首页|化浊解毒通络方治疗胃癌前病变浊毒蕴胃证患者的疗效及作用机制研究

化浊解毒通络方治疗胃癌前病变浊毒蕴胃证患者的疗效及作用机制研究

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目的:观察化浊解毒通络方治疗胃癌前病变浊毒蕴胃证患者的疗效,并探讨其可能的作用机制.方法:选取2017年3月至2019年4月就诊于河北省中医院脾胃病科的胃癌前病变浊毒蕴胃证患者70例作为研究对象,采用简单随机化方法将患者分为观察组和对照组,每组35例.观察组给予化浊解毒通络方治疗;对照组给予胃复春片口服,3次/d,4片/次.2组均治疗6个月.治疗前后用免疫组织化学法、蛋白质免疫印迹法检测胃黏膜组织中音猬因子(Shh)信号通路关键因子胶质瘤相关癌基因蛋白-1(Gli1)、融合抑制因子(SUFU)、细胞周期蛋白D1(CyclinD1)表达,观察2组治疗期间的安全性指标,对比2组中医证候疗效、胃镜疗效、病理疗效.结果:观察组中医证候、胃镜、病理总有效率高于对照组(均P<0.05).Gli1、SUFU、CyclinD1免疫组织化学法染色呈棕黄色颗粒状.治疗前,2组患者胃黏膜组织中Gli1、SUFU、Cy-clinD1蛋白表达(密度值)差异均无统计学意义(均P>0.05);治疗后,2组患者胃黏膜组织中Gli1、CyclinD1蛋白表达均较治疗后降低,SUFU蛋白表达均较治疗后升高,差异均有统计学意义(均P<0.05),且观察组患者以上指标变化较对照组明显(均P<0.05).蛋白质免疫印迹法检测结果:治疗前,2组患者胃黏膜组织中Gli1、SUFU、CyclinD1蛋白表达差异均无统计学意义(均P>0.05);治疗后,2组患者胃黏膜组织中Gli1、CyclinD1蛋白表达均较治疗后降低,SUFU蛋白表达均较治疗后升高,差异均有统计学意义(均P<0.05),且观察组以上指标变化较对照组明显(均P<0.05).2组患者在服药期间均未出现不良反应,血常规、尿常规、粪便常规、肝肾功能及心电图检查均未见明显异常.结论:化浊解毒通络方治疗胃癌前病变浊毒蕴胃证患者疗效优于胃复春片,其作用机制与可能与调控Shh信号通路关键因子Gli1、SUFU、CyclinD1的表达有关.
Efficacy and Mechanism of Huazuojiedu Tongluo Prescription in Treatment of Patients with Gastric Precancerous Lesions of Turbid Toxin Accumulating in Stomach
Objective:This study observed the efficacy of Huazuojiedu Tongluo Prescription in the treatment of patients with gastric precancerous lesions of turbid toxin accumulating in the stomach and explored its possible mechanism.Methods:A total of 70 pa-tients with gastric precancerous lesions of turbid toxin accumulating in the stomach admitted to the Spleen and Stomach Disease De-partment of Hebei Hospital of Traditional Chinese Medicine from March 2017 to April 2019 were selected,and they were randomly divided into observation group and control group,with 35 cases in each group.The observation group was treated with Huazuojiedu Tongluo Prescription,and the control group orally took four Weifuchun Tablets three times a day.Both groups were treated for six months.The expression of the key factors of the sonic hedgehog(Shh)signaling pathway,such as glioma-associated oncogene 1(Gli1),suppressor of fused(SUFU),and Cyclin D1,were detected by immunohistochemistry and western blot before and after treatment,and the safety indexes of the two groups during treatment were observed.The efficacy in terms of traditional Chinese med-icine(TCM)syndrome,gastroscopy,and pathology were compared between the two groups.Results:The total effective rate of TCM syndrome,gastroscopy,and pathology in the observation group was higher than that in the control group(all P<0.05).Immunohis-tochemical staining of Gli1,SUFU,and CyclinD1 showed brown-yellow granules.Before treatment,there was no statistical signifi-cance in the protein expression(density value)of Gli1,SUFU,and CyclinD1 in gastric mucosa between the two groups(all P>0.05).After treatment,the protein expressions of Gli1 and CyclinD1 in gastric mucosa of the two groups were decreased,while the protein expressions of SUFU were increased,with statistical significance(all P<0.05).The above indexes in the observation group were significantly changed compared with the control group(all P<0.05).The western blot test results showed that before treat-ment,there were no significant differences in the expression of Gli1,SUFU,and CyclinD1 in gastric mucosa between the two groups(all P>0.05).After treatment,the protein expressions of Gli1 and CyclinD1 in gastric mucosa of the two groups were decreased,and the protein expressions of SUFU were increased,with statistical significance(all P<0.05).The above indexes in the observa-tion group were significantly changed compared with the control group(all P<0.05).No adverse reactions occurred in the two groups during the medication,and no obvious abnormalities were found in the blood routine,urine routine,stool routine,liver and kidney functions,and electrocardiogram.Conclusion:The efficacy of Huazuojiedu Tongluo Prescription in the treatment of patients with gas-tric precancerous lesions of turbid toxin accumulating in the stomach is better than that of Weifuchun Tablets,and its mechanism may be related to the regulation of the key factor expression in the Shh signaling pathway,such as Gli1,SUFU,and CyclinD1.

Gastric precancerous lesionHuazuojiedu Tongluo PrescriptionSyndrome of turbid toxin accumulating in the stom-achMechanismSonic hedgehog signaling pathwayGlioma-associated oncogene 1Suppressor of fusedCyclinD1

张志威、宋梦蝶、毛宇湘、杨静、钱金花、毕建成、张亚秋、王海洋、白海燕

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河北中医药大学第一附属医院,石家庄,050011

河北省浊毒证重点实验室,石家庄,050011

河北省中西医结合胃肠病研究重点实验室,石家庄,050011

乐陵市人民医院,乐陵,253600

石家庄普济中西医结合医院,石家庄,050000

河北中医药大学浊毒理论研究中心,石家庄,050000

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胃癌前病变 化浊解毒通络方 浊毒蕴胃证 机制 音猬因子信号通路 胶质瘤相关癌基因蛋白-1 融合抑制因子 细胞周期蛋白D1

2024

世界中医药
世界中医药学会联合会

世界中医药

CSTPCDCHSSCD北大核心
影响因子:1.266
ISSN:1673-7202
年,卷(期):2024.19(20)