基于胃黏膜MyD88、ATF2、NF-κB蛋白表达情况分析化浊解毒方加减治疗慢性萎缩性胃炎的机制

Based on the expression of MyD88,ATF2 and NF-κB proteins in gastric mucosa,the mechanism of Huazujiadu decoction in the treatment of chronic atrophic gastritis was analyzed

目的:基于胃黏膜髓样分化因子88(MyD88)、活化复制因子2抗体(ATF2)、核因子-kB(NF-κB)蛋白表达情况分析化浊解毒方加减治疗慢性萎缩性胃炎(CAG)的机制。方法:采用随机数字表法将于2021年1月~2023年5月在上海中医药大学深圳医院接受治疗的120例CAG患者分为A组和B组,每组各60例。A组给予幽门螺杆菌根除三联疗法,B组在A组基础上给予化浊解毒方加减治疗,两组均持续治疗2周。比较两组治疗2周后的临床疗效,治疗前、治疗2周后的胃镜黏膜征象积分、成纤维细胞生长因子23(FGF-23)、白细胞介素-32(IL-32)、降钙素基因相关肽(CGRP)、人表皮生长因子(EGF)、胃黏膜MyD88、ATF2、NF-κB蛋白表达情况,治疗期间的不良反应。结果:B组治疗2周后的总有效率高于A组(88.33%vs 71.67%,P<0.05)。两组治疗2周后的胃镜黏膜征象各项评分均比治疗前低,且与A组比较,B组较低(P<0.05)。两组治疗2周后的血清FGF-23、IL-32、EGF水平均比治疗前低,且与A组比较,B组较低;两组血清CGRP水平比治疗前升高,且与A组比较,B组较高(P<0.05)。两组治疗2周后的胃黏膜MyD88、ATF2、NF-κB蛋白表达均比治疗前低,且与A组比较,B组较低(P<0.05)。B组和A组治疗期间的不良反应发生率比较,差异无统计学意义(5.00%vs 11.67%,P>0.05)。结论:化浊解毒方加减治疗可有效减轻CAG患者胃黏膜炎症反应及胃黏膜损伤程度,分析其机制可能与其能调节胃黏膜MyD88、ATF2、NF-κB蛋白的表达有关,有助于提高治疗效果,且安全性良好。

Objective Based on the expression of myeloid differentiation factor 88(MyD88),activated replicator 2 antibody(ATF2)and nuclear factor-KB(NF-κB)protein in gastric mucosa,the mechanism of Huozhuojidofang in the treatment of chronic atrophic gastritis(CAG)was analyzed.Methods A total of 120 patients with CAG admitted to Shenzhen Hospital of Shanghai University of Traditional Chinese Medicine from January 2021 to May 2023 were divided into the group A and the group B by random number table method,60 cases in each group.The group A was given triple therapy of Helicobacter pylori eradication,and the group B was given addition and subtraction of Huazujiedu prescription on the basis of the group A.Both groups were treated for 2 weeks.The clinical efficacy after 2 weeks of treatment.Score of castroscopic mucosal sign,fibroblast growth factor 23(FGF-23),interleukin-32(IL-32),calcitonin gene-related peptide(CGRP),human epidermal growth factor(EGF),gastric mucosa MyD88,ATF2,NF-κB protein expression before and after 2 weeks of treatment,and adverse reactions during treatment of the two groups were compared.Results The rate of total effective in the group B after 2 weeks of treatment was higher than the group A(88.33%vs 71.67%,P<0.05).The scores of gastroscopy mucosal signs after 2 weeks of treatment were lower than before treatment,and compared with the group A,the group B was lower(P<0.05).The levels of serum FGF-23,IL-32 and EGF in two groups after 2 weeks of treatment were lower than before treatment,and compared with the group A,the group B was lower;the levels of serum CGRP in both groups after 2 weeks of treatment was higher than before treatment,and compared with the group A,the group B was higher(P<0.05).The expressions of MyD88,ATF2 and NF-κB protein in gastric mucosa of two groups after 2 weeks of treatment were lower than before treatment,and compared with the group A,the group B were lower(P<0.05).there was no statistical significance of the incidence of adverse reactions during treatment between the group B and the group A(5.00%vs 11.67%,P>0.05).Conclusion Huazujiedu decoction could effectively reduce the gastric mucosal inflammatory reaction and the degree of gastric mucosal injury in patients with CAG.Analysis of the mechanism might be related to the regulation of the expression of MyD88,ATF2,NF-κB protein in gastric mucosa,which was helpful to improve the therapeutic effect,and with good safety.