健胃愈疡颗粒治疗胃溃疡的临床观察

目的 观察健胃愈疡颗粒对胃溃疡患者临床疗效及胃黏膜白细胞介素-1β（IL-1β）、成纤维细胞生长因子（bFGF）mRNA表达的影响，探讨其对胃溃疡的疗效机制。方法 将56例胃镜下确诊的胃溃疡（中医辨证为肝郁脾虚证）患者随机分为两组，两组HP阳性者均服用阿莫西林与甲硝唑，治疗组（26例）服用健胃愈疡颗粒，对照组（30例）服用法莫替丁片和硫糖铝片，疗程均为4周；治疗前后观察患者的药物依从性、症状积分、胃镜疗效及HP清除率；取胃黏膜活检，并检测IL-1β、bFGF mRNA表达水平。结果（1）治疗组药物依从率（100．0％）明显优于对照组（86．7％，P〈0．01）；（2）治疗后治疗组症状积分优于对照组（P〈0．01）；（3）两组患者胃镜下溃疡治愈率、临床有效率、HP清除率比较差异无显著性；（4）RT—PCR显示：治疗后两组IL-1βmRNA表达明显降低，bFGF mRNA表达增加，与治疗前比较差异均有显著性（P〈0．01），但两组间比较差异无显著性；（5）治疗后胃黏膜形态学显示两组炎症细胞浸润明显减少，黏膜上皮细胞再生，部分腺体重建，呈囊状扩张。结论 健胃愈疡颗粒有较好的药物依从性，能明显改善患者临床症状，降低胃黏膜IL-1βmRNA水平，促进bFGF mRNA的表达，有促进溃疡修复作用。

Clinical Study on Effect of Jianwei Yuyang Granule in Treating Patients with Gastric Ulcer

OBJECTIVE: To observe the clinical effects of jianwei yuyang granule (JYG) in treating patients with gastric ulcer and its influence on interleukin-1beta (IL-1beta) and basic fibroblast growth factor (bFGF) mRNA expression in gastric mucosa for exploring the therapeutic mechanism. METHODS: Fifty-six patients with confirmed gastric ulcer unader gastroscope and differentiated as Gan-stagnant Pi-deficient syndrome were randomly assigned to two groups, the treated group (26 cases) treated with JYG and the control group (30 cases) treated with famotidine and sucralfate, 4 weeks as one therapeutic course. The changes before and after treatment in clinical compliance, symptom integral, ulcer-healing rate, clinical effective rate, and HP-clearance rate were observed. And the gastric mucosa biopsy was fetched for morphological examination and IL-1beta and bFGF mRNA expression detection by RT-PCR as well. RESULTS: The clinical compliance rate in the treated group was 100 %, which was obviously better than that in the control group (86.7 %, P< 0.01); the improvement on symptom integral in the former was also better (P < 0.01); no statistical significance was shown in ulcer-healing rate, clinical effective rate and HP-clearance rate between the two groups. Morphological observation showed markedly decreased inflammatory cell infiltration, epithelial cell regeneration and rather regular glandular arrangement in both groups. The IL-1beta mRNA expression level decreased and that of bFGF increased in both groups after treatment significantly ( P < 0.01), but showed insignificant difference between the two groups. CONCLUSION: JYG, with its good clinical compliance, has favorable effects in relieving clinical symptoms, promoting endoscopic ulcer healing and HP clearance, decreasing the expression of IL-1beta mRNA and increasing the expression of bFGF, therefore, it could promote the recovering of gastric ulcer.