Therapeutic effect of traditional Chinese medicine harmonizing method on reflux esophagitis after gastric cancer surgery
Objective To explore the therapeutic effect of traditional Chinese medicine "harmonizing method" combined with acupuncture on reflux esophagitis after gastric cancer surgery and its effect on serum miR-223 and miR-181a. Methods 86 patients with reflux esophagitis after gastric cancer surgery in Handan Hospital of Traditional Chinese Medicine from March 2019 to August 2022 were selected as the research objects. According to random number table method,they were divided into the control group and the observation group,with 43 cases in each group. The control group was treated with omeprazole enteric-coated capsules and domperidone tablets,and the observation group was treated with Adjusted Chaihulonggumuli Decoction combined with acupuncture on the basis of the treatment of the control group. The clinical efficacy,traditional Chinese medicine (TCM) symptom scores,gastrointestinal hormones,inflammatory factors,miR-223,miR-181a and other indicators were compared between two groups. Pearson correlation analysis was used to analyze the relationship between miR-223,miR-181a and inflammatory factors. Multivariate Logistic regression and ROC curve were used to analyze the predictive value of miR-223 and miR-181a for reflux esophagitis recurrence. Results The total effective rate of the observation group was higher than that of the control group (P＜0.05). After treatment,the TCM symptom score of the observation group was lower than that of the control group (P＜0.001). After treatment,the levels of GAS and MTL in the observation group were higher than those in the control group (P＜0.001). After treatment,the levels of interleukin (IL)-1β,IL-6 and tumor necrosis factor-α (TNF-α) in the observation group were lower than those in the control group (P＜0.001). After treatment,the level of miR-223 in the observation group was lower than that in the control group,and the level of miR-181a was higher than that in the control group (P＜0.001). The serum level of miR-223 was positively correlated with the levels of IL-1β,IL-6 and TNF-α (P＜0.001),and the serum level of miR-181a was negatively correlated with the levels of IL-1β,IL-6 and TNF-α (P＜0.001). miR-223 was an independent risk factor for the recurrence of reflux esophagitis (OR=2.184,P＜0.001),and miR-181a was an independent protective factor for the recurrence of reflux esophagitis (OR=0.268,P＜0.001). The AUC predicted by miR-223,miR-181a and their combination were 0.837,0.811 and 0.934,respectively. The combined prediction of the two was superior to their individual prediction performance (Z=7.168,9.376,P＜0.001). Conclusion Traditional Chinese medicine "harmonizing method" combined with acupuncture can improve the curative effect,improve symptoms,regulate gastrointestinal hormones,inhibit inflammatory response,reduce serum miR-223 level,and increase miR-181a level in patients with reflux esophagitis after gastric cancer surgery. Serum miR-223 and miR-181a are independent influencing factors of reflux esophagitis recurrence. The combination of the two has good predictive value for the recurrence of reflux esophagitis.
harmonizing method of traditional Chinese medicinepostoperative gastric cancerreflux esophagitistype of incoordination between liver and stomachmiR-223miR-181a
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