摘要
[目的]健脾清化散瘀饮治疗脾虚湿热血瘀型隆起糜烂性胃炎(Raised erosive gastritis,REG)一个疗程后,比较治疗前后的临床疗效变化,并通过比较正常对照组和REG患者治疗前后胃黏膜组织突变型P53蛋白(P53)及细胞增殖核抗原蛋白(PCNA)的表达变化,探讨健脾清化散瘀饮治疗REG可能的作用机制。[方法]选取REG属脾虚湿热血瘀证患者36例,予以中药健脾清化散瘀饮口服治疗,3个月为一疗程。36例REG患者(以下属全分析集)中,3例临床相关资料不完整予剔除,另失访脱落1例,共32例患者(以下属符合方案集)进行统计分析,并设正常对照组20例。观察临床疗效,检测健脾清化散瘀饮治疗前后胃黏膜P53及PCNA表达的变化,进行治疗前后的自身对照,并测定20例正常对照组胃黏膜组织中P53及PCNA的表达水平同REG组治疗前后进行空白对照。[结果](1)中医证候疗效(根据症候积分评定):1符合方案集:总有效率为93.75%。2全分析集:总有效率为83.33%。(2)胃镜疗效:1符合方案集:总有效率为78.125%。2全分析集:总有效率为69.44%。(3)病理疗效:1符合方案集:总有效率为84.375%。2全分析集:总有效率为75.00%。(4)治疗前REG患者胃黏膜P53呈强阳性表达,明显髙于正常对照组(P<0.05),经健脾清化散瘀饮治疗后其表达较治疗前明显下降(P>0.05),与正常对照组比较差别无统计学意义(P>0.05)。(5)治疗前REG患者胃黏膜中PCNA的表达呈强阳性表达,表达强度明显高于正常对照组(P<0.05),治疗后其表达强度明显降低,呈弱阳性表达,且接近正常对照组表达,治疗前后比较差异有统计学意义(P<0.05)。[结论]1健脾清化散瘀饮治疗REG疗效确切。2P53及PCNA的过度表达提示REG胃黏膜细胞处于一种高增殖状态,二者介导的细胞异常增殖可能与REG发病密切相关。3健脾清化散瘀饮可能是通过下调P53及PCNA的表达以抑制细胞增殖达到治疗的目的,这可能是其治疗REG的机理之一。
[Objective]To explore the effects of Jianpi Qinghua Sanyu Yin in treating raised erosive gas-tritis（REG）and to investigate the possible mechanisms by detecting the changes of gastric mucosa mutant P53protein（P53）and proliferating cell nuclear antigen protein（PCNA）.[Methods]Thirty-six REG patients were selected and treated with Jianpi Qinghua Sanyu Yin for 3months.Among the 36 cases,except that 3cases＇clinically relevant information was incomplete and 1case was lost,32 cases were sent to the final statistical analysis.Another 20 healthy people were selected as the normal control group.The changes of the syndrome,and P53 and PCNA expression as well as the adverse reactions were observed.[Results]1.Efficacy of Traditional Chinese Medicine symptoms（based on symptom score）：1The total effective rate was 93.75% at the per-protocol set.2 At the full analysis set,the total effective rate was 83.33%.2.Endoscopy efficacy：1The total effective rate was 78.125%at the per-protocol set.2At the full analysis set,the total effective rate was 69.44%.3.Pathological efficacy：1The total effective rate was 84.375% at the per-protocol set.2At the full analysis set,the total effective rate was 75.00%.4.Compared with the normal control group,the P53 and PCNA expression of REG group were much higher（P〈0.05）.They significantly decreased after treatmen（P〈0.05）,but were still higher than the normal control group.There was no significant difference between two groups（P〈0.05）.[Conclusion]1.The curative effect of Jianpi Qinghua Sanyu Yin for REG is obvious.2.The abnormal expression of P53 and PCNA may play an important role in promoting the occurrence and development of REG;3.Jianpi Qinghua Sanyu Yin can significantly reduce the expression level of P53 and PCNA in REG patients,which might be the mechanism of its function.
出处
《中国中西医结合消化杂志》
CAS
2016年第11期820-825,共6页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金
福建省自然科学基金项目(No:2015J01478)
福建省卫生厅中医药科研课题(No:WZPW201302)
