胃复康颗粒对Hp VG湿热证患者胃黏膜p38MAPK及ATF2蛋白表达的影响

Effects of WeiFuKang Granules on the Expressions of ATF2 Protein and p38MAPK in Gastric Mucosa of the Patients with Hp VG of Damp-heat Pattern

目的:探讨胃复康颗粒对幽门螺杆菌相关性疣状胃炎(Hp VG)湿热证患者胃黏膜病理及p38MAPK、ATF2蛋白表达的影响。方法:将Hp VG湿热证患者135例随机分为中药组、联合组及西药组各45例,中药组予胃复康颗粒1袋/次,2次/d;西药组予泮托拉唑钠肠溶片每次1片,1次/d。联合组同时服用中药及西药。3组疗程均为6周。采用定位活检法取得治疗前后胃黏膜病变标本,用HE染色观察胃黏膜病理组织学变化情况;免疫组化Western blot法检测p38MAPK及ATF2蛋白表达情况。结果:3组患者胃黏膜病理改善总有效率中药组为82.2%、联合组为88.9%、西药组为73.3%,中药组、联合组改善优于西药组(P<0.05),中药组与联合组间比较差异无统计学意义(P>0.05)。治疗后3组患者胃黏膜p38MAPK均较治疗前降低(P<0.05),联合组较西药组降低明显(P<0.05),与中药组比较效果相当(P>0.05)。中药组、联合组ATF2蛋白表达较治疗前及西药组降低(P<0.05),西药组较治疗前变化不明显(P>0.05);联合组与中药组比较效果相当(P>0.05)。结论:胃复康颗粒联合西药可能通过下调p38MAPK及ATF2蛋白表达,抑制p38MAPK/ATF2通路,减少下游炎症因子释放,起到减轻Hp VG湿热证患者炎症反应的作用。

Objective: To discuss the effects of WeiFuKang granules on the pathology of gastric mucosa, the expressions of ATF2 protein, p38MAPK of the patients with Hp-related verrucosa gastritis(Hp VG) of damp-heat pattern. Methods: All 135 patients were randomized into herbs group, the combination group and Western medicine group, 45 cases each group, the herbs group were given WeiFuKang granules, one bag each time, twice each day;Western medicine group took pantoprazole sodium enteric-coated tablets, one pill each time, once each day. The combination group took herbs and Western medicine simultaneously, the course was six weeks. Localization biopsy was used to obtain pathological specimen of gastric mucosa, HE staining was adopted to observe histopathological changes of gastric mucosa;Western blot method to detect the expressions of ATF2 protein and p38MAPK. Results: Total effective rates of pathological improvements of gastric mucosa in herbs group were 82.2%, the combination group 88.9% and the Western medicine group 73.3%, the herbs group and the combination group were superior to Western medicine group in the improvements (P<0.05), the difference had no statistical meaning in the herbs group and the combination group(P>0.05). After treating, p38MAPK of gastric mucosa in three groups lowered compared with before treating (P<0.05), the combination group was lower than Western medicine group obviously(P<0.05), compared with the herbs group, the improvement effects were similar(P>0.05). ATF2 proteins of the herbs group and the combination group reduced compared with before treating and Western medicine group(P<0.05), the changes of Western medicine group were not obvious than before treating(P>0.05), the combination group was equivalent to the herbs group(P>0.05). Conclusion: WeiFuKang granules combined with Western medicine could mitigate inflammatory reaction of the patients through down-regulating the expressions of ATF2 protein and p38MAPK, inhibiting p38MAPK/ATF2 pathway and reducing the release of downstream inflammatory factor.