健脾清化散瘀饮对脾胃湿热证隆起糜烂性胃炎黏膜TNF-α、IL-8、IL-10表达的影响

Effect of Jianpi Qinghua Sanyu Soup on IL-8,TNF-αand IL-10 expression in mucosa in raised erosive gastritis with spleen stomach dampness heat syndrome

[目的]健脾清化散瘀饮治疗脾胃湿热证隆起糜烂性胃炎(raised erosive gastritis,REG)3个月后,观察其治疗后疗效,并观察胃黏膜细胞因子白细胞介素-8(IL-8)、IL-10、肿瘤坏死因子-α(TNF-α)治疗前后表达的变化,探讨健脾清化散瘀饮治疗隆起糜烂性胃炎作用机制。[方法]选择REG脾胃湿热证患者32例,口服健脾清化散瘀饮3月,观察其临床疗效,检测健脾清化散瘀饮治疗前后胃黏膜中TNF-α、IL-8、IL-10表达。[结果]32例脾胃湿热证隆起糜烂性胃炎患者经治疗后,症状治愈者18例(56.25%),显效8例(25.00%),有效4例(12.50%),无效2例(6.25%),总有效30例(93.75%);胃镜改变治愈者19例(59.38%),显效3例(9.38%),有效3例(9.38%),无效7例(21.88%),总有效25例(78.12%);活检经病理观察治愈者7例(21.88%),显效11例(34.38%),有效10例(31.25%),无效4例(12.50%),总有效28例(87.50%)。脾胃湿热证REG患者胃黏膜TNF-α、IL-8、IL-10的表达明显高于正常对照组,差异具有统计学意义(P<0.01)。经3个月口服健脾清化散瘀饮治疗后IL-8、TNF-α、IL-10表达降低,差异具有统计学意义(P<0.01、0.05)。[结论]健脾清化散瘀饮治疗脾胃湿热证REG有效。IL-8、TNF-α、IL-10在REG的发生发展过程中起作用的炎症因子,健脾清化散瘀饮可能通过下调胃黏膜IL-8、TNF-α、IL-10表达而治疗隆起糜烂性胃炎。

[Objective]To study the Effect of Jianpi Qinghua Sanyu Soup（JQS）on the expression of IL-8,TNF-αand IL-10 in mucosa in the raised erosive gastritis with spleen stomach dampness heat syndrome.[Methods]Thirty-two patients of raised erosive gastritis with spleen stomach dampness heat syndrome were selected according to TCM dialectics.After three months treating with JQS therapy,the expression of IL-8,TNF-αand IL-10 in mucosa was detected by immunohistochemistry.[Results]According to symptom score of Traditional Chinese Medicine symptoms,the cure rate was 56.25%,remarkable effective rate was 25.00%,efficiency was 12.50%,ineffective rate was 6.25%,and total effective rate was93.75%.Under endoscopy,REG group cure rate was 59.38%,effective rate was 9.38%,the markedly ef-fective rate was 9.38%,and total effective rate was 78.12%after treatment.According to the pathological biopsy,REG group cure rate was 21.88%,the markedly effective rate was 34.38%,the effective rate was31.25%,and total effective rate was 87.50%.The expression level of TNF-α,IL-8,IL-10 in the raised erosive gastritis group was obviously higher than that in the control group（P〈0.01）.After three months treated with JQS,the expression of IL-8,TNF-α,IL-10 was significantly decreased in REG group than that before therapy（P〈0.05,0.01）.The expression level of IL-8,IL-10,TNF-αin REG group after treatment compared with normal control group,there was no difference（P〉0.05）.[Conclusion]The therapy of JQS is effective for REG.Cytokines IL-8,TNF-α,IL-10 play an important role in the occurrence and development of REG.JQS can significantly reduce the expression of IL-8,TNF-αand IL-10,which has a therapeutic effect on REG.