对近10年来有关中医辨治胃癌前病变(precancerous lesions of gastric cancer,PLGC)的研究进行综述。PLGC是指在慢性萎缩性胃炎基础上出现的胃黏膜肠上皮化生和异型增生,作为慢性萎缩性胃炎与胃癌的中间阶段,PLGC的病程较缓慢。中医辨治...对近10年来有关中医辨治胃癌前病变(precancerous lesions of gastric cancer,PLGC)的研究进行综述。PLGC是指在慢性萎缩性胃炎基础上出现的胃黏膜肠上皮化生和异型增生,作为慢性萎缩性胃炎与胃癌的中间阶段,PLGC的病程较缓慢。中医辨治PLGC具有一定的优势。PLGC主要可分为脾胃虚弱证、脾胃湿热证、肝胃气滞证、胃络瘀阻证、胃阴不足证5种证型。胃镜技术的普及促进了胃病微观辨证的发展,微观辨证与宏观辨证的结合为PLGC的中医辨证论治提供了更加丰富的理论支持。PLGC根本病机为脾胃虚弱,脾胃气机不畅,兼有湿热、瘀毒、痰湿等病理因素蕴结,日久胃阴亏耗。中药治疗PLGC的临床研究开展较多,治疗主要采用以益气健脾为主,兼以疏肝活血、化湿消瘀、化瘀解毒、养阴益胃,从而防止PLGC向胃癌进一步发展。针灸治疗胃癌前病变的研究开展较少。今后需开展更多严格且规范的多中心、大样本的临床随机对照试验,深入研究针灸治疗胃癌前病变机制,以期为中医辨治PLGC提供更多高级别的循证依据。展开更多
OBJECTIVE： To discuss the mechanism of Yiqiyang- yin recipe in rats with adriamycin （ADR）-induced ne- phropathyo METHODS： We randomly divided 30 Sprague-Daw- ley rats into 5 groups： control, model, glucocorti- co...OBJECTIVE： To discuss the mechanism of Yiqiyang- yin recipe in rats with adriamycin （ADR）-induced ne- phropathyo METHODS： We randomly divided 30 Sprague-Daw- ley rats into 5 groups： control, model, glucocorti- coid, Chinese herb, and Chinese herb plus glucocor- ticoid groups. The 24-h urine volume was collected on days 7, 14, 21, and 28 after ADR injection, and all rats were killed on day 28. We measured the 24-h levels of urinary protein, serum cholesterol, and se- rum triglycerides, and renal function of all rats by using routine biochemical methods. Pathological changes in the rat kidneys were observed under light and electron microscopes. Heparanase （HPA） mRNA expression levels were measured using re-al-time fluorescence-quantitative polymerase chain reaction. Urine levels of HPA in all groups were measured using enzyme-linked immunosor- bent assay. The expression of nephrin was detected by immunohistochemical staining and quantitative- ly analyzed using Motic image analysis 3.2 software. RESULTS： The levels of urinary protein and serum triglycerides and cholesterol in rats with ADR-in- duced nephropathy increased on day 14. The se- rum albumin levels simultaneously decreased. All the changes reached the peak on day 28. Examina- tion under the light microscope showed inflamma- tory cells and slight fibroplasia in the renal intersti- tium in the model group, but fewer inflammatory cells were observed in the intervention groups than those in the model group. Examination under the electron microscope showed extensive fusion of foot processes in ADR rats. HPA mRNA expres- sion was higher in the model group than that in the control group. The HPA mRNA levels in the in- tervention groups, especially in the Chinese herb group, and Chinese herb plus glucocorticoid group were significantly lower than the level in the model group. The HPA expression levels correlated signifi- cantly with the proteinuria level. No significant dif- ference was found in the HPA level in urine be- tween the intervention groups and the model group, whereas the model group had a higher uri- nary HPA level than the control group. Nephrin mRNA expression levels in the model group were higher than those in the control group. Nephrin mRNA expression levels were significantly lower in the intervention groups than that in the model group, especially the Chinese herb plus glucocorti- cold group. Compared with the control group, themodel group showed increased nephrin expression in the kidney. Nephrin levels in the other groups, es- pecially in the Chinese herb plus glucocorticoid group, were significantly lower than that in the model group. The nephrin levels in the kidney were negatively correlated with the proteinuria level. CONCLUSION： Yiqiyangyin recipe could attenuate foot process injury particularly in combination with a steroid reduce the development of proteinuria possibly by inhibition of HPA in the kidney, and reg- ulate the expression of nephrin in rats with ADR-in- duced nephropathy. Our study showed that treat- ment with Yiqiyangyin recipe plus glucocorticoid was better than a singular intervention, and we ex- plored the pharmacological mechanism of this combination by biochemical and molecular biologi- cal analysis to provide a basis for clinical applica- tion.展开更多
文摘对近10年来有关中医辨治胃癌前病变(precancerous lesions of gastric cancer,PLGC)的研究进行综述。PLGC是指在慢性萎缩性胃炎基础上出现的胃黏膜肠上皮化生和异型增生,作为慢性萎缩性胃炎与胃癌的中间阶段,PLGC的病程较缓慢。中医辨治PLGC具有一定的优势。PLGC主要可分为脾胃虚弱证、脾胃湿热证、肝胃气滞证、胃络瘀阻证、胃阴不足证5种证型。胃镜技术的普及促进了胃病微观辨证的发展,微观辨证与宏观辨证的结合为PLGC的中医辨证论治提供了更加丰富的理论支持。PLGC根本病机为脾胃虚弱,脾胃气机不畅,兼有湿热、瘀毒、痰湿等病理因素蕴结,日久胃阴亏耗。中药治疗PLGC的临床研究开展较多,治疗主要采用以益气健脾为主,兼以疏肝活血、化湿消瘀、化瘀解毒、养阴益胃,从而防止PLGC向胃癌进一步发展。针灸治疗胃癌前病变的研究开展较少。今后需开展更多严格且规范的多中心、大样本的临床随机对照试验,深入研究针灸治疗胃癌前病变机制,以期为中医辨治PLGC提供更多高级别的循证依据。
基金Supported by Shanghai Health Bureau Research Grant Program(Young Funding Program,No.2011QL031B)State Key Clinical Department of TCM pediatrics
文摘OBJECTIVE： To discuss the mechanism of Yiqiyang- yin recipe in rats with adriamycin （ADR）-induced ne- phropathyo METHODS： We randomly divided 30 Sprague-Daw- ley rats into 5 groups： control, model, glucocorti- coid, Chinese herb, and Chinese herb plus glucocor- ticoid groups. The 24-h urine volume was collected on days 7, 14, 21, and 28 after ADR injection, and all rats were killed on day 28. We measured the 24-h levels of urinary protein, serum cholesterol, and se- rum triglycerides, and renal function of all rats by using routine biochemical methods. Pathological changes in the rat kidneys were observed under light and electron microscopes. Heparanase （HPA） mRNA expression levels were measured using re-al-time fluorescence-quantitative polymerase chain reaction. Urine levels of HPA in all groups were measured using enzyme-linked immunosor- bent assay. The expression of nephrin was detected by immunohistochemical staining and quantitative- ly analyzed using Motic image analysis 3.2 software. RESULTS： The levels of urinary protein and serum triglycerides and cholesterol in rats with ADR-in- duced nephropathy increased on day 14. The se- rum albumin levels simultaneously decreased. All the changes reached the peak on day 28. Examina- tion under the light microscope showed inflamma- tory cells and slight fibroplasia in the renal intersti- tium in the model group, but fewer inflammatory cells were observed in the intervention groups than those in the model group. Examination under the electron microscope showed extensive fusion of foot processes in ADR rats. HPA mRNA expres- sion was higher in the model group than that in the control group. The HPA mRNA levels in the in- tervention groups, especially in the Chinese herb group, and Chinese herb plus glucocorticoid group were significantly lower than the level in the model group. The HPA expression levels correlated signifi- cantly with the proteinuria level. No significant dif- ference was found in the HPA level in urine be- tween the intervention groups and the model group, whereas the model group had a higher uri- nary HPA level than the control group. Nephrin mRNA expression levels in the model group were higher than those in the control group. Nephrin mRNA expression levels were significantly lower in the intervention groups than that in the model group, especially the Chinese herb plus glucocorti- cold group. Compared with the control group, themodel group showed increased nephrin expression in the kidney. Nephrin levels in the other groups, es- pecially in the Chinese herb plus glucocorticoid group, were significantly lower than that in the model group. The nephrin levels in the kidney were negatively correlated with the proteinuria level. CONCLUSION： Yiqiyangyin recipe could attenuate foot process injury particularly in combination with a steroid reduce the development of proteinuria possibly by inhibition of HPA in the kidney, and reg- ulate the expression of nephrin in rats with ADR-in- duced nephropathy. Our study showed that treat- ment with Yiqiyangyin recipe plus glucocorticoid was better than a singular intervention, and we ex- plored the pharmacological mechanism of this combination by biochemical and molecular biologi- cal analysis to provide a basis for clinical applica- tion.
