|
Objective: This issue through experimental and clinical research, observation of Jianwei Yuyang Granule (Jianweiyuyang granules, JWYY) peptic ulcer (the Peptic ulcer PU) healing process in the PAF, the PS 2 of expression impact on the the hexosamine phospholipid content and gastric mucosal surface contact angle (Contact Angle, CA), from the perspective of the gastric mucosal surface hydrophobicity to explore JWYY treatment PU and anti-ulcer recurrence mechanism. Methods: 1. Experimental study: 108 rats were randomly divided into 5 groups, normal control group (12), sham operation group (n = 12), model group (n = 36), JWYY group (24), Ray Nigeria for the small group (referred to as the Rani group) (24). Using The improved the Okabe acid smearing copy of experimental gastric ulcer model, modeling normal control group, sham-operated group with saline instead of acetic acid, and 24 h after modeling, JWYY group, Rani group were fed to JWYY and ranitidine drug liquid, the amount of 1.62 g / (kg · d), 27mg / (kg · d) weight, the rest of the group fed with distilled water, the amount of are 1ml/100g body weight once a day. Of modeling 90d, then the model group rats were randomly divided into model group and model of recurrent group, intraperitoneal injection of interleukin-prime-1beta (interleukin-1beta, IL-1beta) (1μg/kg weight) copy the model of gastric ulcer recurrence, model group with saline instead of IL-1beta. Were modeling the first day, 92d (ie, the recurrence of ulcers induced 48h) average 2 batches of each group were sacrificed rats, laparotomy stomach, along around the ulcer cut approximately 1 × 1 cm 2 size of the stomach organizations, scraping the gastric mucus Cryopreservation for the determination of phospholipids and hexosamine, and stomach tissue samples were divided into three: part of its rapidly into the liquid nitrogen bottle standby for RT-PCR and Western blotting. stomach the ulcer recurrence rat PAF, PS 2 expression changes; part of the rapid immersion in 4% paraformaldehyde (pH 7.4) and fixed 16h, then dehydrated, embedded in paraffin, sliced, HE staining, immune was used to detect recurrence of gastric ulcer in rats PAF PS 2 expression changes; the last part of the mucosal surface contact angle measurement, observation JWYY the hexosamine phospholipid content and gastric mucosal surface contact angle. 2 clinical studies: Select peptic ulcer confirmed by endoscopy (Peptic ulcer, PU) patients, 72 cases (TCM is liver depression and spleen deficiency syndrome), which is confirmed by endoscopy and histology and urease check Helicobacter pylori (Helicobacter pylori Up) positive PU and TCM is the liver spleen the 50 patients JWYY the treatment group and ranitidine (ranitidine, Rani) control group of 36 cases. The above cases were consistent with the diagnostic criteria of the 5th edition PU in science \Treatment: The treatment group received JWYY each 9g oral, 3 times / d. The control group was given the the Rani, each 0.15g oral, 2 times / d, HP positive plus amoxicillin and metronidazole. Four weeks constituted one course of treatment. The clinical observation observe the efficacy of endoscopy after treatment, Hp eradication rate, syndromes, 1-year recurrence rate. Two sets of PU patients take endoscopic ulcer edge biopsy specimens 4-5 blocks a Hp test; more than one paraformaldehyde fixed paraffin sections prepared immune histochemical examination detection PAF PS 2 expression changes; a scraped the gastric mucus measured amino hexose, phospholipid content and gastric mucosal surface contact angle; one to two liquid nitrogen tank, and later stored at -70 ℃ to prepare to do immunofluorescence and Western blotting detection PAF PS 2 expression changes. Another in obtaining the informed consent of patients, endoscopy was obtained from 12 patients with no mucosal lesions of gastric mucosa specimens 4-5 block as a control group, the normal group. Normal group without treatment and review, just take the check specimens. After a course the PU patients in accordance with the previous method to take the gastric mucosal biopsy specimens. Results: 1. Experimental study: gastric ulcer modeling 7d, in addition to the normal group and sham operation group, the remaining rats in each group corresponding gastric acid modeling parts of visual observation and histological examination can be seen in ulcerative lesions, ulcers varying degrees , the the model group GUI highest JWYY group, Rani group GUI were significantly lower than the model group (P <0.01). Healing of JWYY group ulcers Histomorphological performance is better than Rani group (P <0.01). The the 92d, JWYY group, model recurrence group, Rani group recurrence rate was 75%, 16.7%, 58.3%, the latter two with the former more significant difference (P <0.01). JWYY group than Rani groups see renewable mucosa thicker, more complete repair. JWYY group significantly reduce the rate of recurrence of ulcers and ulcer index (P <0.01) better than Rani group. Model 92d, the JWYY group UI and ulcer recurrence rate was significantly lower than the other groups (P <0.01). JWYY group hexosamine, increased phospholipid content and CA the ranitidine group difference was significant (P <0.01). Immunohistochemistry and RT-PCR, Western blotting analysis showed that: hexosamine in rats, phospholipid content and CA with PAF, ps 2 of the expression of linear correlation (P <0.01), JWYY particles improve PS 2 and down-regulation of the expression of the PAF, affect gastric mucosal hexosamine and phospholipid content and CA, thus affecting the hydrophobicity of the gastric mucosa, which may be one of the mechanisms that promote ulcer healing. 2 clinical studies: we found through clinical observation JWYY treatment group and Rani control group can be effective in the treatment of PU, to both endoscopic ulcer healing rate (P> 0.05), but the treatment group than the control group to better improve the clinical symptoms and 1-year recurrence rate decreased (P <0.05), treatment group, 1-year recurrence rate was 4.1% in the control group was 30%, the two groups had significant difference (P <0.01). And the optical microscope, the PU patients by JWYY treatment than before treatment, the increase in the thickness of the mucosa, repair a more complete ulcer bed and around the ulcer less infiltration of inflammatory cells, fibers arranged in order, with the ranitidine group than there was significant difference (P <0.01). JWYY group hexosamine, increased phospholipid content and CA the ranitidine group difference was significant (P <0.01). Immunohistochemistry and RT-PCR, Western blotting analysis showed that: the PU patients hexosamine phospholipid content and CA and PAF PS 2 of expression linear correlation (P <0.01), JWYY particles improve PS 2 and down-regulation of the expression of the PAF, affect gastric mucosal hexosamine and phospholipid content and CA, thus affecting the hydrophobicity of the gastric mucosa, which may be one of the mechanisms that promote ulcer healing. Conclusion: from animal experiments to clinical observation, have proved JWYY can promote the healing of peptic ulcer and anti-ulcer recurrence. The 2.JWYY particles by increasing the PS 2 and down PAF expression, affect the gastric mucosal hexosamine and phospholipid content and CA, thus affecting the gastric mucosa hydrophobic, strengthen the stability of the mucus gel layer, which prevent the generation and recurrence of ulcers, which may be one of the mechanisms to promote ulcer healing
|