益气化瘀解毒方对慢性萎缩性胃炎癌前病变的疗效及对细胞周期蛋白E表达和肿瘤标记物的影响
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摘要
目的:探讨益气化瘀解毒方对慢性萎缩性胃炎癌前病变的疗效及对细胞周期蛋白E表达和肿瘤标记物的影响。方法:选择2015年1月—2016年6月在医院接受治疗的90例气虚血瘀型萎缩性胃炎癌前病变患者为研究对象,按照随机数字表法分为对照组(45例)和观察组(45例),对照组给以常规治疗,观察组在对照组基础上给予口服益气化瘀解毒方,3个疗程后观察临床疗效,胃痛、纳差、乏力、嗳气、便溏中医证候积分,免疫组化法检测细胞周期蛋白E(Cyclin E)、E-钙黏着蛋白(E-cadherin)和基质金属蛋白酶9(MMP-9)蛋白表达,ELISA法检测血清肿瘤标志物白介素-2(IL-2)、白介素-10(IL-10)、干扰素-γ(IFN-γ)和肿瘤坏死因子-α(TNF-α)水平。结果:治疗3个疗程后,观察组总有效率93.33%高于对照组的75.56%(χ~2=5.414,P=0.020)。观察组的胃痛、纳差、乏力、嗳气、便溏中医证候积分均低于对照组(P<0.05)。观察组患者的胃组织Cyclin E和MMP-9蛋白表达低于对照组,而E-cadherin蛋白表达高于对照组(P<0.05)。观察组患者血清肿瘤标志物IL-2、IL-10和TNF-α高于对照组,而IFN-γ低于对照组(P<0.05)。结论:益气化瘀解毒方对慢性萎缩性胃炎癌前病变具有较好的临床疗效,可降低中医证候积分,降低细胞周期蛋白E表达,改善患者病情进展。
Objective: To explore the therapeutic effect of supplementing Qi and removing blood stasis and toxin on precancerous lesions of chronic atrophic gastritis and its effect on the expression of cell cycle protein E and tumor markers. Methods: From January 2015 to June 2016 in our hospital,90 cases of Qi deficiency and blood stasis patients with atrophic gastritis precancerous lesions were as the research objects,and randomly divided into the control group( 45 cases) and the observation group( 45 cases). The control group were given routine treatment and the observation group on the basis of the control group were given orally Yiqihuayu Decoction and clinical effect,stomach pain,anorexia,fatigue,belching,loose stools,TCM syndrome score and immunohistochemical method was observed after 3 courses. Detect cell cycle protein E( Cyclin E),E-cadherin( E-cadherin) and matrix metalloproteinases 9( MMP-9) protein expression and serum tumor ELISA method markers of interleukin-2( IL-2),interleukin-10( IL-10) and interferon gamma( IFN-gamma) and tumor necrosis factor alpha( TNF-alpha) levels. Results: After 3 courses of treatment,the total effective rate of the observation group was 75. 56%,higher than that of the control group's 93. 33%( x~2= 5. 414,P =0. 020). The observation group's pain,anorexia,fatigue,belching,loose stools and TCM syndrome integral were lower than those of the control group( P < 0. 05). In the observation group,the expression of E Cyclin and MMP-9 protein in gastric tissue were lower than those in control group while the expression of E-cadherin protein was higher than that of control group( P < 0. 05). The serum tumor markers IL-2,IL-10 and TNF-α in the observation group were higherthan those in the control group while the IFN-γ was lower than those of the control group( P < 0. 05). Conclusion: The method of supplementing Qi and removing blood stasis toxin in treating precancerous lesions of chronic atrophic gastritis has good clinical curative effect and can reduce TCM syndrome integral,the expression of cell cycle protein E and improve the patients' progress.
Objective: To explore the therapeutic effect of supplementing Qi and removing blood stasis and toxin on precancerous lesions of chronic atrophic gastritis and its effect on the expression of cell cycle protein E and tumor markers. Methods: From January 2015 to June 2016 in our hospital,90 cases of Qi deficiency and blood stasis patients with atrophic gastritis precancerous lesions were as the research objects,and randomly divided into the control group( 45 cases) and the observation group( 45 cases). The control group were given routine treatment and the observation group on the basis of the control group were given orally Yiqihuayu Decoction and clinical effect,stomach pain,anorexia,fatigue,belching,loose stools,TCM syndrome score and immunohistochemical method was observed after 3 courses. Detect cell cycle protein E( Cyclin E),E-cadherin( E-cadherin) and matrix metalloproteinases 9( MMP-9) protein expression and serum tumor ELISA method markers of interleukin-2( IL-2),interleukin-10( IL-10) and interferon gamma( IFN-gamma) and tumor necrosis factor alpha( TNF-alpha) levels. Results: After 3 courses of treatment,the total effective rate of the observation group was 75. 56%,higher than that of the control group's 93. 33%( x~2= 5. 414,P =0. 020). The observation group's pain,anorexia,fatigue,belching,loose stools and TCM syndrome integral were lower than those of the control group( P < 0. 05). In the observation group,the expression of E Cyclin and MMP-9 protein in gastric tissue were lower than those in control group while the expression of E-cadherin protein was higher than that of control group( P < 0. 05). The serum tumor markers IL-2,IL-10 and TNF-α in the observation group were higherthan those in the control group while the IFN-γ was lower than those of the control group( P < 0. 05). Conclusion: The method of supplementing Qi and removing blood stasis toxin in treating precancerous lesions of chronic atrophic gastritis has good clinical curative effect and can reduce TCM syndrome integral,the expression of cell cycle protein E and improve the patients' progress.
引文
[1]黄婷婷,周晓虹.二参三草汤治疗慢性萎缩性胃炎癌前病变的临床观察及其对PTEN、ERK、AKT表达影响的研究[J].中医药信息,2016,33(1):49-52.
[2]卢晓杰,焦守霞,李建民,等.慢性萎缩性胃炎癌前病变胃黏膜病理变化与中医证型及幽门螺杆菌感染的相关性研究[J].现代中西医结合杂志,2015,24(26):2910-2912.
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[6]中华中医药学会脾胃病分会.慢性萎缩性胃炎中医诊疗共识意见[J].中医杂志,2010,51(8):749-753.
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[8]潘如燕.两种基因蛋白在慢性萎缩性胃炎不同中医证型中的表达[J].时珍国医国药,2013,24(3):729-730.
[9]李新军,付丽梅,刘敏,等.慢性胃炎病理诊断的一致性研究[J].中华消化内镜杂志,2014,31(3):126-129.
[10]王伟,刘冬梅,袁方,等.慢性萎缩性胃炎癌前病变从“毒”论治新思路[J].江苏中医药,2016,48(3):12-14.
[11]蔡喆,王龙宗,蓝艺明,等.扶正化积方治疗慢性萎缩性胃炎癌前病变(气虚血瘀证)的临床观察[J].中国卫生标准管理,2016,7(15):131-133.
[12]郭亚蕾,饶晶,潘华峰,等.健脾化瘀解毒法对慢性萎缩性胃炎的临床疗效及对细胞周期蛋白E表达的影响[J].中国实验方剂学杂志,2013,19(11):292-295.
[13]党民卿.萎胃灵1号对慢性萎缩性胃炎癌前病变患者中医证候及病理组织学的影响[J].西部中医药,2016,29(7):1-3.
[14]郝迎学,钟华,余佩武,等.CO2气腹对胃癌细胞周期及细胞周期蛋白的影响[J].中华普通外科杂志,2010,25(5):389-392.
[15]米源,杜媛鲲,刘庆熠,等.Gli表达下调对人胃腺癌AZ521细胞生长、转移的影响及机制[J].山东医药,2016,56(7):35-37.
[16]孔振.化浊解毒方治疗慢性萎缩性胃炎癌前病变的临床研究[J].中医临床研究,2015,7(7):14-15.
[17]黄铭涵,黄健,陈琴,等.健脾清化中药复方对大鼠慢性萎缩性胃炎TLR4-My D88依赖途径蛋白表达及TNF-α的影响[J].中国药理学通报,2016,32(9):1321-1325.
[2]卢晓杰,焦守霞,李建民,等.慢性萎缩性胃炎癌前病变胃黏膜病理变化与中医证型及幽门螺杆菌感染的相关性研究[J].现代中西医结合杂志,2015,24(26):2910-2912.
[3]张露,沈洪,周晓波,等.从气虚血瘀论治慢性萎缩性胃炎癌前病变[J].北京中医药大学学报(中医临床版),2013,20(1):16-20.
[4]匡素君,赵丹云.自拟益胃方治疗慢性萎缩性胃炎癌前病变的临床疗效观察[J].实用临床医药杂志,2013,17(16):63-64.
[5]中华医学会消化病学分会.中国慢性胃炎共识意见[J].胃肠病学,2013,18(1):24-36.
[6]中华中医药学会脾胃病分会.慢性萎缩性胃炎中医诊疗共识意见[J].中医杂志,2010,51(8):749-753.
[7]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:124-129.
[8]潘如燕.两种基因蛋白在慢性萎缩性胃炎不同中医证型中的表达[J].时珍国医国药,2013,24(3):729-730.
[9]李新军,付丽梅,刘敏,等.慢性胃炎病理诊断的一致性研究[J].中华消化内镜杂志,2014,31(3):126-129.
[10]王伟,刘冬梅,袁方,等.慢性萎缩性胃炎癌前病变从“毒”论治新思路[J].江苏中医药,2016,48(3):12-14.
[11]蔡喆,王龙宗,蓝艺明,等.扶正化积方治疗慢性萎缩性胃炎癌前病变(气虚血瘀证)的临床观察[J].中国卫生标准管理,2016,7(15):131-133.
[12]郭亚蕾,饶晶,潘华峰,等.健脾化瘀解毒法对慢性萎缩性胃炎的临床疗效及对细胞周期蛋白E表达的影响[J].中国实验方剂学杂志,2013,19(11):292-295.
[13]党民卿.萎胃灵1号对慢性萎缩性胃炎癌前病变患者中医证候及病理组织学的影响[J].西部中医药,2016,29(7):1-3.
[14]郝迎学,钟华,余佩武,等.CO2气腹对胃癌细胞周期及细胞周期蛋白的影响[J].中华普通外科杂志,2010,25(5):389-392.
[15]米源,杜媛鲲,刘庆熠,等.Gli表达下调对人胃腺癌AZ521细胞生长、转移的影响及机制[J].山东医药,2016,56(7):35-37.
[16]孔振.化浊解毒方治疗慢性萎缩性胃炎癌前病变的临床研究[J].中医临床研究,2015,7(7):14-15.
[17]黄铭涵,黄健,陈琴,等.健脾清化中药复方对大鼠慢性萎缩性胃炎TLR4-My D88依赖途径蛋白表达及TNF-α的影响[J].中国药理学通报,2016,32(9):1321-1325.