本文選題：慢性萎縮性胃炎 + 逆萎康��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:研究逆萎康對慢性萎縮性胃炎患者腫瘤壞死因子(INF-a)、白細(xì)胞介素-6(interleukin-6,IL-6)和尾型同源盒轉(zhuǎn)錄因子2(CDX2)表達(dá)的影響。方法:選取2014年6月至2015年10月在我院消化內(nèi)科門診就診的中度及中度以下的慢性萎縮性胃炎患者220例。先進(jìn)行碳13呼氣試驗檢測,如果是陽性,要先進(jìn)行殺菌,直至測試為陰性再入組;如果是陰性,則可以入組。將其隨機分為兩組,逆萎康治療組(118例),胃復(fù)春對照組(102例),兩組均治療5個月,并選擇30例健康的人作為對照組。三組性別、年齡、病程比較差異無統(tǒng)計學(xué)意義(P0.05),具有可比性。三組實驗者治療前后均進(jìn)行胃鏡檢查和抽血化驗,并均簽署知情同意書。觀察比較三組實驗者治療前后的臨床癥狀改變、胃鏡下及病理改變,放射免疫法檢測血清中TNF-a及IL-6的含量,免疫組化方法檢測胃粘膜組織中CDX2表達(dá)。結(jié)果:(1)逆萎康組治療后的胃鏡結(jié)果和病理結(jié)果以及癥狀體征根據(jù)國際療效標(biāo)準(zhǔn)評測均較治療前明顯好轉(zhuǎn)(P0.05),其治療效果與胃復(fù)春對照組未見明顯差異(P0.05);(2)治療前逆萎康組及胃復(fù)春對照組血清TNF-a、IL-6水平均高于健康對照組(P0.01),逆萎康組及胃復(fù)春組治療后血清TNF-a、IL-6含量較治療前均明顯降低(P0.05),而兩組比較差異沒有統(tǒng)計學(xué)意義(P0.05)。(3)治療后逆萎康組和胃復(fù)春組患者的胃粘膜組織中CDX2含量均較治療前明顯下降(P0.05),而兩組比較差異沒有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1.治療前逆萎康組和胃復(fù)春組血液中的TNF-a、IL-6的含量都高于健康對照組(P0.01),說明這兩項指標(biāo)可能是慢性萎縮性胃炎的內(nèi)在因素。2.逆萎康組和胃復(fù)春組治療后血液中TNF-a、IL-6的含量較治療前均明顯下降(P0.05),而兩組之間比較差異沒有統(tǒng)計學(xué)意義(P0.05),說明逆萎康與胃復(fù)春相似也具有治療慢性萎縮性胃炎的作用,其作用是因為降低了TNF-a、IL-6含量。3.逆萎康組和胃復(fù)春組治療后體內(nèi)CDX2水平比治療前明顯下降(P0.05),而兩組比較差異沒有統(tǒng)計學(xué)意義(P0.05),這說明逆萎康和胃復(fù)春相似也具有治療慢性萎縮性胃炎的作用,其作用機制可能與其抗炎及降低胃粘膜CDX2表達(dá)有關(guān)。4.逆萎康組及胃復(fù)春組患者胃粘膜組織中TNF-a、IL-6和CDX2的表達(dá)水平治療后與治療前相比差異沒有統(tǒng)計學(xué)意義,說明逆萎康治療慢性萎縮性胃炎具有理想的臨床療效,治療效果與胃復(fù)春相當(dāng)。
[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.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R573.32

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