【摘要】 目的:观察安胃方对慢性萎缩性胃炎患者胃黏膜Hsp70和p53蛋白表达的影响,揭示其重要的作用机制,同时观察对幽门螺杆菌(Helicobacter pylori,Hp)的影响。方法:选择符合纳入标准的慢性萎缩性胃炎患者90例,分为2组。治疗组50例,口服"安胃方"每日2剂,每次200 mL;对照组40例,口服胃复春片,每次4片,每日3次。疗程均为12周,观察治疗前后胃黏膜大体观、病理、Hsp70和p53蛋白的表达,并作疗效判断。结果:治疗组总有效率为80%,对照组总有效率为52.5%,治疗组萎缩的有效率为86%,肠化的有效率为78.26%,优于对照组(P<0.01),对Hp感染无明显影响(P>0.05)。治疗组中医证候分型脾胃虚弱组疗效优于脾胃湿热组(P<0.05)。免疫组化研究显示安胃方能抑制p53蛋白(P<0.05),上调Hsp70表达(P<0.05)。结论:安胃方对CAG有明显疗效,对病理变化有显著改善,通过下调抑制p53蛋白,上调Hsp70表达,可能是主要作用的机制之一。更多还原

【Abstract】 Objective:To observe the effect on Hsp70,p53 and Hp of the patients’ stomach mucosa and mechanism of Anwei Decoction when treating chronic atrophic gastritis(CAG) lesion.Methods:90 patients who met the diagnostic criteria were divided into two groups.The treatment group(50 cases) was treated with Anwei Decoction orally and the control group(40 cases) was treated with Weifuchun Tablet.The treatment course of both groups was 12 weeks.The clinical effect,gastroscopic and pathological effects and scores for Hsp70,p53 and Hp expression were observed before and after treatment in both groups.Results:The total effective rate of the treatment group was 80% while it was 52.5% in the control group(P < 0.01).The effective rate for atrophy in the treatment group was 86%(P < 0.01) and intestinal metaplasia was78.26%(P < 0.01).There was no effect on Helicobacter pylori(P > 0.05).There was a statistically significant difference between the damp heat of spleen and stomach and the group of deficiency of spleen and stomach(P < 0.05).Immunohistochemical analysis showed that Anwei Decoction could inhibit the expression of p53(P < 0.05) and improve Hsp70(P < 0.05) with significant differences.Conclusion:Anwei Decoction can significantly improve the clinical symptoms,gastroscopic and pathological changes in CAG lesion.Inhibiting the expression of p53 and improving Hsp70 are the probable mechanism.更多还原