疏肝和胃降逆汤对胃食管反流病肝胃不和证患者食管黏膜蛋白酶激活受体-2及环氧合酶-2蛋白表达的影响

目的:探讨疏肝和胃降逆汤对胃食管反流病(GERD)肝胃不和证患者食管黏膜蛋白酶激活受体-2(PAR-2)及环氧合酶-2(COX-2)蛋白表达的影响。方法:选取2015年1月至2016年1月辽宁中医药大学附属医院收治GERD患者178例作为研究对象,以随机数表法分为观察组和对照组,每组89例。2组均给予奥美拉唑肠溶片治疗,观察组在此基础上给予疏肝健脾和胃方治疗。观察2组基线期和治疗后12周(治疗后)反流性疾病问卷(RDQ)症状积分及食管黏膜PAR-2及COX-2蛋白表达变化。结果:基线期,2组RDQ症状积分、食管黏膜PAR-2及COX-2蛋白表达基本相同,差异无统计学意义(P 0. 05);治疗后,观察组RDQ症状积分、食管黏膜PAR-2及COX-2蛋白表达显著低于对照组,差异有统计学意义(P 0. 05)。观察组RDQ症状积分与食管黏膜PAR-2及COX-2蛋白表达正相关(P 0. 05),对照组RDQ症状积分与食管黏膜PAR-2及COX-2蛋白表达无明显相关性(P 0. 05)。结论:奥美拉唑肠溶片联合温阳活血汤治疗胃食管反流病肝胃不和证具有较好的疗效,其机制可能是通过降低患者食管黏膜PAR-2及COX-2蛋白表达而起治疗作用。

Effects of Shugan Hewei Jiangni Decoction on Esophageal Mucosal of PAR-2 and COX-2 Protein in Patients with Gastroesophageal Reflux Disease and with Disharmony between Liver and Stomach Syndrome

To explore the effects of Shugan Hewei Jiangni Decoction on protease activated receptor-2(PAR2)and Cyclooxygenase-2(COX-2)protein in patients with gastroesophageal reflux disease(GERD)and with disharmony between liver and stomach syndrome.Methods:A total of 178 patients with GERD were selected,from January 2011 to January 2016 in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,as the research subjects.And they were randomly divided into the observation group and the control group,with 89 cases in each group.Patients of the two groups were both given with Omeprazole Enteric-coated Tablets for the treatment.And Shugan Hewei Jiangni Decoction was added in the observation group.Changes in symptom score of Reflux diagnostic questionnaire(RDQ),esophageal mucosal of PAR-2 and COX-2 protein in the two groups were observed at baseline phase and 12 week after treatment.Results:During the baseline phase,symptom score of RDQ,esophageal mucosal of PAR-2 and COX-2 protein in the two groups was basically the same.And there was no significant difference(P>0.05); After treatment,symptom score of RDQ,esophageal mucosal of PAR-2 and COX-2 protein of the observation group was significantly lower than control groups,and it was statistically significant(P<0.05).Pearson correlation coefficient showed that symptom score of RDQ in the observation group were positive correlated with esophageal mucosal of PAR-2 and COX-2(P<0.05),while symptom score of RDQ in the control group were not correlated with esophageal mucosal of PAR-2 and COX-2 protein esophageal mucosal of PAR-2(P>0.05).Conclusions:Omeprazole Enteric-coated Tablets combined with Wenyang Huoxue Decoction has good efficacy in treating gastroesophageal reflux disease and disharmony between liver and stomach syndrome.The mechanism may be associated with reducing patients'' esophageal mucosal of PAR-2 and COX-2 protein,to get clinical efficacy.