健脾清化散瘀饮对脾虚湿热血瘀证慢性萎缩性胃炎黏膜TNF-α、p53、Ki-67表达的影响

Effect of Jianpi Qinghua Sanyu soup on TNF-α,p53,Ki-67 expression in mucosa in the chronic atrophy gastritis patients with deficiency of the spleen and damp-heat and blood stagnation

[目的]观察健脾清化散瘀饮对脾虚湿热血瘀证慢性萎缩性胃炎(CAG)治疗作用及对胃黏膜肿瘤坏死因子-α(TNF-α)、p53、Ki-67表达的影响,探讨健脾清化散瘀饮治疗CAG作用机制。[方法]选择脾虚湿热血瘀证CAG患者28例,口服健脾清化散瘀饮3个月,观察临床疗效,检测健脾清化散瘀饮治疗前后胃黏膜TNF-α、p53、Ki-67表达。[结果]28例脾虚湿热血瘀证CAG患者经治疗后,临床症状治疗有效24例(85.71%)。胃镜下改变有效22例(78.57%)。病理改变慢性炎症减退25例(89.29%)。脾虚湿热血瘀证CAG黏膜TNF-α表达水平高于正常对照组(P<0.01);与治疗前比较,治疗后黏膜TNF-α表达水平降低(P<0.01)。脾虚湿热血瘀证CAG黏膜p53低于正常对照组(P<0.01);与治疗前比较,治疗后黏膜p53表达水平升高(P<0.01)。脾虚湿热血瘀证CAG黏膜Ki-67的表达水平低于正常对照组(P<0.01);与治疗前比较,治疗后Ki-67表达水平升高(P<0.01)。[结论]健脾清化散瘀饮治疗脾虚湿热血瘀证CAG有效。TNF-α在CAG的发生发展过程中起促炎作用,p53在治疗CAG的组织抗损伤中起着重要作用。TNF-α、p53、Ki-67在脾虚湿热血瘀证CAG治疗前后黏膜中表达改变,推测健脾清化散瘀饮可能通过下调胃黏膜TNF-α,上调p53表达,促进上皮细胞增殖而治疗慢性萎缩性胃炎。

[Objective]To study the Effect of Jianpi Qinghua Sanyu Soup(JQS) on TNF-α,p53,Ki-67 Expression in mucosa in the chronic atrophy gastritis with deficiency of the spleen and damp-heat and blood stagnation.[Methods]twenty eight chronic atrophic gastritis patients with deficiency of the spleen and damp-heat and blood stagnation were selected accroding to TCM dialectics.After three months treating with JQS therapy,The expression of TNF-α,p53 and Ki-67 in mucosa were detected by immunohistochemistry.And 20 healthy peoples were considered as the control group.[Results]According to symptom score of TCM symptoms,the effective rate was 85.71%(24/28 case).Under the gastroscope,the inflammation vanish was 78.57%(22/28 case).Pathological slices inflammation vanish rate was 89.29%(25/28 case).The expression level of TNF-α in the chronic gastritis group was obviously higher than that in the control group(P<0.01).After three months treated with JQS therapy,the expression of TNF-αwas significantly decreased in mucosa in the CAG with deficiency of the spleen and damp-heat and blood stagnation than that before therapy(P<0.01).The expression level of P53 in the chronic gastritis group was obviously lower than that in the control group(P<0.01).After three months treated with JQS therapy,the expression of P53 was significantly increased in mucosa in the CAG with deficiency of the spleen and damp-heat and blood stagnation than that before therapy(P<0.01).The expression level of Ki-67 in the chronic gastritis group was obviously lower than that in the control group(P<0.05).After three months treated with JQS therapy,the expression of Ki-67 was significantly increased in mucosa in the CAG with deficiency of the spleen and damp-heat and blood stagnation than that before therapy(P<0.05).[Conclusion]the therapy of JQS is effective for CAG.TNF-α may play an important role in promoting the occurrence and development of CAG.P53 is an important cytokine in preventing tissue from damage in the CAG.The difference was found in mucosa between the CAG with deficiency of the spleen and damp-heat and blood stagnation in that before therapy about the expression of TNF-α,P53,Ki-67.It is speculated that JQS can treat chronic atrophic gastritis by down regulating TNF-αand up regulating p53 expression and promoting epithelial cell proliferation.