment, two groups of gastric mirrors, inflammation classification, glandular atrophy classification, intestinal metaplasia classification After the significant difference (P0.05).4 clinical comprehensive curative effect treatment, the treatment group cured 5 cases, effective 10 cases, effective 38 cases, invalid 7 cases, the effective rate is 88.33%, the control group cured 1 cases, 6 cases, effective 37 cases, 16 cases, the effective rate 73.33%, the treatment group is superior to the control group (P0.05).5pg level treatment before, the two groups PGI, PGII, PGR level has no significant difference (P0) .05). After treatment, there was a significant difference in the level of PGI between the treatment group and the pre treatment group (P0.01). There was no significant difference in the level of PGII (P0.05), and there was a significant difference in PGR (P0.05). Compared with the control group, there was a significant difference in PGI level (P0.05), PGII level and PGR (P0.05). After treatment, there was a significant difference between the two groups. No significant difference (P0.05), PGR no significant difference (P0.05).6 gastric mucosa CDX2 expression before the treatment, the two groups of CDX2 expression is equivalent (P0.05). After treatment, the two groups and before the treatment, the gastric mucosa CDX2 expression has significant difference (P0.01). After treatment, the two groups of gastric mucosal CDX2 expression has significant difference (P0.05).7 gastric mucosa before the expression treatment, two groups gastric mucosal surfaces There was no significant difference (P0.05). Compared with before treatment, the expression of li-cd in the two groups was significant (P0.01). After treatment, the expression of li-cd in the two groups of gastric mucosa was significantly different (P0.01).8 two groups had no adverse reactions during the treatment. Conclusion: 1 the Decoction of turbidity detoxification and Luo Dan is effective in the treatment of CAG with IM, and the traditional Chinese medicine is superior to the Mo Luo Dan.2 turbidity solution. Poison prescription can obviously alleviate the symptoms of the patients, improve the gastric image and pathological image, and its mechanism may be related to improving the PG level of the gastric mucosa, reducing the CDX2, and the expression of LI-CD in the gastric mucosa related to the treatment of CAG with IM with.3, the effect is significant, and the adverse reaction is less. It is worth further promoting the research and application.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259
本文编号：2141750
[Abstract]:Objective: Chronic Atrophic Gastritis (Chronic Atrophic Gastritis, CAG) with intestinal metaplasia (Intestinal Metaplasia, IM) is a common digestive system disease, with high canceration rate and lack of effective treatment. This study was used to treat CAG with IM, respectively, by using Chinese traditional Chinese medicine for detoxification of turbidity and morrow, and to compare the corresponding indexes before and after treatment. To observe the therapeutic effect of traditional Chinese medicine on CAG with IM, and to explore the mechanism of action. Methods: 120 patients with the inclusion criteria were randomly divided into the treatment group and the control group, with 60 cases in each group. The two groups had no statistical significance (P0.05) in sex, age and course of disease. 150ml/ bags, 150ml/ bags, early and late warm clothes in each bag; the control group was given Mo Luo Dan oral, 8 pills, 3/ day for 3 months. The symptom score of the patients before and after the contrast treatment, the syndrome effect, the gastric image, the pathological image, the level of serum pepsinogen (Pepsinogen, PG), the ratio of the pepsinogen (Ratio of serum pepsinogen I to pepsinogenII, PGR), and the tail type of the gastric mucosa were the same. The expression changes of source box transcription factor 2 (Caudal type Homeobox Transcription Factor-2, CDX2) and liver intestinal calcium gluconin (Liver Intestinal Cadherin, LI-CD) were evaluated, and their mechanism of action was evaluated. Results: there was no significant difference (P0.05) between the two groups of symptom scores and syndrome scores in the two groups before the 1 symptom integral treatment. Compared with before, there were significant differences (P0.01) in five aspects of gastric distention score, gastric pain score, integral of belching and anti acid, integral of diet and syndrome score (P0.01), and significant difference in nausea and vomiting (P0.05). Compared with before treatment, there were significant differences in gastric distention, gastric pain score, diet reduction score and syndrome score (P0.01). There were significant differences in nausea and vomiting score (P0.05), and no significant difference in belching acid score (P0.05). After treatment, there were four significant differences in gastric distention score, stomach pain score, belching acid reacidity integral and syndrome score (P0.01), and there was significant difference in diet score (P0.05), and no significant difference between nausea and vomiting score (P0.05). Treatment, two groups of syndrome curative effect comparison, treatment group cured 17 cases, effective 24 cases, effective 14 cases, invalid 5 cases, effective 91.66%, 6 cases in the control group, 13 cases, 34 effective, 7 cases, 7 cases, effective 88.33%, statistically significant difference (P0.01).3 stomach mirror, inflammation classification, glandular atrophy classification, intestinal epithelial metaplasia grade two groups before treatment There was no significant difference in gastric image, inflammatory classification, glandular atrophy classification, and intestinal metaplasia grade (P0.05). After treatment, the two groups were compared with before treatment, gastric image, inflammatory classification, glandular atrophy classification, and intestinal metaplasia grade (P0.01). After treatment, two groups of gastric mirrors, inflammation classification, glandular atrophy classification, intestinal metaplasia classification After the significant difference (P0.05).4 clinical comprehensive curative effect treatment, the treatment group cured 5 cases, effective 10 cases, effective 38 cases, invalid 7 cases, the effective rate is 88.33%, the control group cured 1 cases, 6 cases, effective 37 cases, 16 cases, the effective rate 73.33%, the treatment group is superior to the control group (P0.05).5pg level treatment before, the two groups PGI, PGII, PGR level has no significant difference (P0) .05). After treatment, there was a significant difference in the level of PGI between the treatment group and the pre treatment group (P0.01). There was no significant difference in the level of PGII (P0.05), and there was a significant difference in PGR (P0.05). Compared with the control group, there was a significant difference in PGI level (P0.05), PGII level and PGR (P0.05). After treatment, there was a significant difference between the two groups. No significant difference (P0.05), PGR no significant difference (P0.05).6 gastric mucosa CDX2 expression before the treatment, the two groups of CDX2 expression is equivalent (P0.05). After treatment, the two groups and before the treatment, the gastric mucosa CDX2 expression has significant difference (P0.01). After treatment, the two groups of gastric mucosal CDX2 expression has significant difference (P0.05).7 gastric mucosa before the expression treatment, two groups gastric mucosal surfaces There was no significant difference (P0.05). Compared with before treatment, the expression of li-cd in the two groups was significant (P0.01). After treatment, the expression of li-cd in the two groups of gastric mucosa was significantly different (P0.01).8 two groups had no adverse reactions during the treatment. Conclusion: 1 the Decoction of turbidity detoxification and Luo Dan is effective in the treatment of CAG with IM, and the traditional Chinese medicine is superior to the Mo Luo Dan.2 turbidity solution. Poison prescription can obviously alleviate the symptoms of the patients, improve the gastric image and pathological image, and its mechanism may be related to improving the PG level of the gastric mucosa, reducing the CDX2, and the expression of LI-CD in the gastric mucosa related to the treatment of CAG with IM with.3, the effect is significant, and the adverse reaction is less. It is worth further promoting the research and application.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259
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