益生菌疗法根除不同分型H.pylori对胃泌素-17、胃蛋白酶原的影响

目的探讨联合益生菌根除不同分型H.pylori对胃泌素-17(gastrin-17,G-17)、胃蛋白酶原(pepsinogen,PG)的影响。方法将116例H.pylori阳性慢性胃炎患者随机分为四联疗法组和联合益生菌疗法组,疗程均为2周。选取H.pylori阳性健康体检者100名作为健康对照组。对H.pylori抗体CagA、VacA、UreA和UreB进行血清学检测,并检测治疗前后血清中PGⅠ、PGⅡ、PGⅠ/Ⅱ比值(PGⅠ/PGⅡratio,PGR)及G-17水平。结果四联疗法组、联合益生菌疗法组及健康对照组的H.pyloriⅠ型阳性率均高于H.pyloriⅡ型,且两治疗组H.pyloriⅠ型的阳性率明显高于健康对照组(P<0.05);三组CagA+VacA抗体阳性率均高于各组CagA、VacA抗体阳性率(P<0.05)。三组VacA、UreA、UreB抗体阳性率均高于各组CagA抗体阳性率(P<0.05)。不同炎症程度慢性胃炎CagA、UreB抗体的阳性率差异均无统计学意义(P>0.05);重度慢性胃炎与轻度慢性胃炎比较,VacA抗体阳性率显著升高,而UreA抗体阳性率显著下降(P<0.05)。治疗前,与H.pyloriⅡ型感染者相比,三组H.pyloriⅠ型感染者PGⅡ及G-17水平显著升高,PGR水平显著下降(P<0.05),而PGⅠ水平差异无统计学意义(P>0.05);治疗后,联合益生菌疗法组H.pyloriⅠ型患者的PGⅠ、PGⅡ及G-17水平显著下降,PGR水平升高(P<0.05)。结论H.pyloriⅠ型菌株是慢性胃炎的主要致病菌株,并且影响患者血清PGⅠ、PGⅡ、PGR及G-17的水平。联合益生菌疗法治疗H.pyloriⅠ型慢性胃炎,能降低血清PGⅠ、PGⅡ、G-17水平,提高PGR水平。

Urinary metabolic profiles during Helicobacter pylori eradication in chronic gastritis

BACKGROUND Helicobacter pylori(H.pylori)infection is a major risk factor for chronic gastritis,affecting approximately half of the global population.H.pylori eradication is a popular treatment method for H.pylori-positive chronic gastritis,but its mecha-nism remains unclear.Urinary metabolomics has been used to elucidate the mechanisms of gastric disease treatment.However,no clinical study has been conducted on urinary metabolomics of chronic gastritis.AIM To elucidate the urinary metabolic profiles during H.pylori eradication in patients with chronic gastritis.METHODS We applied LC–MS-based metabolomics and network pharmacology to in-vestigate the relationships between urinary metabolites and H.pylori-positive chronic gastritis via a clinical follow-up study.RESULTS Our study revealed the different urinary metabolic profiles of H.pylori-positive chronic gastritis before and after H.pylori eradication.The metabolites regulated by H.pylori eradication therapy include cis-aconitic acid,isocitric acid,citric acid,L-tyrosine,L-phenylalanine,L-tryptophan,and hippuric acid,which were involved in four metabolic pathways:(1)Phenylalanine metabolism;(2)phenylalanine,tyrosine,and tryptophan biosynthesis;(3)citrate cycle;and(4)glyoxylate and dicarboxylate metabolism.Integrated metabolomics and network pharmacology revealed that MPO,COMT,TPO,TH,EPX,CMA1,DDC,TPH1,and LPO were the key proteins involved in the biological progress of H.pylori eradication in chronic gastritis.CONCLUSION Our research provides a new perspective for exploring the significance of urinary metabolites in evaluating the treatment and prognosis of H.pylori-positive chronic gastritis patients.

History of chronic gastritis:How our perceptions have changed

Currently,the diagnostic strategy for chronic gastritis(CG)is aimed not just at fixing the presence of gastric mucosal inflammation,but also at gastric cancer(GC)risk stratification in a particular patient.Modern classification approach with the definition of the stage of gastritis determines the need,activities and frequency of dynamic monitoring of a patient.However,this attitude to the patient suffering from CG was far from always.The present publication is a literature review describing the key milestones in the history of CG research,from the description of the first observations of inflammation of the gastric mucosa,assessment of gastritis as a predominantly functional disease,to the advent of endoscopy of the upper digestive tract and diagnostic gastric biopsy,assessment of the role of Helicobacter pylori infection in progression of inflammatory changes to atrophy,intestinal metaplasia,dysplasia and GC.

Metabolic dynamics in chronic gastritis:Examining urinary profiles post Helicobacter pylori eradication

Chronic gastritis is the persistent and insidious inflammation of the gastric lining.Helicobacter pylori(H.pylori)has been identified as the most common cause of chronic gastritis and consequently elimination of H.pylori can lead to its cure.This editorial explores the use of urinary metabolic profiles before and after eradication to identify biomarkers that can aid in prognosis and treatment.Despite providing promising insights,there are limitations such as a small sample size(17 patients),a narrow treatment period of 2 wk,and treatment heterogeneity,which raise concerns.Nevertheless,these findings have opened a gateway to enhancing the treatment and prognosis of chronic gastritis through urinary metabolomics.

Non-improvement of atrophic gastritis in cases of gastric cancer after successful Helicobacter pylori eradication therapy

BACKGROUND Helicobacter pylori(H.pylori)infection is closely related to the development of gastric cancer(GC).However,GC can develop even after H.pylori eradication.Therefore,it would be extremely useful if GC could be predicted after eradication.The Kyoto classification score for gastritis(GA)is closely related to cancer risk.However,how the score for GC changes after eradication before onset is not well understood.AIM To investigate the characteristics of the progression of Kyoto classification scores for GC after H.pylori eradication.METHODS Eradication of H.pylori was confirmed in all patients using either the urea breath test or the stool antigen test.The Kyoto classification score of GC patients was evaluated by endoscopy at the time of event onset and three years earlier.In ad-dition,the modified atrophy score was evaluated and compared between the GC group and the control GA group.RESULTS In total,30 cases of early GC and 30 cases of chronic GA were evaluated.The pathology of the cancer cases was differentiated adenocarcinoma,except for one case of undifferentiated adenocarcinoma.The total score of the Kyoto classifi-cation was significantly higher in the GC group both at the time of cancer onset and three years earlier(4.97 vs 3.73,P=0.0034;4.2 vs 3.1,P=0.0035,respectively).The modified atrophy score was significantly higher in the GC group both at the time of cancer onset and three years earlier and was significantly improved only in the GA group(5.3 vs 5.3,P=0.5;3.73 vs 3.1,P=0.0475,respectively).CONCLUSION The course of the modified atrophy score is useful for predicting the onset of GC after eradication.Patients with severe atrophy after H.pylori eradication require careful monitoring.

Yiwei Xiaoyu granules for treatment of chronic atrophic gastritis with deficiency syndrome of the spleen and stomach

BACKGROUND The Correa sequence,initiated by Helicobacter pylori(H.pylori),commonly progresses to gastric cancer through the stage of chronic atrophic gastritis(CAG).Although eradication of H.pylori only reduces the risk of gastric cancer,it does not eliminate the risk for neoplastic progression.Yiwei Xiaoyu granules(YWXY)are a commonly used composite preparation in Chinese clinics.However,the pursuit of excellence in clinical trials and the establishment of standardized animal experiments are still needed to contribute to full understanding and application of traditional Chinese medicine in the treatment of CAG.AIM To demonstrate the effectiveness of YWXY in patients with CAG and spleenstomach deficiency syndrome(DSSS),by alleviating histological scores,improving response rates for pathological lesions,and achieving clinical efficacy in relieving DSSS symptoms.METHODS We designed a double-blind,randomized,controlled trial.The study enrolled seventy-two H.pylori-negative patients(mean age,52.3 years;38 men)who were randomly allocated to either the treatment group or control group in a 1:1 ratio,and treated with 15 g YWXY or 0.36 g Weifuchun(WFC)tablet combined with the respective dummy for 24 wk.The pre-randomization phase resulted in the exclusion of 72 patients:50 participants did not meet the inclusion criteria,12 participants declined to participate,and 10 participants were excluded for various other reasons.Seven visits were conducted during the study,and histopathological examination with target endoscopic biopsy of narrow-band imaging was requested before the first and seventh visits.We also evaluated endoscopic performance scores,total symptom scores,serum pepsinogen and gastrin-17.RESULTS Six patients did not complete the trial procedures.Treatment with YWXY improved the Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM)stage,compared with WFC(P<0.05).YWXY provided better relief from symptoms of DSSS and better improvement in serum gastric function,compared with WFC(P<0.05).CONCLUSION YWXY compared with WFC significantly reduced the risk of mild or moderate atrophic disease,according to OLGIM stage,significantly relieved symptoms of DSSS,and improved serum gastric function.

Estimate the Prevalence of Helicobacter pylori Infection among Diabetes & Non-Diabetes Mellitus Patients and Its Correlation with Malignant Gastritis Patients Attending in Lower Shabelle Region (Somalia)

Background: Several conducted studies have reported a higher and more frequent Helicobacter pylori infection rate in type 2 diabetes mellitus (T2DM). The aim of this study was to estimation the prevalence of H. pylori and its association between H. pylori infection and T2DM. Materials and Methods: A sectional-cross study was conducted based on 200 patients studded with socioeconomic characteristics through a questionnaire & H. pylori was diagnosed by serum anti-H. pylori immunoglobulin G (IgG) and IgA. Furthermore, patients were investigated for fasting blood glucose (FBG) levels, glycosylated hemoglobin (HbA1c), serum cholesterol, and other biochemistry parameters. Results: The findings showed The prevalence of Hp positive infection was significantly higher in the total sample was 134 with (67%). While 66 out of 200 patients with (33%) was H. pylori negative infection. of H. pylori. Further, the mean values were statistically significant for diabetes with H. pylori infection for IgG > 300 titer and IgA > 250 titer, regarding, HbA1C (7.52 ± 0.41) (P Conclusions: The current study revealed that H. pylori prevalence infections were significantly higher in diabetic patients studied compared to non-diabetic patients. Furthermore, T2DM patients infected with H. pylori positive reported a higher prevalence rate of symptoms than H. pylori negative.

Mucosal patterns change after Helicobacter pylori eradication:Evaluation using blue laser imaging in patients with atrophic gastritis

BACKGROUND Mucosal patterns(MPs)observed on blue laser imaging in patients with atrophic gastritis can be classified as spotty,cracked,and mottled.Furthermore,we hypothesized that the spotty pattern may change to the cracked pattern after Helicobacter pylori(H.pylori)eradication.AIM To further substantiate and comprehensively investigate MP changes after H.pylori eradication in a larger number of patients.METHODS We included 768 patients who were diagnosed with atrophic gastritis with evaluable MP using upper gastrointestinal endoscopy at the Nishikawa Gastrointestinal Clinic,Japan.Among them,325 patients were H.pylori-positive,and of them,101 patients who underwent upper gastrointestinal endoscopy before and after H.pylori eradication were evaluated for post-eradication MP changes.The patients’MPs were interpreted by three experienced endoscopists who were blinded to their clinical features.RESULTS Among 76 patients with the spotty pattern before or after H.pylori eradication,the pattern disappeared or decreased in 67 patients[88.2%,95%confidence interval(CI):79.0%-93.6%),appeared or increased in 8 patients(10.5%,95%CI:5.4%-19.4%),and showed no change in 1 patient(1.3%,95%CI:0.2%-7.1%).In 90 patients with the cracked pattern before or after H.pylori eradication,the pattern disappeared or decreased in 7 patients(7.8%,95%CI:3.8%-15.2%),appeared or increased in 79 patients(87.8%,95%CI:79.4%-93.0%),and showed no change in 4 patients(4.4%,95%CI:1.7%-10.9%).In 70 patients with the mottled pattern before or after H.pylori eradication,the pattern disappeared or decreased in 28 patients(40.0%,95%CI:29.3%-51.7%),appeared or increased in 35 patients(50.0%,95%CI:38.6%-61.4%),and showed no change in 7 patients(10.0%,95%CI:4.9%-19.2%).CONCLUSION After H.pylori eradication,MPs changed from spotty to cracked in most patients,which may help endoscopists easily and precisely evaluate H.pylori-related gastritis status.

慢性萎缩性胃炎胃黏膜形态与病理、H.pylori相关分析

目的探讨慢性萎缩性胃炎普通白光胃镜下胃黏膜形态与病理的关系及H.pylori相关性。方法2020年1月至2021年6月经普通白光胃镜诊断慢性萎缩性胃炎患者430例,同时行病理检查及H.pylori检测,比较胃镜与病理诊断慢性萎缩性胃炎的符合率,H.pylori感染率及不同胃黏膜形态与H.pylori感染的关系;同时比较不同胃黏膜形态中的各种程度萎缩及肠化和上皮内瘤变结果,以及不同程度萎缩的各种肠化程度及上皮内瘤变结果。结果胃镜诊断慢性萎缩性胃炎共430例,病理诊断慢性萎缩性胃炎共282例,二者符合率为65.58%。胃镜诊断慢性萎缩性胃炎共430例患者中,H.pylori的感染率45.81%;病理诊断为慢性萎缩性胃炎共282例患者中,H.pylori的感染率为46.80%。各种胃黏膜形态下H.pylori感染率最高的是B+b型,B+b型与其他胃黏膜形态下H.pylori感染率比较,差异有统计学意义(P<0.05)。重度萎缩以B+b型最常见,重度肠化以B+b型最常见。不同胃黏膜形态的各种萎缩程度比较,差异有统计学意义(P<0.05)。在不同胃黏膜形态的各种肠化程度比较,差异有统计学意义(P<0.05)。上皮内瘤变以B+b型最常见;不同胃黏膜形态的上皮内瘤变结果比较,差异无统计学意义(P>0.05)。在不同程度的萎缩中,各种肠化程度结果比较,差异有统计学意义(P<0.05)。中度萎缩中的中度肠化结果高于轻度萎缩,重度萎缩的重度肠化结果高于轻度和中度萎缩,差异有统计学意义(P<0.05)。重度萎缩中的上皮内瘤变结果高于轻度和中度萎缩,但差异无统计学意义(P>0.05)。结论应用普通白光胃镜检查胃黏膜形态对于慢性萎缩性胃炎具有很好的诊断价值,必要时联合病理检查提高诊断价值,H.pylori感染是慢性萎缩性胃炎的重要病因之一,应关注H.pylori诊治和随访。

Effects of Chaihu Guizhi Ganjiang Decoction Combined with Standard Triple Therapy on Reducing Serum CagA and Hp-NAP in Patients with H.pylori-Related Gastritis

OBJECTIVE: To explore the effects of Chaihu Guizhi Ganjiang Decoction combined with standard triple therapy on treating H.pylori-related gastritis. METHODS: Eighty-two patients with H. pylori-related gastritis treated in our hospital from January 2016 to December 2017 were selected according to the random number table method and divided into experimental group and control group, with 41 patients in each group. The control group was treated with standard triple therapy, while the experimental group was additionally treated with modified Chaihu Guizhi Ganjiang Decoction. The venous blood of one elbow was taken before and after treatment. The concentrations of serum CagA and Hp-NAP were detected by enzyme-linked immunosorbent assay(ELISA). The symptoms were evaluated according to the change of symptom scores before and after the intervention. The H.pylori eradication rate was calculated. RESULTS: There was no significant difference in CagA and Hp-NAP concentrations between the 2 groups before intervention(P > 0.05). After intervention, CagA and Hp-NAP concentrations in experimental group were(19.21±6.27) ng/L and(24.37±6.10) ng/L respectively which were lower than(25.81±7.14) ng/L and(32.09±5.73) ng/L of control group. The differences were statistically significant(P < 0.05). The total effective rate of major symptoms in experimental group was 39 cases(95.12%), which was significantly higher than that of the control group(31 cases, 75.61%). There was statistically significant difference between the 2 groups(P < 0.05). The eradication rate of H.pylori was 38 cases(92.68%) in the experimental group, which was significantly higher than 31 cases(75.61%) of the control group. The difference between the 2 groups was statistically significant(P < 0.05). CONCLUSION: Chaihu Guizhi Ganjiang Decoction combined with standard triple therapy can effectively reduce CagA, Hp-NAP of serum level in patients with H.pylori-related gastritis, improve efficacy of symptoms and eradication rate of H.pylori, and is worthy of clinical promotion.

Research status and hotspots of autoimmune gastritis:A bibliometric analysis

BACKGROUND As an emerging potential risk factor for gastric cancer,autoimmune gastritis(AIG)has garnered increasing attention from researchers.AIM To analyze the research overview and popular topics in the field of AIG using bibliometrics.METHODS Relevant publications on AIG in the Web of Science Core Collection were collated,and data visualization and analysis of the number of publications,countries,institutions,journals,authors,keywords,and citations were performed using software such as VOSviewer,CiteSpace,and Scimago Graphic.RESULTS In total,316 relevant articles were included in the analysis.From 2015 to 2022,the number of publications increased annually.The countries,institutions,authors,and journals with the highest number of publications in this field were Italy,Monash University,Toh BH,and Internal Medicine.The main keywords used in this field of research were pathogenesis,Helicobacter pylori,autoantibody,parietal cell antibody,atrophic gastritis,classification,diagnosis,autoimmune disease,risk,cancer,gastric cancer,vitamin B12 deficiency,and pernicious anemia.The following directions may be popular for future research:(1)The role of Helicobacter pylori in the pathogenesis of AIG;(2)diagnostic criteria for AIG and reference values for serum antibodies;(3)comorbidity mechanisms between AIG and other autoimmune diseases;(4)specific risks of AIG complicating gastric and other cancers;and(5)the role of vitamin B12 supplementation in patients with early-stage AIG.CONCLUSION This bibliometric analysis reported on popular topics and emerging trends in AIG,with diagnosis and prognosis being research hotspots in this field.

Study on Professor Diangui Li's Medication Experience in Treating Atrophic Gastritis Concomitant with Helicobacter Pylori Infection Based on Data Mining

Objective Our objective was to explore the national traditional Chinese medicine by studying master Diangui Li's medication experience in treating atrophic gastritis(AG)concomitant with Helicobacter pylori(Hp)infection based on data mining,and to provide the reference for the clinical treatment of relevant diseases.Methods The Chinese medicine prescriptions of the patients'first visits to the Famous Doctors'Consultation Room in Hebei Provincial Hospital of Chinese Medicine from May 2019 to December 2022 were collected and frequency analysis of the Chinese herbs,association rules analysis of the Chinese herbs,and cluster analysis were conducted using the Famous Doctor Inheritance Assistance Platform.ResultsA total of 188 prescriptions were collected,with 136 kinds of Chinese herbs.The highest use frequency of Chinese herbs was 185 and the lowest was 1.There were 28 kinds of Chinese herbs with high use frequency.The top 10 herbs with the high use frequency include Baihuasheshecao(Hedyotis Diffusae Herba),Huanglian(Coptidis Rhizoma),Yinchen(Artemisiae Scopariae Herba),jigucao(Abriherba),Baishao(Paeoniae Radix Alba),Danggui(Angelicae Sinensis Radix),Banzhilian(Scutellariae Barbatae Herba),Baihe(Lili Bulbus),Zhishi(Auranti Immaturus Fructus),Chuanxiong(Chuanxiong Rhizoma).Chinese herbs with high frequency use are mostly heat-clearing herbs and qi-regulating herbs;the flavors of the herbs are mainly pungent,bitter,and sweet;the properties are mainly warm,cold,and neutral;the meridian tropism is mainly the spleen,liver,and stomach meridians.The core herbal medicines are Huanglian(Coptidis Rhizoma),Yinchen(Artemisiae Scopariae Herba),Baishao(Paeoniae Radix Alba),Danggui(Angelicae Sinensis Radix),etc.;the results of association rules:Jigucao(Abriherba)-Kushen(Sophorae Flavescentis Radix),Jjiaogulan(Gynostemmatis Pentaphylli Rhizoma seu Herba)-Banlangen(lsatidis Radix),Huangqin(Scutellariae Radix)-Banlangen(lsatidis Radix),etc.;the results of cluster analysis showed that there were 10 clusters:(1)Yinchen(Artemisiae Scopariae Herba),Huanglian(Coptidis Rhizoma),Baihuasheshecao(Hedyotis Diffusae Herba),Banzhilian(Scutellariae Barbatae Herba),Jigucao(Abriherba);(2)Baishao(Paeoniae Radix Alba),Danggui(Angelicae Sinensis Radix),Chuanxiong(Chuanxiong Rhizoma),Wuyao(Linderae Radix);(3)Yuanhu(Corydalis Rhizoma),Danshen(Salviae Miltiorrhizae Radix et Rhizoma),Baizhi(Angelicae Dahuricae Radix).Conclusions For the treatment of AG concomitant with Hp infection,Professor Diangui Li mainly adopts the method of clearing heat and removing the toxin,regulating qi and resolving phlegm,combining disease differentiation with syndrome differentiation,performing reinforcing method,and reducing method simultaneously to regulate the mechanism of the human body.

Prevalence and Factors Associated with Intestinal Metaplasia in Chronic Helicobacter pylori Gastritis in a Country with High Endemicity: Ivory Coast Case

Context/Objective: Few studies have been carried out in a country with high endemicity for Helicobacter pylori (H. pylori) infection in Sub-Saharan Africa looking for the association of intestinal metaplasia (IM) with chronic gastritis. We hypothesize that IM is correlated with the intensity of H. pylori infection in a country with high endemicity, Ivory Coast. The objective of this study was to determine the prevalence of intestinal metaplasia in chronic H. pylori gastritis in Ivory Coast. Methods: This was a prospective, cross-sectional, multicenter study, carried out over a period of 5 months, in the reference hospital centers of Abidjan, specialized in Gastroenterology. All patients who had undergone Gastroscopy with biopsies according to the criteria of the Sydney System for the anatomopathological study, those with chronic gastritis and/or H. pylori intestinal metaplasia on histology and in whom all the parameters of the Sydney system classification had been well informed. The quantitative variables were expressed by their means accompanied by their standard deviations and the qualitative variables by their numbers and percentages. Chi-square and Fischer tests were used to look for associations between variables. The significance level was set at 5%. Results: 152 patients were retained. The mean age was 44.9 ± 12.9 years. The prevalence of intestinal metaplasia was 11.8%. In univariate analysis, no significant association was found between clinical and pathological sociodemographic factors (age, sex, ethnicity, educational level, profession) and intestinal metaplasia in chronic Helicobacter pylori gastric cases. In multivariate analysis we found that prolonged use of Proton Pump Inhibitors (PPIs) and a history of Gastroesophageal Reflux Disease (GERD) were significantly associated with the absence of IM. Conclusion: Chronic H. pylori gastritis is the main risk factor for intestinal metaplasia. Prolonged use of PPIs and a history of GERD were significantly identified as factors that would protect against intestinal metaplasia.

Kyoto classification of gastritis,virtual chromoendoscopy and artificial intelligence:Where are we going?What do we need?

Chronic gastritis(CG)is a widespread and frequent disease,mainly caused by Helicobacter pylori infection,which is associated with an increased risk of gastric cancer.Virtual chromoendoscopy improves the endoscopic diagnostic efficacy,which is essential to establish the most appropriate therapy and to enable cancer prevention.Artificial intelligence provides algorithms for the diagnosis of gastritis and,in particular,early gastric cancer,but it is not yet used in practice.Thus,technological innovation,through image resolution and processing,optimizes the diagnosis and management of CG and gastric cancer.The endoscopic Kyoto classification of gastritis improves the diagnosis and management of this disease,but through the analysis of the most recent literature,new algorithms can be proposed.

左枳六君汤治疗肝胃不和型幽门螺杆菌阳性慢性胃炎的效果

目的探讨左枳六君汤治疗肝胃不和型幽门螺杆菌(Hp)阳性慢性胃炎的效果。方法选取2021年1月至2022年12月江西中医药高等专科学校附属医院(抚州市中医医院)收治的70例慢性胃炎患者(肝胃不和型Hp阳性)作为研究对象,按照随机数字表法分为观察组(35例)与对照组(35例),观察组采用常规西药四联治疗+左枳六君汤治疗方法,对照组采用常规西药四联治疗方法。比较两组的临床疗效、中医证候积分、Hp根除及复发率、血清生化指标。结果观察组的治疗总有效率(97.15%)、Hp根除率(94.28%)均高于对照组(82.85%、77.14%),Hp复发率(2.86%)低于对照组(17.14%),差异有统计学意义(P<0.05)。治疗后,观察组的中医证候积分低于对照组,血清胃泌素、胃动素水平均高于对照组,炎症因子(C反应蛋白、白介素-6、肿瘤坏死因子-α)水平低于对照组,差异有统计学意义(P<0.05)。结论在基础对症治疗上,将左枳六君汤引入肝胃不和型Hp阳性慢性胃炎患者的治疗中,能够提升临床综合治疗效果,作用显著,推荐参考使用。

Ezrin蛋白在幽门螺杆菌感染的结节性胃炎中的研究进展

ERM蛋白家族(包括ezrin、radixin、moesin)在细胞形态、迁移和信号转导中发挥着至关重要的作用。Ezrin是ERM蛋白家族的成员之一,是幽门螺杆菌(Helicobacter pylori)感染宿主所致细胞毒性的重要介质,通过ezrin磷酸化可以调节其与肌动蛋白细胞骨架的相互作用,进而对细胞形态产生显著影响。本文综述了ezrin蛋白在H.pylori感染引发的结节性胃炎中的重要性,探讨了ezrin蛋白的结构及其功能、信号通路及磷酸化与结节性胃炎的关系,为以ezrin蛋白作为潜在的治疗靶点对结节性胃炎的防治提供新思路。

幽门螺杆菌微生物学特征及其与慢性萎缩性胃炎的相关性

目的探讨幽门螺杆菌(Hp)微生物学特征及其与慢性萎缩性胃炎(CAG)的关系。方法回顾性分析2020年11月—2022年11月自贡市第四人民医院300例慢性胃炎(CG)伴Hp感染患者临床资料,根据是否发生胃黏膜萎缩分为未萎缩组(136例)和萎缩组(164例)。分析2组患者临床特征、分离的Hp菌株微生物学特征和对常用抗菌药物的耐药性。采用Logistic回归分析评价胃黏膜萎缩的影响因素。构建贝叶斯网络预测模型,采用受试工作者特征(ROC)曲线和校准曲线对预测模型的区分度和准确度进行评价。结果萎缩组饮食不规律、有胃肠道疾病家族史、食用腌制品所占比例高于未萎缩组(P<0.05)。分离自萎缩组患者的Hp血清型、毒力基因和Ⅰ型菌株均高于未萎缩组(P<0.05)。分离自萎缩组患者的Hp对阿莫西林、甲硝唑和左氧氟沙星的耐药率均高于未萎缩组(P<0.05)。Logistic回归分析结果显示,饮食不规律、有胃肠道疾病家族史、食用腌制品、携带CagA抗体和cagA毒力基因、Ⅰ型菌株,以及阿莫西林、甲硝唑、左氧氟沙星耐药是胃黏膜萎缩的危险因素(P<0.05)。ROC曲线分析结果显示,贝叶斯网络预测模型具有良好的区分度和准确度。结论Hp菌株微生物学特征与CAG密切相关。

乌梅丸对Hp阳性萎缩性胃炎的临床研究

目的:探讨幽门螺杆菌(Hp)阳性萎缩性胃炎患者采用乌梅丸治疗的应用效果。方法:选取2022年1~12月在佛山市中医院接受治疗的Hp阳性萎缩性胃炎患者100例,以随机数字表法分成治疗组(50例)与对照组(50例)。对照组采用四联根除Hp疗法治疗,治疗组采用乌梅丸联合四联根除Hp疗法治疗,比较两组Hp转阴情况、临床疗效、中医症候积分、胃镜及病理情况、胃蛋白酶原Ⅰ(PGⅠ)及胃蛋白酶原Ⅱ(PGⅡ)水平。结果:治疗组Hp转阴率(96.00%)较对照组(82.00%)更高(P<0.05);治疗组治疗总有效率(92.00%)较对照组(76.00%)更高(P<0.05);两组治疗后中医证候积分降低(P<0.05),且治疗组较对照组更低(P<0.05);两组治疗后胃镜及病理情况评分降低(P<0.05),但两组间比较,差异无统计学意义(P>0.05);两组治疗后PGⅠ、PGⅡ水平提高(P<0.05),且治疗组较对照组更高(P<0.05)。结论:乌梅丸应用于Hp阳性萎缩性胃炎患者中,能够促进Hp转阴情况、临床症状改善,促进临床疗效提高,改善胃黏膜萎缩情况,提高PGⅠ及PGⅡ水平。

基于胃不和则卧不安探讨Hp相关慢性胃炎对患者睡眠的影响

目的探讨幽门螺杆菌(Hp)相关慢性胃炎对患者睡眠的影响及具体表现形式。方法通过问卷调查,对比分析Hp相关慢性胃炎及非Hp相关慢性胃炎患者睡眠的具体特点。结果Hp相关慢性胃炎男性患者总体睡眠显著优于非Hp相关慢性胃炎男性患者及Hp相关慢性胃炎女性患者,明显较非Hp相关慢性胃炎男性患者睡眠质量好、睡眠时间长、睡眠效率高,明显较Hp相关慢性胃炎女性患者睡眠质量好、入睡时间短、睡眠效率高、睡眠障碍少、催眠药物使用少(P<0.05);Hp相关慢性胃炎男性患者较Hp相关慢性胃炎女性患者明显更少出现夜间易醒或早醒、呼吸不畅、感觉冷、做噩梦及其他影响睡眠的事情,更易咳嗽或鼾声高(P<0.05);Hp相关慢性胃炎女性患者催眠药物使用显著多于非Hp相关慢性胃炎女性患者,咳嗽或鼾声高显著多于非Hp相关慢性胃炎女性患者(P<0.05)。结论Hp相关慢性胃炎患者常有睡眠异常且具有一定的性别差异。

柴芍胃康汤联合四联疗法治疗肝胃气滞证Hp阳性慢性萎缩性胃炎的疗效观察

目的:观察柴芍胃康汤联合四联疗法治疗肝胃气滞证幽门螺杆菌(Hp)阳性慢性萎缩性胃炎(CAG)的疗效及对患者胃泌素-17(G-17)、丙二醛(MDA)、胃蛋白酶原(PG)Ⅰ和PGⅡ水平,胃黏膜组织病理和Hp根除的影响。方法:选取2021年6月至2023年5月该院收治的肝胃气滞证Hp阳性CAG患者140例,按随机数字表法分为联合组和对照组(各70例)。对照组患者给予标准四联疗法,联合组患者在对照组的基础上给予柴芍胃康汤治疗。比较两组患者治疗前后血清G-17、MDA、PGⅠ和PGⅡ水平,胃黏膜组织病理评分、Hp根除率,观察安全性和临床疗效。结果:治疗后,两组患者血清G-17、PGⅠ水平明显升高,MDA、PGⅡ水平和胃黏膜组织病理评分明显降低;且联合组患者血清G-17、PGⅠ水平较对照组升高,MDA、PGⅡ水平和胃黏膜组织病理评分较对照组降低,差异均有统计学意义(P<0.05)。联合组患者的Hp根除率、总有效率分别为92.86%(65/70)、92.86%(65/70),明显高于对照组的81.43%(57/70)、81.43%(57/70),差异均有统计学意义(P<0.05)。结论:柴芍胃康汤联合四联疗法治疗肝胃气滞证Hp阳性CAG的疗效较好,可改善患者胃功能、氧化应激和胃黏膜组织病理损伤,并可有效提高Hp根除率。