健胃愈疡颗粒抗消化性溃疡复发的疗效及作用机理

Therapeutic Effect and Mechanism of Jianwei Yuyang Granules on the Relapse of Peptic Ulcer

目的观察健胃愈疡颗粒抗消化性溃疡(PU)复发的临床疗效及其可能机理。方法 381例PU患者随机分为治疗组(202例)和对照组(179例),并设胃镜及组织学正常者18例为正常组。治疗组给予健胃愈疡颗粒每次9g口服,每日3次。对照组给予雷尼替丁胶囊每次0.15g口服,每日2次;幽门螺杆菌(Hp)阳性者加用阿莫西林胶囊和甲硝唑片,用药7天。两组均治疗4周。观察两组患者临床疗效、一年复发率及Hp清除率,并测定治疗前后两组患者及正常组胃黏膜组织血管内皮生长因子(VEGF)、黏蛋白5AC(MUC5AC)、核因子-κBp65(NF-κBp65)蛋白及其mRNA的表达。结果治疗组愈合率为79.2%,一年复发率为9.35%,Hp根除率为76.6%;对照组愈合率为81.8%,一年复发率为30.00%,Hp根除率为81.0%。治疗组复发率显著低于对照组(P<0.01)。治疗组治疗后较治疗前VEGF、MUC5AC及其mRNA表达明显增高,NF-κBp65蛋白及其mRNA表达降低(P<0.01),并且在升高VEGF、MUC5AC及其mRNA方面优于对照组(P<0.01)。结论健胃愈疡颗粒具有良好的抗PU复发作用,可能通过提高PU患者溃疡周边组织VEGF、MUC5AC的表达,降低NF-κBp65的表达改善溃疡愈合质量,从而抗PU复发。

Objective To observe the therapeutic effect and mechanism of Jianwei Yuyang Granules （granules to fortify the stomach and cure ulcers, JYG） on the relapse of peptic ulcer （PU）. Methods Totally 381 cases of PU were randomized into the treatment group （202 cases） and control group （179 cases）. Another 18 persons with normal endoscopy and histology were chosen as the normal group. The treatment group was given 9g of JYG once orally, three times daily. The control group was given 0.15g of Ranitidine Capsules once orally, twice daily. Helicobacter pylori （Hp）-positive patients were added with Amoxicillin Capsule and Metronidazole for 7 days. Both groups were treated for 4 weeks. The therapeutic effect, 1-year recurrence rate and Hp clearance rate were observed. The expressions of gastric mucosa tissue ascular endothelial growth factor （VEGF）, VEGF mRNA, mucin SAC （MUCSAC）, MUCSAC mRNA, nuclear factor-kBp65 （NF-kBp65） and NF-kBp65 mRNA were detected. Results The cure rate, 1-year recurrence rate and Hp clearance rate of the treatment group were 79.2%, 9.35% and 76.6%. The cure rate, 1-year recurrence rate and Hp clearance rate of the control group were 81.8%, 30. 00% and 81.0%. The 1-year recurrence rate of the treatment group was significantly lower than that of the control group （P〈0.01）. The expressions of VEGF, VEGF mRNA, MUC5AC and MUC5AC mRNA increased significantly in the treatment group after treatment （P〈0.01）, with a significant difference between groups （P〈0.01）. The expressions of NF-kBp65 and NF-kBp65 mRNA decreased significantly in the treatment group after treatment （P〈0.01）. Conclusion JYG has a good anti-PU recurring effect that may be relevant to improving the expressions of VEGF and MUCSAC and reducing the expression of NF-kBp65.