消痈溃得康颗粒对胃溃疡活动期患者血清前列腺素及肿瘤坏死因子的影响

目的：探讨消痈溃得康颗粒对胃溃疡活动期患者血清前列腺素（PGE2）及肿瘤坏死因子（TNF-α）的影响,反证＂毒热＂为胃溃疡活动期的病因,PGE2及TNF-α细胞因子为＂毒热＂病因要素的生物学基础。方法：选取胃溃疡活动期符合中医胃毒热证患者,采用随机对照双盲双模拟试验研究方法,试验组22例口服消痈溃得康颗粒加溃疡胶囊模拟剂,对照组22例口服溃疡胶囊加消痈溃得康颗粒模拟剂,6周后,采用ELASA法测定血清PGE2及TNF-α的变化及中医症状积分变化,进行统计分析。结果：试验组PGE2疗前（0.15±0.04）ng/mL,疗后（0.33±0.18）ng/mL,P〈0.01,有显著统计学差异。对照组疗前（0.18±0.08）ng/mL,疗后（0.19±0.03）ng/mL,P〉0.05,无统计学差异。疗后两组比较P〈0.01,有显著统计学差异,试验组优于对照组。TNF-α试验组疗前（76.45±11.36）ng/L,疗后（34.38士5.03）ng/L,P〈0.01,有显著统计学差异。对照组疗前（78.37±15.89）ng/L,疗后（57.90±10.74）ng/L,P〈0.01,有显著统计学差异。疗后两组比较P〈0.01,有显著统计学差异,试验组优于对照组。中医证侯积分试验组疗前（10.633±3.37）分,与疗后（1.667±2.11）分比较,P〈0.01,有显著统计学差异;对照组疗前（10.700±3.28）分,与疗后（4.500±2.39）分比较,P〈0.01,有显著统计学差异;两组疗后比较,P〈0.01,有显著统计学差异。结论：清热解毒、消痈生肌之消痈溃得康颗粒对胃溃疡活动期患者可以明显增强血清PGE2的水平,降低TNF-α的水平,改善中医症状,从而达到治疗溃疡的目的,且疗效优于对照组,以效测证,以效证因,反证＂毒热＂为胃溃疡活动期的病因。

Effect of Xiaoyongkuidekang Granule Acted on PGE2/TNF-α in Serum of Patients with Gastric Ulcer in Active Stage

Objective：Disprooving the ＂poison-heat＂ was the etiopathogenisis of gastric ulcer in active stage and cyto-kine as PGE2 /TNF-αwere biological substructure of ＂poison-heat＂ through aprroching the action of Xiaoyongkuidekang Granule acted on PGE2 /TNF-α in serum of patients with gastric ulcer in active stage.Method：Patient with gastric ulcer in active stage were selected with features of gastric poison-heat syndrome in TCM and devided into experiment and control group with double-blind /simulation test randomly.22 patient in experiment group were treated with Xiaoyongkuidekang Granule and Kuiyang simulated capsule;22 patient in control group were treated with Kuiyang capsule and Xiaoyongkuidek-ang simulated Granule.PGE2 /TNF-α in serum tested by elisa method and symptoms integral of TCM collected in 6 weeks were analyzed statistically.Result ：There were significant statistical difference of serum PGE2（0.15 ± 0.04） ng/L（before treatment） compared with PGE2（0.33 ± 0.18） ng/L（after treatment） which got a P 〈 0.01 in experiment group.There were no significant statistical difference of PGE2（0.18 ±0.08） ng/L（before treatment） compared with PGE2（0.19 ±0.03） ng/L（after treatment） which got a P 〉 0.05 in control group.There were significant statistical difference of PGE2（after treatment） between groups which got a P 〈0.01 and the experimental group got a better effect.There were significant sta-tistical difference of serum TNF-α（76.45 ±11.36） ng/L（before treatment） compared with TNF-α（34.38 ±5.03） ng/L（after treatment） which got a P 〈0.01 in experiment group.There were significant statistical difference of serum TNF-α（78.37 ±15.89） ng/L（before treatment） compared with TNF-α（57.90 ±10.74） ng/L（after treatment） which got a P 〈 0.01 in control group.There were significant statistical difference of TNF-α（after treatment） between groups which got a P 〈0.01 and the experimental group got a better effect.There were significant statistical difference of symptoms integral of TCM collected after treatment（1.667 ±2.11） compared with integral collected before treatment（10.633 ±3.37） which got a P 〈 0.01 in experiment group.There were significant statistical difference of symptoms integral of TCM collected after treatment（4.500 ±2.39） compared with integral collected before treatment（10.700 ±3.28） which got a P 〈0.01 in control group.There were significant statistical difference of symptoms integral of TCM collected after treatment between groups which got a P 〈0.01.Conclusion： Xiaoyongkuidekang Granule had got a function with clearing away the heat evil and ex-pelling poisons,resolving carbuncle and promoting tissue regeneration.It depressed the level of serum TNF-α,increased the level PGE2 and improved symptoms of TCM of gastric ulcer,got a better effect in the treatment of gastric ulcer in active stage than control group,which disprooved the ＂poison-heat＂ was the etiopathogenisis of gastric ulcer in active stage and cytokine as PGE2 /TNF-αwere biological substructure of ＂poison-heat＂.