荆花胃康胶囊治疗慢性萎缩性胃炎的疗效及对NLRP3通路介导炎症及焦亡的影响

Efficacy of Jinghua Weikang Capsule in the treatment of chronic atrophic gastritis and its effect on inflammation and pyroptosis mediated by the NLRP3 pathway

目的研究荆花胃康胶囊治疗慢性萎缩性胃炎的疗效及对NOD样蛋白受体3(NLRP3通路介导炎症及焦亡的影响。方法选择2021年1月至2022年3月寿县人民医院消化内科收治的慢性萎缩性胃炎患者进行前瞻性研究,采用随机数字表分为接受荆花胃康胶囊联合西医药物治疗的观察组(n=58)和西医药物治疗的对照组(n=57)。治疗4个疗程后评价两组疗效、中医证候积分及胃黏膜病理积分,检测两组胃黏膜中NLRP3、Caspase-1的mRNA表达水平及血清中IL-1β、IL-18、GSDMD的水平。结果观察组的治疗有效率高于对照组,差异有统计学意义(P<0.05);两组治疗后的胃痛、胃痞满、嗳气泛酸、食少纳差中医证候积分,腺体萎缩、肠上皮化生、异型增生的病理积分,胃黏膜中NLRP3、Caspase-1的mRNA表达水平,血清中IL-1β、IL-18、GSDMD的水平低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论荆花胃康胶囊治疗能够改进慢性萎缩性胃炎的治疗效果,改善中医证候及胃黏膜病理改变,抑制NLRP3通路介导的炎症及焦亡可能是与之相关的分子机制。

Objective To study the therapeutic efficacy of Jinghua Weikang capsule on chronic atrophic gastritis and its effect on NOD-like protein receptor 3(NLRP3)pathway mediated inflammation and pyroptosis.Methods Patients with chronic atrophic gastritis admitted to the Department of Gastroenterology of Shouxian People's Hospital from January 2021 to March 2022 were selected for the prospective study and were divided into the observation group(n=58)receiving Jinghua Weikang capsule combined with Western medicine and the control group(n=57)receiving Western medicine by random number table.After 4 courses of treatment,the therapeutic effect,TCM syndrome score and gastric mucosa pathological score were evaluated,and the mRNA expression levels of NLRP3 and Caspase-1 in gastric mucosa and the levels of IL-1β,IL-18 and GSDMD in serum were detected.Results The effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).After treatment,the TCM syndrome integral of gastric pain,gastric fullness,belching pantothenic acid,eating less and tolerating poor,the pathological scores of glandular atrophy,intestinal metaplasia,dysplasia,the mRNA expression levels of NLRP3 and Caspase-1 in gastric mucosa,and serum levels of IL-1β,IL-18 and GSDMD were lower than those before treatment in two groups and the observation group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion Jinghua Weikang capsule treatment can improve the therapeutic effect of chronic atrophic gastritis,improve traditional Chinese medicine syndrome and pathological changes of gastric mucosa,and inhibiting inflammation and pyroptosis mediated by the NLRP3 pathway may be the related molecular mechanism.