中西医结合根除幽门螺杆菌对萎缩性胃炎核因子-κB表达的影响

[目的]观察以胃舒散为主的三联疗法（胃舒散、呋喃唑酮和克拉霉素）治疗幽门螺杆菌（Hp）阳性慢性萎缩性胃炎（CAG）的临床效果及其对核因子-κB（NF-κB）表达的影响。[方法]41例Hp阳性CAG患者服用胃舒散2．0g，呋喃唑酮0．1g，各3次／d，克拉霉素0．25g，2次／d，1周后再继服胃舒散4周。治疗前及治疗结束1年后行内镜及病理组织学检查，取活检观察病理组织学改变及NF-κB表达变化，采用银染色法、^14C-尿素呼气试验或快速尿素酶试验检测Hp。[结果]三联疗法结束1年后，Hp根除率为85．4％；根除Hp能显著减轻患者胃窦部慢性炎症（P〈0．05）和活动程度（P〈0．01），下调NF-κB表达（P〈0．01），但胃炎的萎缩和肠化生等病理无明显改变。[结论]以胃舒散为主的三联疗法对Hp有较高根除率。根除Hp可抑制NF-κB的表达，减轻活动性炎症，但近期观察对萎缩、肠化生等病理改变无明显作用。

Effect of eradication Helicobacter pylori on NF-KB expression in Helicobacter pylori-positive chronic atrophic gastritis

[Objective]To evaluate the effect of Weishusan combined with furazolidone and claramycillin on the eradication of Helicobacter pylori （Hp） and on chronic atrophic gastritis as well as the expression of NF-κB in the gastric mucosa. [Methods]Forty one patients with Hp positive chronic atrophic gastritis conformed by endoscopy were received Weishusan 2. 0 （containing Bi 0. 12）, furazolidone 0. 1, bid, claramycillin 0. 25, rid for 1 weeks, and continued to receive Weishusan 2.0 tid for 4 weeks. An endoscopy with biopsy samples was performed before and one year after therapy. Hp was determined by histology of warthin-starry silver stain, ^14 C-urine breath test or rapid urease test. Biopsy specimens were analyzed by histological methods. The expression of NF-κB in the gastric mueosa was tested by immunohistoehemistry. [Results]Hp eradication rate was 85.4% after one year of the combined therapy. In patients with Hp eradication （n=31）, the chronic inflammation and active degree of gastric antrum were significantly relieved （P〈0. 05 and P〈0.01 respectively）; The expression of NF-κB was significantly down-regulated （P〈0. 01）, however,there were no significant differences in the atrophy and intestinal metaplasia pathology before and after Hp eradication （ both P〉0. 05 ）. [Conclusion ]The combined therapy with Weishusan, furazolidone and claramyeillin is highly effective in Hp eradication. The eradication of Hp significantly inhibited the activation of NF-κB and decreased the chronic active gastritis, but not improved atrophic pathohistology in gastric mucosa.