健胃愈疡颗粒治疗胃溃疡的临床观察

作者	单位
林源	中南大学湘雅医院中西医结合研究所 (长沙410008)
廖书胜	中南大学湘雅医院中西医结合研究所 (长沙410008)
周勇杰	中南大学湘雅医院中西医结合研究所 (长沙410008)
李家邦	中南大学湘雅医院中西医结合研究所 (长沙410008)

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中文摘要:

目的观察健胃愈疡颗粒对胃溃疡患者临床疗效及胃黏膜白细胞介素-1β(IL-1β)、成纤维细胞生长因子(bFGF)mRNA表达的影响,探讨其对胃溃疡的疗效机制。方法将56例胃镜下确诊的胃溃疡(中医辨证为肝郁脾虚证)患者随机分为两组,两组HP阳性者均服用阿莫西林与甲硝唑,治疗组(26例)服用健胃愈疡颗粒,对照组(30例)服用法莫替丁片和硫糖铝片,疗程均为4周;治疗前后观察患者的药物依从性、症状积分、胃镜疗效及HP清除率;取胃黏膜活检,并检测IL-1β、bFGFmRNA表达水平。结果(1)治疗组药物依从率(100.0%)明显优于对照组(86.7%,P<0.01);(2)治疗后治疗组症状积分优于对照组(P<0.01);(3)两组患者胃镜下溃疡治愈率、临床有效率、HP清除率比较差异无显著性;(4)RT-PCR显示:治疗后两组IL-1βmRNA表达明显降低,bFGFmRNA表达增加,与治疗前比较差异均有显著性(P<0.01),但两组间比较差异无显著性;(5)治疗后胃黏膜形态学显示两组炎症细胞浸润明显减少,黏膜上皮细胞再生,部分腺体重建,呈囊状扩张。结论健胃愈疡颗粒有较好的药物依从性,能明显改善患者临床症状,降低胃黏膜IL-1βmRNA水平,促进bFGFmRNA的表达,有促进溃疡修复作用。

英文摘要:

Objective To observe the clinical effects of Jianwei Yuyang Granule(JYG)in treating patients with gastric ulcer and its influence on interleukin-1β(IL-1β)and basic fibroblast growth factor(bFGF)mRNA expression in gastric mucosa for exploring the therapeutic mechanism.Methods Fifty-six patients with confirmed gastric ulcer unader gastroscope and differentiated as Gan-stagnant Pi-deficient syndrome were randomly assigned to two groups,the treated group(26 cases)treated with JYG and the control group(30 cases)treated with famotidine and sucralfate,4 weeks as one therapeutic course.The changes before and after treatment in clinical compliance,symptom integral,ulcer-healing rate,clinical effective rate,and HP-clearance rate were observed.And the gastric mucosa biopsy was fetched for morphological examination and IL-1β and bFGF mRNA expression detection by RT-PCR as well.Results The clinical compliance rate in the treated group was 100%,which was obviously better than that in the control group(86.7 %,P<0.01);the improvement on symptom integral in the former was also better(P<0.01);no statistical significance was shown in ulcer-healing rate,clinical effective rate and HP-clearance rate between the two groups.Morphological observation showed markedly decreased inflammatory cell infiltration,epithelial cell regeneration and rather regular glandular arrangement in both groups.The IL-1β mRNA expression level decreased and that of bFGF increased in both groups after treatment significantly(P<0.01),but showed insignificant difference between the two groups.Conclusion JYG,with its good clinical compliance,has favorable effects in relieving clinical symptoms,promoting endoscopic ulcer healing and HP clearance,decreasing the expression of IL-1β mRNA and increasing the expression of bFGF,therefore,it could promote the recovering of gastric ulcer.

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