化濁解毒中藥對慢性萎縮性胃炎伴腸上皮化生患者CDX2、LI-CD表達(dá)的影響
發(fā)布時間：2018-07-24 15:00
【摘要】：目的:慢性萎縮性胃炎(Chronic Atrophic Gastritis,CAG)伴腸上皮化生(Intestinal Metaplasia,IM)是現(xiàn)在較為常見的消化系統(tǒng)疾病,癌變率高,缺乏有效的治療方法。本研究通過選用化濁解毒中藥與摩羅丹分別治療CAG伴IM,比較患者治療前后相應(yīng)指標(biāo)變化,以觀察化濁解毒中藥對CAG伴IM的治療效果,并探索其作用機(jī)制。方法:將符合納入標(biāo)準(zhǔn)的120例患者隨機(jī)分為治療組和對照組,每組60例,兩組患者在性別、年齡、病程方面比較無統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。治療組給予化濁解毒中藥口服,150ml/袋,早、晚溫服各1袋;對照組給予摩羅丹口服,8丸,3/日,療程3個月。通過對比治療前后患者癥狀積分、證候療效、胃鏡像、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)、胃黏膜尾型同源盒轉(zhuǎn)錄因子2(Caudal type Homeobox Transcription Factor-2,CDX2)及肝腸鈣黏連蛋白(Liver Intestinal Cadherin,LI-CD)表達(dá)變化,進(jìn)行療效性評價,探討其作用機(jī)制。結(jié)果:1癥狀積分治療前兩組各癥狀積分及證候積分比較,無顯著性差異(P0.05)。治療組與治療前相比,在胃脹積分、胃痛積分、噯氣反酸積分、飲食減少積分、證候積分五個方面,有顯著性差異(P0.01),惡心嘔吐積分有顯著性差異(P0.05);對照組與治療前相比,在胃脹積分、胃痛積分、飲食減少積分、證候積分四個方面,有顯著性差異(P0.01),惡心嘔吐積分有顯著性差異(P0.05),噯氣反酸積分無顯著性差異(P0.05)。治療后,在胃脹積分、胃痛積分、噯氣反酸積分、證候積分四個方面,兩組有顯著性差異(P0.01),飲食減少積分有顯著性差異(P0.05),惡心嘔吐積分無顯著性差異(P0.05)。經(jīng)過治療,兩組證候療效比較,治療組痊愈17例,顯效24例,有效14例,無效5例,有效率91.66%,對照組痊愈6例,顯效13例,有效34例,無效7例,有效率88.33%,經(jīng)統(tǒng)計(jì)學(xué)比較,有顯著性差異(p0.01)。3胃鏡像、炎癥分級、腺體萎縮分級、腸上皮化生分級治療前兩組胃鏡像、炎癥分級、腺體萎縮分級、腸上皮化生分級比較無顯著性差異(p0.05)。兩組治療后與治療前比較,胃鏡像、炎癥分級、腺體萎縮分級、腸上皮化生分級有顯著性差異(p0.01)。治療后,兩組胃鏡像、炎癥分級、腺體萎縮分級、腸上皮化生分級有顯著性差異(p0.05)。4臨床綜合療效治療后,治療組痊愈5例,顯效10例,有效38例,無效7例,有效率為88.33%,對照組痊愈1例,顯效6例,有效37例,無效16例,有效率為73.33%,治療組優(yōu)于對照組(p0.05)。5pg水平治療前,兩組pgi、pgii、pgr水平無顯著性差異(p0.05)。經(jīng)過治療,治療組與治療前比較,pgi水平有顯著差異(p0.01),pgii水平無顯著性差異(p0.05),pgr有顯著性差異(p0.05);對照組與治療前比較,pgi水平有顯著性差異(p0.05),pgii水平、pgr無顯著性差異(p0.05)。治療后兩組比較,pgi、pgii水平有顯著性差異(p0.05),pgr無顯著性差異(p0.05)。6胃黏膜cdx2表達(dá)治療前,兩組cdx2表達(dá)相當(dāng)(p0.05)。經(jīng)過治療,兩組與治療前比較,胃黏膜cdx2表達(dá)有顯著性差異(p0.01)。治療后,兩組胃黏膜cdx2表達(dá)有顯著性差異(p0.05)。7胃黏膜li-cd表達(dá)治療前,兩組胃黏膜li-cd表達(dá)比較無顯著性差異(p0.05)。與治療前比較,兩組li-cd表達(dá)變化顯著(p0.01)。治療后兩組胃黏膜li-cd表達(dá)有顯著性差異(p0.01)。8兩組治療期間均無不良反應(yīng)發(fā)生。結(jié)論:1化濁解毒方與摩羅丹治療cag伴im均有效,化濁解毒中藥優(yōu)于摩羅丹。2化濁解毒方可明顯減輕患者癥狀,改善胃鏡像、病理像,其作用機(jī)制可能與提高胃黏膜PG水平,降低CDX2、LI-CD在胃黏膜的表達(dá)有關(guān)。3化濁解毒方治療CAG伴IM,效果顯著,不良反應(yīng)少,值得進(jìn)一步推廣研究與應(yīng)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.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
本文編號：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.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 張淑霞;;慢性萎縮性胃炎患者的臨床治療研究[J];當(dāng)代醫(yī)學(xué);2017年01期
2 于鵬飛;車聰;趙坤;梁坤;牛慶慧;張翠萍;;逆萎康對慢性萎縮性胃炎病人TNF-α、IL-6和CDX2表達(dá)影響[J];青島大學(xué)醫(yī)學(xué)院學(xué)報(bào);2016年05期
3 袁龍良;辛毅;燕善軍;;胃復(fù)春治療慢性萎縮性胃炎療程與療效相關(guān)性研究[J];臨床醫(yī)學(xué);2016年11期
4 余吉;任順平;;補(bǔ)陽還五湯加減治療胃絡(luò)瘀阻型慢性萎縮性胃炎療效觀察[J];山西中醫(yī);2016年11期
5 胡乃強(qiáng);林才志;趙海燕;唐健;;林才志“病證結(jié)合”治療萎縮性胃炎臨床經(jīng)驗(yàn)[J];中醫(yī)藥臨床雜志;2016年11期
6 冀雯芳;;柴芍六君子湯加減治療肝郁脾虛型慢性萎縮性胃炎的效果觀察[J];河南醫(yī)學(xué)研究;2016年11期
7 楊茜;劉少康;;“老十針”穴位埋線聯(lián)合胃復(fù)春片治療慢性萎縮性胃炎臨床療效觀察[J];新疆中醫(yī)藥;2016年05期
8 王富莉;張連莊;崔應(yīng)珉;;崔應(yīng)珉教授治療慢性萎縮性胃炎腸上皮化生的經(jīng)驗(yàn)[J];國醫(yī)論壇;2016年05期
9 劉思毅;卞嵩京;;卞嵩京辨治慢性萎縮性胃炎腸腺化生經(jīng)驗(yàn)舉隅[J];天津中醫(yī)藥;2016年09期
10 梁艷麗;李鳳;王欣;蒲澤宴;;血清胃蛋白酶原檢測在胃部疾病診斷中的臨床意義[J];臨床醫(yī)藥實(shí)踐;2016年08期
，本文編號：2141750
本文鏈接：http://sikaile.net/zhongyixuelunwen/2141750.html
最近更新
教材專著
