自拟健脾益气方治疗慢性萎缩性胃炎

Clinical study on self-made Jianpi-Yiqi decoction in the treatment of chronic atrophic gastritis

目的评价健脾益气方治疗慢性萎缩性胃炎(chronic atrophic gastritis,CAG)的临床疗效。方法将符合入选标准的100例CAG患者采用随机数字表法分为2组,每组50例。对照组口服奥美拉唑肠溶胶囊治疗,观察组口服健脾益气方治疗。2组均治疗8周。采用ELISA法检测胃黏膜增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)、Bcl-2、TNF-α水平,采用RT-qPCR法检测PCNA、Bcl-2mRNA表达,评价临床疗效。结果观察组临床疗效总有效率为92.0%(46/50)、对照组为80.0%(40/50),2组临床疗效总有效率比较,差异有统计学意义(χ^2=9.623,P=0.031);观察组胃镜疗效总有效率为94.0%(47/50)、对照组为74.0%(37/50),2组胃镜疗效总有效率比较,差异有统计学意义(χ^2=11.254,P=0.026)。治疗后,观察组胃黏膜组织PCNA[(4.36±1.95)μg/mg比(8.62±2.43)μg/mg,t=8.465]、Bcl-2[(3.06±1.63)μg/mg比(7.54±1.73)μg/mg,t=9.316]、TNF-α[(4.13±1.86)μg/mg比(7.29±2.14)μg/mg,t=9.473]蛋白水平低于对照组(P<0.05),PCNA[(0.053±0.033)比(0.074±0.023),t=2.316]、Bcl-2[(0.004±0.003)比(0.006±0.002),t=5.842]mRNA表达低于对照组(P<0.05)。结论自拟健脾益气方可下调CAG患者胃黏膜组织PCNA、Bcl-2及TNF-α蛋白水平和PCNA、Bcl-2mRNA高表达,有效改善患者症状,提高临床疗效。

Objective To evaluate the efficacy of self-made Jianpi-Yiqi decoction in the treatment of chronic atrophic gastritis (CAG). Methods A total of 100 patients with CAG who met the inclusion criteria were randomly divided into two groups, 50 in each group. The control group received oral omeprazole enteric-coated capsules and the observation group oral Jianpi-Yiqi decoction. Both groups were treated for 8 weeks. The clinical efficacy, proliferating cell nuclear antigen (PCNA), B cell lymphoma-2 (Bcl-2), TNF-α and PCNA, Bcl-2 mRNA expression were evaluated and compared. Results The total effective rate was 92.0% (46/50) in the observation group and 80.0% (40/50) in the control group. The difference between the two groups was statistically significant (χ2=9.623, P=0.031). The total effective rate of endoscopy was 94.0% (47/50) in the observation group and 74.0% (37/50) in the control group. The difference between the two groups was statistically significant (χ2=11.254, P=0.026). After treatment, the PCNA (4.36 ± 1.95 μg/mg vs. 8.62 ± 2.43 μg/mg, t=8.465), Bcl-2 (3.06 ± 1.63 μg/mg vs. 7.54 ± 1.73 μg/mg, t=9.316), TNF-α (4.13 ± 1.86 μg/mg vs. 7.29 ± 2.14 μg/mg, t=9.473) in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the PCNA (0.053 ± 0.033 vs. 0.074 ± 0.023, t=2.316), Bcl-2 (0.004 ± 0.003 vs. 0.006 ± 0.002, t=5.842) mRNA expression in the observation group were significantly lower than those in the control group (P<0.05). Conclusions The self-made Jianpi-Yiqi decoction can down-regulate the expression of PCNA, Bcl-2 and TNF-α protein and PCNA and Bcl-2 mRNA in gastric mucosa, improve the symptoms of CAG patients and improve clinical efficacy.