胃复春联合替普瑞酮对慢性萎缩性胃炎患者血清核转录因子-κB、环氧合酶-2、白细胞介素8的影响

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目的:观察胃复春联合替普瑞酮对慢性萎缩性胃炎(CAG)患者血清核转录因子-κB(NF-κB)、环氧化酶-2(COX-2)、白细胞介素8(IL-8)的影响。方法:将2017年6月至2018年6月在余姚市妇幼保健院就诊且符合纳入标准的CAG患者118例,依据随机单盲法将其分为联合治疗组和西药组各59例。两组患者在常规治疗的基础上,联合治疗组给予胃复春和替普瑞酮联合口服治疗,西药组给予口服替普瑞酮治疗;治疗2个疗程后,观察比较两组临床症状改善情况、胃镜下疗效及患者血清NF-κB、COX-2、IL-8水平的变化情况。结果:经过2个疗程的治疗后,共脱落4例患者,其中联合治疗组、西药组各2例。联合治疗组患者在充血(85.42%)、水肿(86.00%)、糜烂(80.77%)、胆汁反流(41.18%)方面的改善情况均明显优于西药组[充血(66.67%)、水肿(68.63%)、糜烂(52.17%)、胆汁反流(35.29%)](χn 2=5.763、6.421、8.976、0.001,均n P<0.05);两组患者胃镜下观察积分[联合治疗组(1.98±0.65)分、西药组(2.03±0.57)分]均比治疗前[联合治疗组(0.92±0.47)分、西药组(1.19±0.46)分]显著改善(n t=6.127、5.764,均n P<0.05),联合治疗组的积分差高于西药组(n t=5.413,n P<0.05);联合治疗组症状积分:上腹疼痛(2.89±1.45)分、嗳气(2.62±1.38)分、反酸(2.34±0.87)分、恶心呕吐(3.06±1.67)分,均明显优于西药组[上腹疼痛(3.98±1.58)分、嗳气(3.72±0.93)分、反酸(4.16±1.26)分、恶心呕吐(4.92±1.15)分](n t=8.142、6.199、0.786、9.462,均n P<0.05)。联合治疗组NF-κB(8.94±2.01)ng/mL、COX-2(11.84±3.27)ng/mL及IL-8(28.32±6.85)pg/mL水平在治疗后明显降低,且差异均有统计学意义(n t=9.643、8.096、5.718,均n P<0.05)。n 结论:胃复春可明显改善患者胃镜下胃黏膜充血、水肿、糜烂情况,有效抑制胃黏膜萎缩,与替普瑞酮联合应用治疗CAG疗效确切,这可能与其调节血清NF-κB、COX-2及IL-8的水平相关。“,”Objective:To observe the effect of Weifuchun combined with teprenone on serum nuclear transcription factor-κB (NF-κB), cyclooxygenase-2 (COX-2) and interleukin 8(IL-8) in patients with chronic atrophic gastritis (CAG).Methods:From June 2017 to June 2018, 118 CAG patients who admitted in the Yuyao Maternal and Child Health Hospital and met the inclusion criteria were divided into combination treatment group and western medicine group according to the randomized single-blind method, with 59 cases in each group.On the basis of conventional treatment, the combination treatment group was given Weifuchun and teprenone in combination with oral therapy, and the western medicine group was given oral teprenone.After 2 courses of treatment, the improvement of clinical symptoms, efficacy under gastroscopy and the changes of serum NF-κB, COX-2 and IL-8 levels of the two groups were observed and compared.Results:After two courses of treatment, a total of 4 patients were shed, of which 2 cases were in the combined treatment group and 2 cases in the western medicine group.The patients in the combination treatment group had significantly better improvements in congestion (85.42%), edema (86.00%), erosion (80.77%) and bile reflux (41.18%) than those in the western medicine group[congestion (66.67%), edema (68.63%), erosion (52.17%), bile reflux (35.29%)](χn 2=5.763, 6.421, 8.976, 0.001, all n P<0.05). The underwent gastroscopy scores of the two groups after treatment [combined treatment group (1.98±0.65)points, the western medicine group (2.03±0.57)points] were significantly improved compared with pre-treatment[combined treatment group (0.92±0.47)points, the western medicine group (1.19±0.46)points](n t=6.127, 5.764, all n P<0.05). The score difference of the combined treatment group was higher than that of the western medicine group (n t=5.413, n P<0.05). The symptom scores of the combined treatment group [epigastric pain (2.89±1.45)points, belching (2.62±1.38)points, and acid reflux (2.34±0.87)points, nausea and vomiting (3.06±1.67)points] were significantly better than those of the western medicine group[upper abdominal pain (3.98±1.58)points, belching (3.72±0.93)points, acid reflux (4.16±1.26)points, nausea and vomiting (4.92±1.15) points](n t=8.142, 6.199, 0.786, 9.462, all n P<0.05). The levels of NF-κB [(8.94±2.01)ng/mL], COX-2 [(11.84±3.27)ng/mL] and IL-8 [(28.32±6.85)pg/mL] in the combined treatment group were significantly reduced after treatment, and the differences were statistically significant (n t=9.643, 8.096, 5.718, all n P<0.05).n Conclusion:Weifuchun can significantly improve the gastric mucosa congestion, edema and erosion under gastroscopy, effectively inhibit gastric mucosal atrophy, and the combined use of teprenone in treating CAG is effective, which may be related to its effect on adjusting serum NF-κB, COX-2 and IL-8 levels.
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