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[目的]观察治疗前、后反流性食管炎(RE)患者血清PPARγ、HIF-1α水平及其主要症状变化,探讨半夏厚朴汤治疗RE可能机制。[方法]采用简单随机对照设计,40例符合诊断标准、纳入标准和排除标准的反流性食道炎患者,按1:1分为对照组与治疗组。对照组给予泮托拉唑,治疗组予半夏厚朴汤+泮托拉唑治疗,疗程均为4周。采用临床症状评分对患者病情进行评估,应用Western blot技术检测食管黏膜组织中PPARγ及HIF-1α水平。[结果]治疗组总有效率为85%;对照组总有效率为75%,差异无统计学意义。治疗前,各组食道黏膜PPARγ及HIF-1α水平均呈上升趋势;治疗后,治疗组PPARγ及HIF-1α表达均呈下降趋势,经比较,差异有统计学意义(P<0.05),而对照组治疗后,上述指标无明显变化。[结论]半夏厚朴汤可能通过下调PPARγ及HIF-1α表达,改善食道黏膜炎症状态下缺氧微环境变化,发挥缓解反流性食道炎临床症状的效用。
[Objective] To observe the changes of serum PPARγ, HIF-1α levels and their main symptoms in patients with reflux esophagitis (RE) before and after treatment and explore the possible mechanism of the treatment of RE with Banxia Houpu Decoction. [Method] A simple randomized controlled trial was designed. Forty patients with reflux esophagitis who met the diagnostic criteria and were excluded from the standard were divided into control group and treatment group according to 1: 1. The control group was given pantoprazole, and the treatment group was treated with Banxia Houpu Tong + Pantoprazole for 4 weeks. The clinical symptom score was used to evaluate the patient’s condition. Western blot was used to detect the levels of PPARγ and HIF-1α in esophageal mucosa. [Results] The total effective rate of the treatment group was 85%; the total effective rate of the control group was 75%, the difference was not statistically significant. Before treatment, the levels of PPARγ and HIF-1α in esophageal mucosa of all groups showed an increasing trend. After treatment, the expression of PPARγ and HIF-1α in the treatment group showed a decreasing trend, the difference was statistically significant (P <0.05) After treatment, the above indexes did not change significantly. [Conclusion] Banxia Houpu Decoction may reduce the hypoxia and microenvironment changes of esophageal mucosa inflammation by down-regulating the expression of PPARγ and HIF-1α and exert the effect of relieving the clinical symptoms of reflux esophagitis.