幽门螺杆菌根除与灭Hp煎剂对慢性胃炎胃黏膜屏障的影响

Effect of Helicobacter pylori eradication and Hp-killing decoction on gastric mucosa barrier of chronic gastritis

目的观察幽门螺杆菌(H.pylori,Hp)根除后灭Hp煎剂对慢性胃炎胃黏膜屏障的影响。方法46例Hp(+)慢性胃炎患者应用丽珠胃三联根除治疗后,随机分成3组;分别予以灭Hp煎剂、胃复春、氢氧化铝(胃舒平)治疗3个月,治疗前后行胃镜检查,观察药物对慢性胃黏膜病变的治疗情况,同时测定血清表皮生长因子(EGF)和胃窦黏膜磷脂含量以及胃黏膜表皮生长因子受体(EGFR)表达情况。结果单纯Hp根除使各组胃黏膜急性炎症明显消退,但对慢性病变没有影响;灭Hp煎剂治疗后慢性胃黏膜病变明显好转,磷脂含量显著增加,血清EGF从治疗前的(0.45±0.08)μg/L下降至治疗后的(0.36±0.05)μg/L(P<0.05);EGFR表达从治疗前的(35.20±4.95)%增加至治疗后的(48.80±5.19)%(P<0.05),而胃复春组则无明显变化。结论灭Hp煎剂能够增加胃黏膜表面磷脂和血清EGF含量,并使胃黏膜EGFR表达上调,有增强胃黏膜屏障的作用。

Objective To observe the effect of ＂Hp-killing decoction＂ on expression of serum epidermal growth factor（EGF） and mucosal epidermal growth factor receptor（EGFR） after Hp eradication. Methods Forty-six patients of chronic gastritis with Hp positive were orally given Livzon Weisanlian for 7 days. Then the patients with Hp eradication were randomly divided into three groups ： Group A, B and C, treated with H p-killing decoction, Weifuchun and Gastropine, respectively. After a three-months＂ treatment, gastroscopy and histopathological biopsy of antrum and corpus were performed in each patient for pathological changes of gastric mucosa, at same time,the expression of EGF and mucosal EGFR were also detected. Results After H p eradication,the acute inflammation of gastric mucosa in every group was reduced obviously,but no evident influence on chronic pathological changes of gastritis. After a three-months treatment with the Hp-killing decoction ,the chronic pathological changes of gastric mucosa were improved evidently, the serum level of EGF decreased from （0. 45±0. 08） g/L to （0.36±0.05） μg/L （ P 〈0.05）; however,the mucosal EGFR expression in the Hp-killing decoction group increased from （35.20±4.95）% to （48.80±5.19）% （ P 〈0. 05）, while group B was not. Conclusion The Hp-killing decoction has definite therapeutic action on chronic pathological changes of Hp-related gastritis and protective effect on gastric mucosa barrier.