健胃消萎方治疗慢性萎缩性胃炎疗效及相关机制探讨

To explore the effect and related mechanism of Jianwei Xiaowei Decoction in the treatment of chronic atrophic gastritis

关键词:  慢性萎缩性胃炎  中药  健胃消萎方  胃蛋白酶原  Janus激酶2  信号转导和转录激活剂3

Key words:  chronic atrophic gastritis  traditional Chinese medicine  Jianwei Xiaowei Decoction  pepsinogen  Janus kinase 2  signal transducers and activators of transcription 3

摘要:

[目的] 探讨健胃消萎方治疗慢性萎缩性胃炎（CAG）临床疗效，初步分析其治疗机制。[方法] 选择南通市第二人民医院消化内科2021年3月—2022年9月收治的CAG患者103例，按照随机数字表法随机分为观察组51例和对照组52例，最终每组纳入48例。对照组予以奥美拉唑肠溶胶囊、瑞巴派特片治疗，观察组在对照组治疗基础上予以中药健胃消萎方口服，疗程均为12周。比较两组治疗前后中医证候评分、胃黏膜病理评分；并比较两组血清胃蛋白酶原（PG）Ⅰ、PGⅡ和胃泌素-17（G-17）水平，计算PGⅠ/PGⅡ值（PGR）；比较两组外周血单个核细胞（PBMCs）Janus激酶2（JAK2）mRNA、信号转导和转录激活剂3（sSTAT3）mRNA相对表达量，并比较两组治疗总有效率。[结果] 治疗后观察组各项中医证候评分、胃黏膜病理评分均低于对照组（P<0.01）；血清PGⅠ、G-17水平、PGR高于对照组（P<0.01），血清PGⅡ水平低于对照组（P<0.01）；PBMCs JAK2、STAT3 mRNA相对表达量低于对照组（P<0.01）；治疗总有效率高于对照组（P<0.05）。[结论] 健胃消萎方可改善CAG患者中医证候和胃黏膜病理状态，调节PG分泌，提高CAG临床疗效，其机制可能与抑制JAK2/STAT3表达有关。

Abstract:

[Objective] To investigate the effect of Jianwei Xiaowei Decoction in the treatment of chronic atrophic gastritis (CAG),and analyze its therapeutic mechanism preliminarily. [Methods] The 103 CAG patients admitted to our hospital from March,2021 to September,2022 were selected and divided into observation group(51 cases) and control group(52 cases) according to the random number table method. Finally,48 cases were included in each group. The control group were treated with omeprazole enteric-coated capsules and Rebamipide tablets,and the observation group were treated with Chinese medicine Jianwei Xiaowei Decoction on the basis of the treatment of the control group. The course of treatment was for 12 weeks. The traditional Chinese medicine(TCM) syndrome score and gastric mucosal pathological score were compared between the two groups before and after treatment. The serum levels of pepsinogen (PG) Ⅰ,PGⅡ and gastrin-17 (G-17) were compared between the two groups,and the PGⅠ/PGⅡ ratio (PGR) was calculated. The relative expression levels of Janus kinase 2 (JAK2) mRNA and signal transducer and activator of transcription 3 (sSTAT3) mRNA in peripheral blood mononuclear cells (PBMCs) were compared between the two groups,and the total effective rate of the two groups was compared. [Results] After treatment,the TCM syndrome score and gastric mucosal pathological score of the observation group were lower than those of the control group (P<0.01). The serum levels of PGⅠ,G-17 and PGR of the observation group were higher than those of the control group(P<0.01),and the serum level of PGⅡ was lower than that of the control group(P<0.01). The relative expression of JAK2mRNA and STAT3 mRNA in PBMCs were lower than that of the control group(P<0.01). The total effective rate of the treatment group was higher than that of the control group (P<0.05). [Conclusion] Jianwei Xiaowei Decoction can improve the TCM syndrome and pathological state of gastric mucosa in patients with CAG,regulate the secretion of PG,and improve the clinical effect of CAG. The mechanism may be related to the inhibition of JAK2/STAT3 expression.