疏肝和胃降逆汤对胃食管反流病肝胃不和证患者食管黏膜蛋白酶激活受体-2及环氧合酶-2蛋白表达的影响
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摘要
目的:探讨疏肝和胃降逆汤对胃食管反流病(GERD)肝胃不和证患者食管黏膜蛋白酶激活受体-2(PAR-2)及环氧合酶-2(COX-2)蛋白表达的影响。方法:选取2015年1月至2016年1月辽宁中医药大学附属医院收治GERD患者178例作为研究对象,以随机数表法分为观察组和对照组,每组89例。2组均给予奥美拉唑肠溶片治疗,观察组在此基础上给予疏肝健脾和胃方治疗。观察2组基线期和治疗后12周(治疗后)反流性疾病问卷(RDQ)症状积分及食管黏膜PAR-2及COX-2蛋白表达变化。结果:基线期,2组RDQ症状积分、食管黏膜PAR-2及COX-2蛋白表达基本相同,差异无统计学意义(P> 0. 05);治疗后,观察组RDQ症状积分、食管黏膜PAR-2及COX-2蛋白表达显著低于对照组,差异有统计学意义(P <0. 05)。观察组RDQ症状积分与食管黏膜PAR-2及COX-2蛋白表达正相关(P <0. 05),对照组RDQ症状积分与食管黏膜PAR-2及COX-2蛋白表达无明显相关性(P> 0. 05)。结论:奥美拉唑肠溶片联合温阳活血汤治疗胃食管反流病肝胃不和证具有较好的疗效,其机制可能是通过降低患者食管黏膜PAR-2及COX-2蛋白表达而起治疗作用。
Objective: To explore the effects of Shugan Hewei Jiangni Decoction on protease activated receptor-2( PAR2) and Cyclooxygenase-2( COX-2) protein in patients with gastroesophageal reflux disease( GERD) and with disharmony between liver and stomach syndrome. Methods: A total of 178 patients with GERD were selected,from January 2011 to January 2016 in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,as the research subjects. And they were randomly divided into the observation group and the control group,with 89 cases in each group. Patients of the two groups were both given with Omeprazole Enteric-coated Tablets for the treatment. And Shugan Hewei Jiangni Decoction was added in the observation group. Changes in symptom score of Reflux diagnostic questionnaire( RDQ),esophageal mucosal of PAR-2 and COX-2 protein in the two groups were observed at baseline phase and 12 week after treatment. Results: During the baseline phase,symptom score of RDQ,esophageal mucosal of PAR-2 and COX-2 protein in the two groups was basically the same. And there was no significant difference( P > 0. 05);After treatment,symptom score of RDQ,esophageal mucosal of PAR-2 and COX-2 protein of the observation group was significantly lower than control groups,and it was statistically significant( P < 0. 05). Pearson correlation coefficient showed that symptom score of RDQ in the observation group were positive correlated with esophageal mucosal of PAR-2 and COX-2( P < 0. 05),while symptom score of RDQ in the control group were not correlated with esophageal mucosal of PAR-2 and COX-2 protein esophageal mucosal of PAR-2( P > 0. 05). Conclusions: Omeprazole Enteric-coated Tablets combined with Wenyang Huoxue Decoction has good efficacy in treating gastroesophageal reflux disease and disharmony between liver and stomach syndrome. The mechanism may be associated with reducing patients' esophageal mucosal of PAR-2 and COX-2 protein,to get clinical efficacy.
Objective: To explore the effects of Shugan Hewei Jiangni Decoction on protease activated receptor-2( PAR2) and Cyclooxygenase-2( COX-2) protein in patients with gastroesophageal reflux disease( GERD) and with disharmony between liver and stomach syndrome. Methods: A total of 178 patients with GERD were selected,from January 2011 to January 2016 in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,as the research subjects. And they were randomly divided into the observation group and the control group,with 89 cases in each group. Patients of the two groups were both given with Omeprazole Enteric-coated Tablets for the treatment. And Shugan Hewei Jiangni Decoction was added in the observation group. Changes in symptom score of Reflux diagnostic questionnaire( RDQ),esophageal mucosal of PAR-2 and COX-2 protein in the two groups were observed at baseline phase and 12 week after treatment. Results: During the baseline phase,symptom score of RDQ,esophageal mucosal of PAR-2 and COX-2 protein in the two groups was basically the same. And there was no significant difference( P > 0. 05);After treatment,symptom score of RDQ,esophageal mucosal of PAR-2 and COX-2 protein of the observation group was significantly lower than control groups,and it was statistically significant( P < 0. 05). Pearson correlation coefficient showed that symptom score of RDQ in the observation group were positive correlated with esophageal mucosal of PAR-2 and COX-2( P < 0. 05),while symptom score of RDQ in the control group were not correlated with esophageal mucosal of PAR-2 and COX-2 protein esophageal mucosal of PAR-2( P > 0. 05). Conclusions: Omeprazole Enteric-coated Tablets combined with Wenyang Huoxue Decoction has good efficacy in treating gastroesophageal reflux disease and disharmony between liver and stomach syndrome. The mechanism may be associated with reducing patients' esophageal mucosal of PAR-2 and COX-2 protein,to get clinical efficacy.
引文
[1]杨健,刘梅,何键,等.胃食管反流病研究进展[J].检验医学与临床,2012,9(14):1752-1754.
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[4]周丽雅. 2014《中国胃食管反流病专家共识意见》要点[J].中华医学信息导报,2014,29(23):21.
[5]国家食品药品监督管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:101.
[6]赵迎盼,廖宇,钟家珮,等.胃食管反流病问卷(GerdQ)与反流性疾病问卷(RDQ)的比较研究[J].胃肠病学和肝病学杂志,2015,24(5):572-574.
[7]田燕,陈吉.炎症介质与胃食管反流病发病机制的研究进展[J].疾病监测与控制,2016,10(1):34-35.
[8]罗璇.胃食管反流病发病机制研究进展[J].微量元素与健康研究,2015,32(4):60-61.
[9]吴丽权,张亚历,朱薇.非糜烂性胃食管反流病烧心症状感知机制的认识[J].现代消化及介入诊疗,2016,21(4):667-670.
[10]朱宝宇,宋德锋,施春雨,等.胃食管反流病发病机制研究进展[J].中国实验诊断学,2015,5(2):344-346.
[11]戴结,胡炳德,赵晓玲,等.胃食管反流症状与Barrett食管关系的Meta分析[J].胃肠病学和肝病学杂志,2016,25(9):1030-1036.
[12]崔西玉,陈曼彤,吴穗清.胃食管反流病与哮喘关系初探[J].现代消化及介入诊疗,2005,10(2):76-78.
[13]秦永菊,孙志广.胃食管反流病的中西医病机及治疗研究进展[J].中国中西医结合消化杂志,2015,23(2):147-149.
[14]王文婷,张厂,王林恒,等.胃食管反流病中医证候学研究探索[J].环球中医药,2016,9(8):931-936.
[15]丁文娟,唐翰章,龚枚.胃食管反流中医证型与胃镜下食道像关系探析[J].亚太传统医药,2015,11(19):89-90.
[16]楚振荣,李春婷.浅谈胃食管反流病之中医辨证治疗[J].中国临床研究,2015,28(6):817-819.
[17]谢冰颖,葛振华,周凡,等.慢性浅表性胃炎胃黏膜增殖细胞核抗原和热休克蛋白与中医证型的关系[J].中国中西医结合消化杂志,2009,17(1):31-33.
[18]吴齐飞,吴继敏,白兴华,等.胃食管反流病患者在督脉背段的压痛反应规律[J].中国针灸,2014,34(8):775-777.
[19]Scholz M,Ulbrich HK,Soehnlein O,et al. Diaryl-dithiolanes andisothiazoles:COX-1/COX-2 and 5-LOX-inhibitory,*OH scavenging and anti-adhesive activities[J]. Bioorg Med Chem,2009,17(2):558-568.
[20]邹磊,李道堂,穆殿斌,等.食管鳞状细胞癌中Survivin和COX-2的表达与临床病理因素的关系[J].中国肿瘤临床,2007,34(12):670-673.
[2]牟向东,谢鹏雁.胃食管反流病生活质量的研究现状[J].社区医学杂志,2008,6(7):47-49.
[3]危北海.胃食管反流病中西医药治疗的现状和展望[J].北京中医药,2008,27(3):163-164.
[4]周丽雅. 2014《中国胃食管反流病专家共识意见》要点[J].中华医学信息导报,2014,29(23):21.
[5]国家食品药品监督管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:101.
[6]赵迎盼,廖宇,钟家珮,等.胃食管反流病问卷(GerdQ)与反流性疾病问卷(RDQ)的比较研究[J].胃肠病学和肝病学杂志,2015,24(5):572-574.
[7]田燕,陈吉.炎症介质与胃食管反流病发病机制的研究进展[J].疾病监测与控制,2016,10(1):34-35.
[8]罗璇.胃食管反流病发病机制研究进展[J].微量元素与健康研究,2015,32(4):60-61.
[9]吴丽权,张亚历,朱薇.非糜烂性胃食管反流病烧心症状感知机制的认识[J].现代消化及介入诊疗,2016,21(4):667-670.
[10]朱宝宇,宋德锋,施春雨,等.胃食管反流病发病机制研究进展[J].中国实验诊断学,2015,5(2):344-346.
[11]戴结,胡炳德,赵晓玲,等.胃食管反流症状与Barrett食管关系的Meta分析[J].胃肠病学和肝病学杂志,2016,25(9):1030-1036.
[12]崔西玉,陈曼彤,吴穗清.胃食管反流病与哮喘关系初探[J].现代消化及介入诊疗,2005,10(2):76-78.
[13]秦永菊,孙志广.胃食管反流病的中西医病机及治疗研究进展[J].中国中西医结合消化杂志,2015,23(2):147-149.
[14]王文婷,张厂,王林恒,等.胃食管反流病中医证候学研究探索[J].环球中医药,2016,9(8):931-936.
[15]丁文娟,唐翰章,龚枚.胃食管反流中医证型与胃镜下食道像关系探析[J].亚太传统医药,2015,11(19):89-90.
[16]楚振荣,李春婷.浅谈胃食管反流病之中医辨证治疗[J].中国临床研究,2015,28(6):817-819.
[17]谢冰颖,葛振华,周凡,等.慢性浅表性胃炎胃黏膜增殖细胞核抗原和热休克蛋白与中医证型的关系[J].中国中西医结合消化杂志,2009,17(1):31-33.
[18]吴齐飞,吴继敏,白兴华,等.胃食管反流病患者在督脉背段的压痛反应规律[J].中国针灸,2014,34(8):775-777.
[19]Scholz M,Ulbrich HK,Soehnlein O,et al. Diaryl-dithiolanes andisothiazoles:COX-1/COX-2 and 5-LOX-inhibitory,*OH scavenging and anti-adhesive activities[J]. Bioorg Med Chem,2009,17(2):558-568.
[20]邹磊,李道堂,穆殿斌,等.食管鳞状细胞癌中Survivin和COX-2的表达与临床病理因素的关系[J].中国肿瘤临床,2007,34(12):670-673.