三仁汤干预脾胃湿热型慢性糜烂性胃炎后HSP-70及IL-1β的变化

Effect of San Ren decoction treating chronic erosive gastritis based on the changes of HSP 70 and IL-1β

目的:基于治疗前后热休克蛋白70(HSP-70)、白细胞介素-1β(IL-1β)以及中医证侯变化,主客观指标合参,评价三仁汤干预脾胃湿热型慢性糜烂性胃炎(CEG)的临床疗效及可能机制。方法:140例符合诊断标准、纳入标准的CEG患者按1∶1随机分为治疗组和对照组,治疗组予三仁汤干预4周,对照组予安慰剂干预4周。详细记录治疗前、治疗后中医证侯变化;应用实时免疫酶链反应(Real-time PCR)技术检测胃黏膜HSP-70、IL-1β变化。结果:三仁汤治疗脾胃湿热型慢性糜烂性胃炎总有效率为84.28%,对照组总有效率为30%,治疗前两组患者HSP70 mRNA表达呈下降趋势,IL-1βmRNA表达呈上升趋势;治疗后,治疗组血清HSP70 mRNA表达呈上升趋势,与治疗前比较有统计学差异(P<0.05);IL-1βmRNA变化较治疗前比较,变化明显下降,有统计学差异(P<0.05);对照组血清HSP70及IL-1βmRNA较治疗前比较,无统计学差异(P>0.05)。结论:三仁汤可能通过诱导HSP-70表达,抑制IL-1β分泌从而发挥治疗慢性糜烂性胃炎作用。

Aim：The mechanisms of San Ren decoction discussed by observing the TCM syndrome and the changes interfering with chronic erosive gastritis were of HSP70 and IL-1β. Methods： One hundred and forty CEG patients were divided into two groups randomly. Each group was administrated with San Ren decoction and placebo for 4 weeks respectively. The changes of clinical manifestations were documented before and after treatment. The expression of HSP70 and IL-1β were assayed by Real-time PCR. Results： The total effect rate of San Ren decoction in treating CEG is 84. 28%. The total effect rate in Control group is 30%. Before treatment, the expression of HSP70 mRNA is on the decline, whereas the expression of IL-1β mRNA is on the increment. After treatment, the expression of HSP70 mRNA in intervention group is on the increment. However the expression of IL-1β mRNA in intervention group is on the decline. There is a significant difference in the expression of HSP70 and IL-1β before and after treatment in intervention group（P 〈0. 05）. There is no significant difference in the expression of HSP70 and IL-1β mRNA in control group before and after treatment（P 〉 0. 05）. Conclusion：San Ren decoction ex- erts an exact effect on alleviating chronic erosive gastritis by regulating the expression of HSPT0 and IL- 1β.