幽门螺杆菌根除与灭幽门螺杆菌煎剂对慢性胃炎病变和胃黏膜屏障的影响

Effect of Helicobacter pylori eradication therapy and H pylori-killing Decoction on chronic gastritis and gastric mucosa barrier

目的:观察幽门螺杆菌(Helicobacter pylori,H pylori) 根除与灭Hpylori煎剂对慢性胃炎慢性黏膜病变和胃黏膜屏障的影响. 方法:46例幽门螺杆菌阳性慢性胃炎患者应用丽珠胃三联行H pylori根除治疗后,随机分成三组;分别予以灭Hpylori煎剂、胃复春(阳性对照)、胃舒平(阴性对照) 治疗3 mo,治疗前后行胃镜检查,观察对慢性胃黏膜病变的治疗情况,同时测定血清EGF和胃窦黏膜磷脂含量以及胃黏膜EGFR表达情况. 结果:单Hpylori根除后胃黏膜急性炎症明显消退,但对慢性胃黏膜病变无明显影响.经“灭H pylori煎剂”与“胃复春”治疗后慢性胃黏膜病变明显消退,磷脂含量显著增加,血清EGF含量下降,但前者可使EGFR表达增加,而胃复春则无影响. 结论:“灭Hpylori煎剂”对Hpriori相关性慢性胃炎胃黏膜慢性炎症具有良好治疗作用,能够增加胃黏膜表面磷脂和血清EGF含量,有增强胃黏膜屏障作用的功能.

AIM: To investigate the effect of Helicobacterpylori(Hpylon) eradication therapy and H pylori-Killing Decoction on chronic pathological mucosal changes. METHODS: Forty-six chronic gastritis patients with positive H pylori were orally administered with Livzon Weisanlian (Bismuth agent 0.22 g, b.i.d. + Tinidazole 0.5 g, b.i.d. + Clarithromycin 0.25 g. b.i.d) for 7 days for eradication of H pylori. The patients were then randomly divided into 3 groups, treated with H pylori-Killing Decoction, Weifuchun and Gastropine respectively. After 3-month treatment, gastroscopy and histopathological biopsy of antrum and corpus were performed to assess the pathological changes of gastric mucosa. Meanwhile, the serum concentration of epidermal growth factor (EGF), the mucosal content of phospholipid and epidermal growth factor receptor (EGFR) was also detected. RESULTS: After the eradication treatment of Hpylori, the acute inflammation of gastric mucosa was reduced obviously, but no evident influence on chronic pathological changes was observed. After 3-month treatment with H pylori-Killing Decoction and Weifuchun, the chronic pathological changes of gastric mucosa were improved significantly. The mucosal content of phospholipid was increased remarkably, and the serum levels of EGF were decreased significantly in both groups. However, the mucosal EGFR expression was significantly increased in H pylori-killing decoction group, but not Weifuchun goup. CONCLUSION: H pylori-killing Decoction has therapeutic effect on the chronic pathological changes of H pylori-related gastritis and protective effect on gastric mucosa barrier.