善胃系列方治疗胃癌前病变的相关基因蛋白表达试验研究

Experimental research with Benefiting stomach prescriptions expression of the revelant gene of the Precancerous of gastric cancer

[目的]观察中药善胃系列方对慢性萎缩性胃炎(CAG)伴有胃黏膜异型增生(Dys)和(或)肠上皮化生(IM)的治疗效果,并观察相关基因蛋白在治疗前后的表达情况。[方法]将确诊为慢性萎缩性胃炎伴胃黏膜异型增生和(或)肠上皮化生(IM)的患者154例,随机分为观察组106例,口服善胃系列方中药,根据辨证分型又分为3组:血瘀热毒型(善胃Ⅰ号方)组34例,阴虚有热型(善胃Ⅱ号方)组43例,气阴两虚型(善胃Ⅲ号方)组29例;对照组48例,口服猴头菌片,连续治疗6个月,观察两组患者临床症状改善情况、胃镜所见及胃黏膜病理组织学改善情况;利用免疫组化方法观察服药前后胃黏膜组织中ras癌基因P21蛋白和抑癌基因P16蛋白的表达情况。[结果]观察组患者治疗后总有效率为83.96%;对照组患者治疗后总有效率为29.17%,两组有显著性差异,P>0.01;观察组治疗后多数患者腺体萎缩程度、肠上皮化生、胃黏膜异型增生均有改善,P<0.01;而对照组改善不明显;观察组明显优于对照组,P<0.5;观察组治疗后癌基因蛋白P21显著降低,P<0.05;抑癌基因蛋白P16表达显著提高,P<0.05。[结论]中药善胃系列方对胃癌前期病变临床疗效确切,并通过降低P21的表达水平,提高P16的表达水平,在一定程度上使胃黏膜病理逆转。

[Objective] It is to observe the effect benefiting stomach prescriptions on chronic atrophic gastritis patients with dysplasis and（or） intestinal metaplasia ,and the expression of relative gene of stomach mucous membrane tissue. [Methods] 154 cases of precancerous lesions of gastric cancer are divided into 2 groups at random, among which, 106 cases in observation group（were given benefiting stomach prescriptions）, the observation group is once more divided into 3 groups according to differentiation types, among which, 34 cases in the pattern of blood stasis and heat toxicity （benefiting stomach Ⅰ ）, 43 cases in the pattern of Yin deficiency with heat （benefiting stomach Ⅱ ）, 29 cases in the pattern of Qi and Yin deficiency （benefiting stomach Ⅲ ）.48 cases in control group （were given Houtoujun tables）,all patients in two groups were treated for 6 months. Research items include clinical manifestation, endoscope sign, tissue pathogenesis, and the expressive condition of relative gene of stomach mucous membrane tissue （ras primary cancer gene P21 and cancer suppressor gene P16）by immune histochemistry method. [Results] The total efficient is 83.96% in observation group; And 29.17% in control group, there was obviously difference between them, P〈0.01; There were great improvement in the degree of gland atrophy, intestinal metaplasia,dysplasis of stomach mucous membrane tissue in ,ob-servation group, P〈0.01; and it was not obvious in control group; There is significant decrease in the expressive level of ras cancer gene P21 after treatment comparing with that before treatment, P〈0.05; There, is significant increase in the expressive level of cancer suppressor gene pl6 after treatment comparing with that before treatment, P〈0.05. [Conclusion] Chinese herb series of benefiting stomach prescriptions can properly adjust the expressive level of relative gene protein（P21,P16）.