顺胃降逆方对复发反流性食管炎患者食管黏膜p16蛋白表达的影响
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摘要
目的观察顺胃降逆方对复发反流性食管炎肝脾胃不和、寒湿热错杂证患者临床疗效,及对食管黏膜p16蛋白表达的影响。方法采用随机数字表法将100例患者分为治疗组和对照组各50例。治疗组予顺胃降逆方颗粒剂,每日2次冲服。对照组予泮托拉唑钠肠溶胶囊,每日1粒,早餐前30min口服。2组均治疗8周。观察2组治疗前后耐信量表(RDQ)积分、食管黏膜炎症积分及食管黏膜p16蛋白表达,比较2组临床疗效。结果治疗组RDQ积分疗效总有效率为92.00%(46/50),对照组为72.00%(36/50),2组比较差异有统计学意义(P<0.05)。与本组治疗前比较,2组治疗后RDQ积分及食管黏膜炎症积分降低(P<0.05);2组治疗后比较,治疗组RDQ积分低于对照组(P<0.05)。与本组治疗前比较,治疗组患者食管黏膜p16蛋白表达降低(P<0.05)。结论顺胃降逆方可改善复发反流性食管炎患者的临床症状,修复食管黏膜炎症,降低食管黏膜p16蛋白表达。
Objective To observe the clinical efficacy of Shunwei Jiangni Prescription on patients with recurrent reflux esophagitis of liver-spleen-stoma disharmony and cold-dampness heat syndrome, and effect on the expression of p16 protein in esphageal mucosa. Methods Totally 100 recurrent reflux esophagitis patients were divided into treatment group and control group according to random number table method, with 50 cases in each group. Patients in the treatment group were treated with Shunwei Jiangni Prescription, twice a day, mixing with water. Patients in the control group were treated with pantoprazole sodium enteric-coated capsules, one capsule per day, 30 min before breakfast, orally. The treatment for both groups lasted for 8 weeks. Reflux Diagnostic Questionnaire(RDQ) scores,esophageal mucosa inflammation score and esophageal mucosa p16 protein expression were statistically analyzed.Clinical efficacy of both groups was compared. Results The total effective rate of RDQ scores in the treatment group was 92.00%(46/50), and that in the control group was 72.00%(36/50), with statistical significance(P<0.05).Compared with before treatment, the RDQ scores and esophageal mucosal inflammation scores of both groups were lower(P<0.05). After treatment, the RDQ scores of the treatment group were lower than those of the control group(P<0.05). Compared with before treatment, the expression of p16 protein in esophageal mucosa was reduced in the treatment group(P<0.05). Conclusion Shunwei Jiangni Prescription can not only improve the clinical symptoms of patients with recurrent reflux esophagitis, but also repair the esophageal mucosa inflammation and decrease expression of p16 protein in esophageal mucosa.
Objective To observe the clinical efficacy of Shunwei Jiangni Prescription on patients with recurrent reflux esophagitis of liver-spleen-stoma disharmony and cold-dampness heat syndrome, and effect on the expression of p16 protein in esphageal mucosa. Methods Totally 100 recurrent reflux esophagitis patients were divided into treatment group and control group according to random number table method, with 50 cases in each group. Patients in the treatment group were treated with Shunwei Jiangni Prescription, twice a day, mixing with water. Patients in the control group were treated with pantoprazole sodium enteric-coated capsules, one capsule per day, 30 min before breakfast, orally. The treatment for both groups lasted for 8 weeks. Reflux Diagnostic Questionnaire(RDQ) scores,esophageal mucosa inflammation score and esophageal mucosa p16 protein expression were statistically analyzed.Clinical efficacy of both groups was compared. Results The total effective rate of RDQ scores in the treatment group was 92.00%(46/50), and that in the control group was 72.00%(36/50), with statistical significance(P<0.05).Compared with before treatment, the RDQ scores and esophageal mucosal inflammation scores of both groups were lower(P<0.05). After treatment, the RDQ scores of the treatment group were lower than those of the control group(P<0.05). Compared with before treatment, the expression of p16 protein in esophageal mucosa was reduced in the treatment group(P<0.05). Conclusion Shunwei Jiangni Prescription can not only improve the clinical symptoms of patients with recurrent reflux esophagitis, but also repair the esophageal mucosa inflammation and decrease expression of p16 protein in esophageal mucosa.
引文
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[11]李丽,齐凤英,刘俊茹,等.人参皂苷Rh2对食管癌细胞Eca-109细胞周期的影响[J].中国中药杂志,2005,30(20):1617-1621.
[12]闵玮,林秉奖,骆丹.黄芩苷对中波紫外线所致HaCaT细胞凋亡、细胞周期变化及p16、原癌基因c-myc蛋白表达的影响[J].临床皮肤科杂志,2010,39(6):345-348.
[13]袁海建,李国银,姜俊,等.半夏-厚朴药对抗肿瘤功效物质基础及作用机制研究新思路[J].中草药,2018,49(8):1924-1931.
[14]刘红岗,赖远阳,朱以芳,等.黄连素抗食管癌EC109细胞的作用及其机制[J].临床与病理杂志,2017,37(12):2524-2529.
[15]何占坤,张国梁,唐方,等.陈皮、藿香不同提取物对胃肠动力障碍大鼠胃肠平滑肌收缩活动及胃肠激素的影响[J].天津医药,2017,45(11):1175-1179.
[16]钟凌云,谭玲龙,何平平.3种姜汁炮制后厚朴对大鼠胃黏膜损伤的抑制作用[J].中成药,2018,40(9):2062-2065.
[17]邓志燕,万强.黄芩苷对幽门螺杆菌诱导人胃黏膜上皮GES-1细胞损伤的保护作用及机制[J].中国实验方剂学杂志,2017,23(19):145-149.
[18]付彬,席利力,高鸿亮,等.荜茇根对胆汁反流性胃炎大鼠胃黏膜炎症程度、GAS、P21、PCNA、C-erb B-2表达的影响[J].中药药理与临床,2016,32(2):142-146.
[19]高铭彤,王佳奇,陈凯,等.精氨酸双糖苷对脂多糖诱导的巨噬细胞分泌炎症因子的影响[J].中国兽药杂志,2016,50(11):65.
[20]孙俊波,赵璐,史素琴,等.甘草次酸抑制胃溃疡大鼠胃黏膜细胞的凋亡[J].中成药,2017,39(3):462-466.
[2]韩笑,陆荣柱.早期食管癌中ATM和p16蛋白的表达及临床意义[J].临床与实验病理学杂志,2017,33(12):1379-1381.
[3]中华医学会消化病学分会.2014年中国胃食管反流病专家共识意见[J].胃肠病学,2015,20(3):155-168.
[4]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:243-253.
[5]中国中西医结合学会消化系统疾病专业委员会.胃食管反流病中西医结合诊疗共识意见(2010)[J].中国中西医结合杂志,2011,31(11):1550-1553.
[6]中国胃食管反流病研究协作组.反流性疾病问卷在胃食管反流病诊断中的价值[J].中华消化杂志,2003,23(11):651-654.
[7]中华中医药学会脾胃病分会.胃食管反流病中医诊疗共识意见(2009,深圳)[J].中医杂志,2010,51(9):844-847.
[8]潘祖林,刘俊峰.食管癌中p16蛋白的研究现状[J].食管外科电子杂志,2014,2(1):16-19.
[9]LAPAK K M,CHRISTIN E,BURD C E.The molecular balancing act of p16INK4a in cancer and aging[J].Mol Cancer Res,2014,12(2):167-183.
[10]叶萍,李兆申,许国铭.反流性食管炎和食管腺癌组织中P16、P53、PCNA表达及其临床意义[J].解放军医学杂志,2000,25(5):326.
[11]李丽,齐凤英,刘俊茹,等.人参皂苷Rh2对食管癌细胞Eca-109细胞周期的影响[J].中国中药杂志,2005,30(20):1617-1621.
[12]闵玮,林秉奖,骆丹.黄芩苷对中波紫外线所致HaCaT细胞凋亡、细胞周期变化及p16、原癌基因c-myc蛋白表达的影响[J].临床皮肤科杂志,2010,39(6):345-348.
[13]袁海建,李国银,姜俊,等.半夏-厚朴药对抗肿瘤功效物质基础及作用机制研究新思路[J].中草药,2018,49(8):1924-1931.
[14]刘红岗,赖远阳,朱以芳,等.黄连素抗食管癌EC109细胞的作用及其机制[J].临床与病理杂志,2017,37(12):2524-2529.
[15]何占坤,张国梁,唐方,等.陈皮、藿香不同提取物对胃肠动力障碍大鼠胃肠平滑肌收缩活动及胃肠激素的影响[J].天津医药,2017,45(11):1175-1179.
[16]钟凌云,谭玲龙,何平平.3种姜汁炮制后厚朴对大鼠胃黏膜损伤的抑制作用[J].中成药,2018,40(9):2062-2065.
[17]邓志燕,万强.黄芩苷对幽门螺杆菌诱导人胃黏膜上皮GES-1细胞损伤的保护作用及机制[J].中国实验方剂学杂志,2017,23(19):145-149.
[18]付彬,席利力,高鸿亮,等.荜茇根对胆汁反流性胃炎大鼠胃黏膜炎症程度、GAS、P21、PCNA、C-erb B-2表达的影响[J].中药药理与临床,2016,32(2):142-146.
[19]高铭彤,王佳奇,陈凯,等.精氨酸双糖苷对脂多糖诱导的巨噬细胞分泌炎症因子的影响[J].中国兽药杂志,2016,50(11):65.
[20]孙俊波,赵璐,史素琴,等.甘草次酸抑制胃溃疡大鼠胃黏膜细胞的凋亡[J].中成药,2017,39(3):462-466.