化石利胆汤对胆石成石基因B-UGT及CYP7A1mRNA表达的影响
摘要
目的:研究化石利胆汤对胆总管结石患者胆石成石基因B-UGT及CYP7A1mRNA表达的影响。
材料与方法:2010年1月至2010年10月,在沈阳军区总医院中医科与内镜中心就诊的经ERCP术最终确诊为胆总管结石的患者100例,随机分为两组(n=50例)。实验组,在西医常规治疗的同时,给予化石利胆汤100ml 3/日口服,对照组,术后仅给予西医常规治疗。采用RT-PCR方法,检测患者术后第1天、服药后第7天、及第30天的胆红素尿苷二磷酸葡萄糖醛酸基转移酶(Bilirubin UDP-Glucronosyl Transferase,B-UGT)及人胆固醇7α羟化酶(Human Cholesterol 7α-Hydroxylase,CYP7A1)mRNA的表达。
结果:实验组治疗后第7天的血B-UGT的mRNA表达值为1.34±0.055,第30天为2.14±0.019,第7天的CYP7A1的mRNA表达为1.139±0.037,第30天为1.890±0.118,均较治疗前明显升高,亦高于同期的对照组,而对照组无变化。两组比较具有统计学意义(P<0.05)。
结论:化石利胆汤可以提高胆总管结石患者血中B-UGT及CYP7A1的mRNA的含量,从而增加游离胆红素及内源性胆固醇的代谢,抑制成石性胆汁的形成,对其能否起到防治结石的作用仍需长期大量临床观察。
Purpose:To explore the effects of the genes shows of cholelithiasis B-UGT and CYP7A1 after the treatment of ERCP and the Huashilidan decoction.
Material and method:One hundred patients had been check-up by ultrasound of the abdomen、CT scan-abdominal、magnetic resonance cholangiopancre atography,had been certified by with cholelithiasis undergoing ERCP,and had been done with EST、mechanical lithotripsy、basket removal of stone. After the operation, they were randomly divided into two groups averagely. One was the experiment group given Huashilidan decoction after ERCP.The other was the control group only given the normal therapy. We scale the genes shows of B-UGT and CYP7A1,at the first day, the seventh day and the 30th day after the therapy.
Results:After the treatment, the genes shows of B-UGT and CYP7A1 were greatly higher than before of the experiment group. But the control group were not. P<0.05.
Conclusion:Huashilidan decoction can improve the genes shows of B-UGTand activity of monoconjugated bilirubin,then to reduce the rates of gall-stone by intervene the genes shows of B-UGT and CYP7A1.
材料与方法:2010年1月至2010年10月,在沈阳军区总医院中医科与内镜中心就诊的经ERCP术最终确诊为胆总管结石的患者100例,随机分为两组(n=50例)。实验组,在西医常规治疗的同时,给予化石利胆汤100ml 3/日口服,对照组,术后仅给予西医常规治疗。采用RT-PCR方法,检测患者术后第1天、服药后第7天、及第30天的胆红素尿苷二磷酸葡萄糖醛酸基转移酶(Bilirubin UDP-Glucronosyl Transferase,B-UGT)及人胆固醇7α羟化酶(Human Cholesterol 7α-Hydroxylase,CYP7A1)mRNA的表达。
结果:实验组治疗后第7天的血B-UGT的mRNA表达值为1.34±0.055,第30天为2.14±0.019,第7天的CYP7A1的mRNA表达为1.139±0.037,第30天为1.890±0.118,均较治疗前明显升高,亦高于同期的对照组,而对照组无变化。两组比较具有统计学意义(P<0.05)。
结论:化石利胆汤可以提高胆总管结石患者血中B-UGT及CYP7A1的mRNA的含量,从而增加游离胆红素及内源性胆固醇的代谢,抑制成石性胆汁的形成,对其能否起到防治结石的作用仍需长期大量临床观察。
Purpose:To explore the effects of the genes shows of cholelithiasis B-UGT and CYP7A1 after the treatment of ERCP and the Huashilidan decoction.
Material and method:One hundred patients had been check-up by ultrasound of the abdomen、CT scan-abdominal、magnetic resonance cholangiopancre atography,had been certified by with cholelithiasis undergoing ERCP,and had been done with EST、mechanical lithotripsy、basket removal of stone. After the operation, they were randomly divided into two groups averagely. One was the experiment group given Huashilidan decoction after ERCP.The other was the control group only given the normal therapy. We scale the genes shows of B-UGT and CYP7A1,at the first day, the seventh day and the 30th day after the therapy.
Results:After the treatment, the genes shows of B-UGT and CYP7A1 were greatly higher than before of the experiment group. But the control group were not. P<0.05.
Conclusion:Huashilidan decoction can improve the genes shows of B-UGTand activity of monoconjugated bilirubin,then to reduce the rates of gall-stone by intervene the genes shows of B-UGT and CYP7A1.
引文
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[22]黄雄飞,陈良万,黄文栋,GdCI3对小鼠肝脏再生早期Cyp7A1基因转录的影响,第四军医大学学报2007,28(24):2239-2241
[23]马晓明,董秀山,赵浩亮,大鼠肝再生时血清胆汁酸及肝脏CYP7A1mRNA表达的变化,中国药物与临床2010,3(lO):3291-292
[24]陈进宏,蔡端,张延龄,胆汁成石趋势及成石性质多因素判断程序的研制及其临床意义.肝胆胰外科杂志,1999,11(3):149-151
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[26]李奇为,曹亦军,EST术后胆总管结石复发的内镜处理疗效分析,外科理论与实践2010,15(3):289-290
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[2]粱酉,黄太秀,裴晓红,等.荤素膳食与胆石症发病关系的流行病学调查.临床肝胆病杂志,1997.13(3):152—153
[3]吴卫泽,韩天权,张圣道,胆道结石的病因学和临床处理.肝胆外科杂志2010,18(2):85-87
[4]程世虎,严一先.肝胆结石片治疗胆石症82例疗效观察.现代中西医结合杂志,2005,14(14):1873
[5]岳志华,孙会敏,田颂九.人体胆结石成分的研究进展.药物分析杂志,2005,25(8):1003-1007
[6]吴阶平,裘法祖.黄家驷外科学.第6版,北京:人民卫生出版社,2002,1282.
[7]刘红云,胆总管结石的治疗,中国实用医学研究杂志2003.2(4):379-380
[8]王智峰,祝学光,刘玉兰,胆石症的诊断与治疗进展,临床消化病杂志2006,18(6):325-327
[9]章丽娟.中国胆石症危险因素的流行病学研究.医学信息,2009,22(12):2979-2982
[10]陈希纲,刘家奇,彭民浩,等.广西结石病的l9年变迁.中华肝胆外科杂志,2001.7(5):262—265
[11]钱浪,周玉环.杭州地区996例胆石症调查分析.浙江医学,l994,l6(2):l17-1l8
[12]张仕国,靳士美,孪华,等.乐山地区胆石症特点的研究.四川医学,l989,1O(1):7-8
[13]李哲夫,陈孝平.胆固醇胆石成因的研究进展.中国普通外科杂志,2007,16(2):170-172
[14]傅德良,胆囊运动在胆固醇结石形成中的作用.国外医学外科学分册,1994,3:139-141
[15]周峰,陈一,冯全林,胆囊炎、胆石症中医辨证分型与幽门螺杆菌感染,2006,2l(11)中华中医药杂志(原中国医药学报)683-684
[16]Shoda J,Tanaka N,Osuga T.Hepatolithiasis—epidemmiology and pathogenesis update.Front Biosci,2003(8):398—409
[17]Maki T.Pathogenesis of calcium bilirubinate gallstone:role of E.coli,β-glucuronidase,and coagulation by inorganie ions polyectrolytes and agiration.Annsurg,1966,164:90—100
[18] Kang Jey Ho . Development and optimization of an enzyme linked immunosorbent assay employing two murine monoclonal antibodies for absolute quantitation of humanβ-glucu—ronidase.Biotechnol Appl Biochem,1992,16:1-10
[19]张久聪,聂青和.胆红素尿苷二磷酸葡萄糖醛酸基转移分子生物学研究进展.肝脏,2008,13(2):164-165
[20]马保金,蔡瑞,张群华,胆汁泡成核活性的研究.中华肝胆外科杂志.1998,4(2):104-106
[21]张红军,祝学光,陈翔柏,药物诱导胆红素葡萄糖醛酸转移酶的基因表达对小鼠胆结石形成的抑制作用,中华普通外科杂志1999,4(5):344-347
[22]黄雄飞,陈良万,黄文栋,GdCI3对小鼠肝脏再生早期Cyp7A1基因转录的影响,第四军医大学学报2007,28(24):2239-2241
[23]马晓明,董秀山,赵浩亮,大鼠肝再生时血清胆汁酸及肝脏CYP7A1mRNA表达的变化,中国药物与临床2010,3(lO):3291-292
[24]陈进宏,蔡端,张延龄,胆汁成石趋势及成石性质多因素判断程序的研制及其临床意义.肝胆胰外科杂志,1999,11(3):149-151
[25]李家德,胆总管结石的CT检查与诊断,中国医学创新2009,6(27):129-130
[26]李奇为,曹亦军,EST术后胆总管结石复发的内镜处理疗效分析,外科理论与实践2010,15(3):289-290
[27]黄震,王日武,张为民,顾继礼.内镜在胆囊切除术后综合征病因诊断和治疗中的应用价值.肝胆胰外科杂志,2006,4(5):43-50
[28]麻树人,邵晓冬,张宁,等.治疗性ERCP在胆胰疾病中的应用价值.中华消化内镜杂志,2006,1(3):24-27
[16]Shoda J,Tanaka N,Osuga T.Hepatolithiasis—epidemmiology and pathogenesis update.Front Biosci,2003(8):398—409
[17]Maki T.Pathogenesis of calcium bilirubinate gallstone:role of E.coli,β-glucuronidase,and coagulation by inorganie ions polyectrolytes and agiration.Annsurg,1966,164:90—100
[18] Kang Jey Ho . Development and optimization of an enzyme linked immunosorbent assay employing two murine monoclonal antibodies for absolute quantitation of humanβ-glucu—ronidase.Biotechnol Appl Biochem,1992,16:1-10
[19]张久聪,聂青和.胆红素尿苷二磷酸葡萄糖醛酸基转移分子生物学研究进展.肝脏,2008,13(2):164-165
[20]马保金,蔡瑞,张群华,胆汁泡成核活性的研究.中华肝胆外科杂志.1998,4(2):104-106
[21]张红军,祝学光,陈翔柏,药物诱导胆红素葡萄糖醛酸转移酶的基因表达对小鼠胆结石形成的抑制作用,中华普通外科杂志1999,4(5):344-347
[22]黄雄飞,陈良万,黄文栋,GdCI3对小鼠肝脏再生早期Cyp7A1基因转录的影响,第四军医大学学报2007,28(24):2239-2241
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