| Bile reflux gastritis (BRG) is a chronic, recurrent common digestive system disease, in today’s society because of people’s diet, lifestyle changes, make its incidence increased year by year.And bile reverse flow into the stomach after the destruction of gastric mucous membrane barrier function, make the disease has superficial gastritis, atrophy and intestinal-dysplasia-the development tendency of gastric cancer, now is still very satisfied to his treatment plan, belong to the refractory diseases of the digestive system.So we get down to research about the three parts of the syndrome distribution of the characteristics, curative effect and intervention mechanism around the basic pathogenesis of BRG which is gallbladder-stomach disharmony.1 ObjectDiscussing the syndromes distribution characteristics of bile reflux gastritis. Evaluating the curative effect of the therpay of clearing heat and phlegm and harmonizing the stomach and gallbladder.Studying the mechanism of clinical intervention about BRG.2 Methods:(1) theoretical research:the bile reflux gastritis modern research progress and research progress of traditional Chinese medicine were reviewed, summarized professor Yang Jinxiang experience of treating bile reflux gastritis;(2) syndrome research:with prospective, multicenter clinical research method, collecting 140 cases from Beijing and hangzhou each through descriptive and statistical analysis method, discusses the bile reflux gastritis in syndromes differences and analyze its related impact on climate, diet, life habits;(3) therapy research:140 patients will be collected in Beijing, using randomized controlled methods, gives the cholagogic and stomach (Bamboo shavings lOg, Qing Pinellia 9 g, Artemisia Apiacea 10g, Scutellaria 10g, Fructus aurantii immaturuslOg,Pericarpium ArecaelOg, Tuckahoel5g, Cynanchum PaniculatumlOg, Tangerine PeellOg) intervention, treatment for a month, through the integration of the symptoms improvement and gastroscope microscopically and microscopically integral observed treatment effect, and 6 months follow-up after treatment symptoms integral and compared after treatment;(4) mechanism research:to explored part of the mechanism of the action by observing the changes of plasma Ghrelin, COX-1, COX-2 and PGE2 expression of the treatment group and control group patients before and after treatment with the therapy of clearing heat and phlegm and harmonizing the stomach and gallbladder.3 Results3.1 Patients in gender, age, educational background, professional distribution did not see obvious difference between Beijing and Hangzhou(P>0.05).3.2 the proportion of alcohol, tobacco in Beijing area is slightly higher than Hangzhou area (P<0.05).Spicy proportion (30.7%) of Beijing is significantly higher than Hangzhou (19.3%) (P<0.05), while the number of people fond of sweet food of Hangzhou region (37.9%) is significantly higher than the Beijing region (25.0%) (P<0.05).3.3 Beijing, hangzhou dual BRG patients with gallbladder heat make stomach syndrome (22.8%and 16.4%) and liver stomach doesn’t pass (45.7% and 35.7%), the most common liver stomach in Beijing with syndrome (22.8%), bile hot make stomach syndrome (45.7%), the incidence of gastric collaterals blood stasis syndrome (11.4%) than (16.4%,35.7%,5%) of hangzhou, hangzhou in the spleen and stomach weakness syndrome (12.1%), spleen and stomach wet and heat syndrome (14.3%), on the incidence of stomach Yin deficiency syndrome (12.9%) than in Beijing (8.6%,7.6%, 3.6%).The stomach Yin deficiency of syndrome and stomach collaterals blood stasis in both has a significant statistical difference (P<0.05).3.4 two groups of symptoms integral aspects after treatment in treatment group and control group patients before symptoms integral whole treatment improved significantly (P<0.01), the treatment group improved significantly better than that of control group (P<0.01).Symptoms of two groups in cure rate in treatment group was better than control group (P<0.05).Tip clear heat phlegm, cholagogic and stomach method to improve the symptoms of BRG is better than that in control group.3.6 the treatment group on the gastroscope integral effect significantly better than the control group (P<0.01), the evaluation of curative effect in treatment group were above 53.5%, total effective rate was 88.4%;The control group were more than 27.8%, total effective rate was 69.4%.Upon examination (P<0.05)3.7 After follow-up of patients with effective treatment, the treatment group recurrence rate was 25.4%, control group recurrence rate was 57.4%.Which has significant difference (P<0.01).Recurrence rate treatment group was obviously lower than the control group.At the time of 6 months after treatment follow-up integral treatment group and control group with significant difference (P<0.01).Points at the time of treatment group after treatment and follow-up did not differ significantly (P>0.05), while the control group after treatment and follow-up of symptom integral exists significant difference (P<0.01), follow-up points worse.3.8 Clear bravery and stomach soup treatment group after treatment of plasma Ghrelin and expression levels of PGE2 may significantly higher than that of control group (P<0.01), two groups compared with before treatment Ghrelin and the expression of PGE2 levels were elevated (P<0.01).4 Conclusion:Bile reflux gastritis in Beijing, hangzhou, both with gallbladder heat make stomach syndrome and liver stomach with the most common, the liver, gallbladder heat make stomach stomach with syndrome, gastric collaterals blood stasis syndrome type three occurrence rate is higher than in hangzhou, hangzhou weak spleen and stomach syndrome, spleen and stomach hot and humid, the incidence of stomach Yin deficiency syndrome is higher than Beijing.And influence both syndrome distribution distribution is the cause of most food, modern, and climate.Using the the therpay of clearing heat and phlegm and harmonizing the stomach and gallbladder in the treatment of bile reflux gastritis can obviously improve the symptoms, not only can better improve the BRG under gastroscope performance, at the same time can obviously reduce the disease recurrence.And clear the mechanism of action of qingdanhewei decoction treating BRG may on the one hand, through the role of Ghrelin promote gastrointestinal make bile reflux condition was significantly reduced, on the other hand, the regulation of the PGE2 by Ghrelin to implement on gastric mucosal injury repair. |
