Clinical And Pathological Intervention Study On Treatment Of Primary Bile Reflux Gastritis With Qingchanghewei Decoction

1Object Discussing the syndromes distribution characteristics of primary bile reflux gastritis correlation with endoscopic performance,Evaluating the curative effect of the therpay and pathology of qingdanhewei decoction. Studying the mechanism of clinical intervention about PBRG.2Methods:(1)Theoretical study is divided into modern research of bile reflux gastritis and traditional Chinese medicine of bile reflux gastritis. (2) Syndrome association study:By collecting 102 cases of clinical data compilation and statistical description, to explore the correlation between TCM syndrome and endoscopic performance;(3) therapy research:102 patients will be collected in Beijing, using randomized controlled methods, gives the Qingdanhewei decoction(Bamboo shavings 10g, Qing Pinellia 9 g, Artemisia Apiacea 10g, Scutellaria 10g, Fructus aurantii immaturus10g,Pericarpium Arecae10g, Tuckahoe15g, Cynanchum Paniculatum10g, Tangerine Pee110g) intervention, treatment for a month, Through the integration of the symptoms improvement and gastroscope microscopically and gastric mucosa pathological histology change observed treatment effect;(4) mechanism research:to explored part of the mechanism of the action by observing the changes of MTL and GAS,TNF-a expression of the treatment group and control group patients before and after treatment with the therapy of Qingdanhewei decoction.3ResultsExperiment 1:In the age distribution, PBRG patients 51-60 years of age, the highest incidence; in the course of distribution 1--3 years the largest proportion, distribution predisposing factors, mainly diet most common. Among them, eat spicy and most sweets. In Syndrome distribution, gallbladder heat Fan Wei syndrome is the most common, followed by liver and stomach syndrome, spleen and stomach, spleen, stomach yin deficiency syndrome, stomach meridian stasis syndrome. Syndromes and gastric Relevance:mucosal edema more common in disharmony and permits, followed by Fan Wei gallbladder heat syndrome; mucosal edema, erosion is more common in hot gallbladder Fan Wei syndrome, followed by Spleen; mucosal bleeding found in the stomach meridian stasis syndrome, liver and stomach syndrome. Experiment II:Clinical symptoms:the two groups in terms of clinical symptoms total score after treatment, the treatment group and the control group of patients overall symptom scores than before treatment improved significantly (P<0.05), the improvement of the treatment group than the control group (P<0.05). Tip phlegm, stomach and gallbladder BRG method in improving symptoms than the control group. Gastroscopy efficacy:the efficacy of the two groups in endoscopy evaluation of the treatment group and 87.5%; control group, the total efficiency of 72.4%. Upon examination P<0.05, treatment group than the control group. Gastric pathology effect:after being treated for integral lamina propria edema, vasodilatation integration, integration of inflammation were decreased (P <0.05) than before, the treatment group than the control group (P<0.05), gall bladder and stomach prompt clearance soup by reducing the blood vessels to dilate, lamina propria edema, reduce inflammation and play a therapeutic role.Experiment III:In the two groups after treatment in patients with serum MTL level significantly increased compared with before treatment (P<0.05), two groups of patients’serum GAS, after treatment TNF-a level are significantly lower than before treatment, and GAS, serum TNF-a treatment group were significantly lower than the control group (P<0.05).4Conclusion:①Various syndrome of traditional Chinese Medicine and microscopically mucosal lesions has certain relevance, provide a micro basis for syndrome differentiation of traditional Chinese medicine.②Bile reflux gastritis with gallbladder heat make stomach syndrome and liver stomach with the most common, treatment should be clear heat phlegm, cholagogic and stomach for treatment; It not only can obviously improve symptoms, can also relieve inflammation of bile reflux gastritis.③qingdanhewei decoction treating PBRG may be through regulating the pathological state of TNF alpha, excessive secretion of GAS and MTL secretion insufficiency, thus reducing the degree of bile reflux gastritis.