摘要
目的:评价根除H pylori加疗胃煎剂对大鼠H pylori相关性慢性胃炎病变的影响.同时观察治疗前后环氧合酶-2 (Cyclooxygenase-2,COX-2)表达的变化. 方法:体质量80-100 g二级(?) Wister大鼠80只,采用H pylori及MNNG综合方法制备大鼠H pylori相关性慢性胃炎模型76只,血清H pylori抗体阳性54只随机分为4组:H pylori根除与疗胃煎剂组(14只)、H pylori根除与“麦滋林”组(阳性对照组)(14只)、自然恢复组(阴性对照组)(13只)、单纯H pylori根除组(13只).治疗结束后,行胃窦黏膜涂片Gram染色和快速尿素酶试验,检测H pylori的定植情况,并对胃窦黏膜组织学各项指标进行评定;采用免疫组化染色方法,检测胃窦黏膜的COX-2的表达. 结果:自然恢复组大鼠均有H pylori定植,其他各组大鼠胃黏膜均未发现H pylori定植;自然恢复组的大鼠表现中度萎缩病变(2.0±0.20分),伴有中度急性、慢性炎症(2.0±0.20分、1.90±0.39分);而H pylori根除联用疗胃煎剂组,与自然恢复组比较,萎缩病变(1.25±0.44分)轻度改善,伴急性炎症(0.3±0.47分)消退,慢性炎症(1.05±0.22分)轻度改善,差异显著(P<0.05);H pylori根除与麦滋林组胃窦黏膜层萎缩病理积分为2.0±0.43分,较自然恢复组无明显差异,但急性炎症消退,慢性炎症无改善.单纯H pylori根除组,与自然恢复组比较,萎缩病变和慢性炎症未见改善,但活动性炎症消退;单纯根除H pylori 组、根除H pylori与联用疗胃煎剂组、H pylori根除与麦滋林组、自然恢复组COX-2表达率分别为14.0±3.7%、10.0±3.8%、13.0±4.0%、19.0±10.2%,治疗组与自然恢复组比较,胃窦黏膜COX-2表达率明显下降,差异显著(P<0.05). 结论:对H pylori相关性慢性胃炎,根除H pylori可明显降低COX-2表达,明显改善急性炎症,但对慢性病变尤其萎缩病变无明显影响.根除H pylori的基础上应用疗胃煎剂治疗12 wk有较好的疗效.
AIM: To evaluate the effects of H pylori eradication with liaowei decoction on pathologic changes and COX-2 expression of H pylori-associated chronic gastritis in rats. METHODS: A total of 80 grade-Ⅱ male Wister rats weighing 80-100 g were given H pylori and MNNG to prepare H pylori-associated chronic gastritis model with 4 mice dead. Among them, 54 rats with H pylori serum antibody positive were randomly divided into 4 groups: H pylori eradication with liaowei decoction (14 rats); H pylori eradication with Maizilin (positive control, 14 rats); spontaneous recovery (negative control, 13 rats); and simple H pylori eradication therapy (13 rats). After treatment, both Gram staining of gastric antrum mucosal smear and rapid urease testing were made to detect the H pylori colonization of the gastric mucosa and to assess the histological indexes of gastric antrum mucosa. Immunohistochemical staining was also performed to detect COX-2 expression. RESULTS: The colonization of gastric mucosa by H pylori was found in rats from spontaneous recovery group, as an indication of long-term continuous H pylori infection, while no colonization was found in rats from other groups. Pathological changes of gastric antrum mucosa included moderate gastric mucosal atrophy in rats from spontaneous recovery group (pathologic integration 2.0±0.20 points), associatded with moderate acute or chronic gastric mucosal inflammation (pathologic integrations were 2.0±0.20 points and 1.90±0.39 points, respectively). In comparison with spontaneous recovery group, treatment effectiveness in the group of H pylori eradication with liaowei decoction was remarkably different (P<0.05). The gastric mucosal atrophy in the combination group (pathologic integration 1.25+0.44 points) was less severe, while acute gastric mucosal inflammation (pathologic integration 0.3±0.47 points) was extincted, and chronic inflammation (pathologic integration 1.05±0.22 points) was less severe; For the group of H pylori eradication and 'Maizilin', pathologic integration of gastric mucosal atrophy was 2.0±0.43 points. In comparison with spontaneous recovery group, there was no remarkable difference, however, acute inflammation was extincted and chronic inflammation was the same as before. Gastric mucosal atrophy and chronic inflammation were more severe in simple H pylori eradication group than those in spontaneous recovery group, while active inflammatory changes extincted. COX-2 expression of gastric antrum mucosa in the group of simple H pylori eradication, group of H pylori eradication with liaowei decoction, group of H pylori eradication and Maizilin as well as spontaneous recovery group were 14±3.7%, 10+3.8%, 13±4.0% and 19±10.2%, respectively. In comparison with spontaneous recovery group, COX-2 expression of the treatment groups were greatly decreased as an indication of remarkable difference (P<0.05). CONCLUSION: COX-2 expression and acute inflammation can be greatly decreased by applying H pylori eradication therapy in the treatment of H pylori-associated chronic gastritis, but the therapy cannot do much to chronic pathologic changes, especially to atrophic changes. Application of the combined therapy of H pylori eradication with 'liaowei decoction' for 12 weeks will have better treatment effectiveness on chronic pathologic changes, especially atrophic changes.
出处
《世界华人消化杂志》
CAS
2004年第1期97-100,共4页
World Chinese Journal of Digestology
