四君子汤对脾胃虚弱证型消化性溃疡患者肠道微生态变化及COX-1、COX-2、PGE2表达的影响

Effect of Sijunzi Decoction on Intestinal Microecology Changes of Deficiency of Spleen and Stomach Peptic Ulcer Patients’and Expression of COX-1,COX-2 and PGE2

目的探讨中药方剂四君子汤对脾胃虚弱症型消化性溃疡患者肠道菌群变化、环氧化酶(COX-1、COX-2)及前列腺素E2表达水平的影响。方法从2017年1月-2018年12月收治的消化性溃疡患者中按年龄组、性别、溃疡类型1∶1匹配后,随机分配于试验组与对照组(试验组与对照组各240名患者)。其中,对照组患者给予思密达治疗,试验组使用思密达协同四君子汤,分别治疗8周。比较治疗前后2组患者的治疗效果、肠道微生态变化、环氧化酶及前列腺素E2水平表达情况。结果治疗后,试验组的阳性与阴性杆菌数减少,阳性球菌数增多,且阳性球菌与阴性球菌数量均高于对照组。而对照组的阳性、阴性杆菌与阴性球菌均显著减少(P<0.05);2组的COX-1、COX-2、PGE2表达水平均增高(P<0.05),且中药组显著高于对照组(P<0.05)。结论在思密达基础上加用四君子汤治疗脾胃虚弱症型消化性溃疡可有效调节其胃肠道菌群平衡、增强对胃黏膜的覆盖保护作用。

Objective To discuss the impact of deficiency of spleen and stomach peptic ulcer(PU)patients’intestinal flora change,expression of cyclooxygenase-1(COX-1),cyclooxygenase-2(COX-2),prostaglandin E2(PGE2)after eight weeks treatment by using traditional Chinese medicine Sijunzi decoction.Methods 480 cases of deficiency of spleen and stomach PU patients(range from January 2017 to December 2018)were enrolled into study.The intervention group and control group was 1:1 matched by age group,sex and ulcer type.All participants were randomly enrolled into 2 groups.Intervention group was given Smecta powder and Sijunzi decoction,while control group only used Smecta powder.Two groups patients will be tested the intestinal microecology and expression of COX-1,COX-2 and PGE2 after 8 weeks treatments.All indicators will be compared within each group and between two groups.Results After treatment,numbers of positive and negative bacillus were decreased,and the number of positive coccus were increased in intervention group(P<0.05).Furthermore,the number of positive and negative coccus were lower than in control group(P<0.05).In the control group,the number of bacillus and coccus lower than before treatment.2.Two group patients’expression of COX-1,COX-2,PGE2 was significantly increased and expressions in intervention group was higher than in control group(P<0.05).Conclusion Using Smecta power and Sijunzi decoction treat deficiency of spleen and stomach PU patients can get a better clinical efficacy than isolate using Smecta power because that Sijunzi decoction was potentially balanced intestinal flora,increase coverage protection of gastric mucosal.