The Clinical And Experimental Study Of JZYYP To Prevent And Cure The Injury Of Gastrointestinal Tract By NSAIDs

Nonsteroidal anti-inflammatory drugs(NSAIDs) is a group nonsteroidal drugs which have anti-inflammatory, analgesic and antipyretic effects. NSAIDs is the generally clinical active drugs to treat rheumatoid arthritis and osteoarthritis, even more use for fever, painful disease and prevent heart-cerebral vascular accident. But NSAIDs is one kind drugs of much adverse effect, especially in long-term use. The most common adverse effect is the injury of gastrointestinal tract. NSAIDs can cause dyspepsia, mucosal erosion of gastrointestinal tract, peptic ulcer or hemorrhage, even more threat to life. Therefore, it is an ordinary problem for clinical doctors to prevent and cure the injury of gastrointestinal tract by NSAIDs. This article is the initial research on how the Chinese Medicine to prevent and cure the injury of gastrointestinal tract by NSAIDs. The paper includes theoretical, experimental and clinical study.Theoretical ResearchNSAIDs have a lot of adverse effects, the most common is reaction of gastrointestinal tract. It is have been proved that NSAIDs can result in the injury of gastric mucosa by inhibition of protective prostaglandin synthesis through suppress the activity of cycloxygenase interfere with the metabolism of arachidonic acid. Numerous researches have showed that the protection gastric mucosa of the traditional Chinese medicine relevant to increase prostaglandin synthesis in the gastric mucosa. For example, the extractive of Codonopsis pilosula can obviously elevate the prostaglandin E2 density of the normal rat. The complex prescription of Astragali seu Hedysari Decoctioncan prohibite the degression of the prostaglandin E2 density caused by indomethacin in rat, and also obviously elevate the prostaglandin E2 and prostaglandin El density of the patients in treatment of the peptic ulcer and erosive gastritis. Therefore, it' s presumed that the YIQIJIANPI traditional Chinese medicine prevent and cure the injury of gastrointestinal tract by NSAIDs relevant to regulate expression of cycloxygenase influence on the synthesis of prostaglandin .Clinical ResearchThrough clinical observation the semiquantitative score of traditional Chinese medicine symptom in prior treatment and post treatment of JIANZHONGYUYANGPIAN and famotidine to cure the injury of gastrointestinal tract by NSAIDs, evaluate therapeutic effect of JIANZHONGYUYANGPIAN to cure the injury of gastrointestinal tract by NSAIDs.Object and MethodThe 47 subjects of the injury of gastrointestinal tract by NSAIDs were divided into 2 groups according to the random number of 1: 1 proportion. The treatment group were administered JIANZHONGYUYANGPIAN 4 tablets every time, three times a day; the control group were administered famotidine 20mg every time, twice a day, take the medicine after meals. The therapeutic course for both groups was 2 weeks. Observe indicatrix were the symptoms of the inflation of gastric cavity, the pain of gastric cavity, nausea and vomiting, belching and pantothenic acid, anorexia, fatigued and weak, tasteless and dry mouth, noncoagulativ stool and so on. According to the light and heavy press the symptoms were divided into 4 ranks(0, 1, 2, 3). Evaluate the therapeutic effect is count scores on prior treatment and post treatment.ResultThe 47 objects were divided into 2 groups: the treatment group(n=23) and the control group(n=24). The 2 groups have the comparability prior to the treatment, the difference between gender, age, the degree of pathogenetic condition, the score of traditional Chinese medicine symptom, entity and the NSAIDs is not statistically significant(P>0.05).Among the treatment group 23 objects , it' s 4 objects were clinical control,11 objects were excellence, 6 objects were in effect, 2 objects were ineffective. The markedly effective rate was 65.2%, the effective rate was 91. 3%.In the control group, it' s 4 objects were clinical control,10 objects were excellence, 7 objects were in effect, 3 objects were ineffective. The markedly effective rate was 58.3%, the effective rate was 87. 5%. The 2 groups were therapeutic equivalence and not statistically significant. They have the therapeutic equivalence on clinical relief in symptom of the inflation of gastric cavity, the pain of gastric cavity, belching and pantothenic acid, anorexia, fatigued and weak, tasteless and dry mouth. The treatment group have an advantage on fatigued and weak than the control group.ConclusionThe JZYYP have the efficacy of invigoration the spleen and the stomach, astringe sore and recover ulcer, promoting blood flow and dissolve stagnant blood. It' s effect in relieve the symptoms of the injury of gastrointestinal tract by NSAIDs.Experimental ResearchTo investigate the mechanism action of JZYYP prevent and cure the injury of gastrointestinal tract by NSAIDs, observe JZYYP, Codonopsis pilosula drug granules and famotidine protect the gastric mucosa of indomethacin rat and the influence on the prostaglandin E2 , cox-1, cox-2.Material and Method(?) SD 102 rats were divided into 7 groups, each group contain 16 rats. The 7 groups were: ①the blank control group: intragastric administration isotonic Na chloride 2ml/d. ②the model group: intragastric administration isotonic Na chloride 2ml/d.　③ the famotidine group: intragastric administration famotidine 7.14mg/kg D d-1。④Codonopsis pilosula 1 group: intragastric administration Codonopsis pilosula 0. 71g/kg · d-1。 ⑤Codonopsis pilosula 2 group: intragastric administration Codonopsis pilosula 2. 84g/kg·d-1。 ⑥JZYYP 1 group: intragastric administration JZYYP 0. 27g/kg·d-1。 ⑦JZYYP 2 group: intragastric administration JZYYP 1.08g/kg · d-1。Afterintragastric administration continuously 7 days, every rat was hypodermic inject indomethacin 20mg/kg except the blank control group. Seven hours later, 8 rats from each group randomly were etherizated and executed, cut the belly open to take the stomach. The remnant 8 rats of each group were executed after continue feed and intragastric administration for the other 7 days. Scissore the 0. 5cm×0.5cm tissue from the sinus ventriculi, then put into the 10% neutral formalin to fixate. The gastric mucosa were scraped with glass slide above the ice, quick freeze by placed into liquid nitrogen in the freeze survive tube, then transfer into -70℃ refrigerator to be conserved. It' s used HE dyeing and Guth> Whittle score standard to evaluate the injury of gastric mucosa. The enzyme immunoassay was applied to detect the prostaglandin E2 density of the gastric mucosa, the immunohistochemistry and western blotting were applied to detect the expression of cox-land cox-2 in the gastric mucosa of the indomethacin rats.Result1. Evaluation to the injury of gastric mucosaSeven hours after hypodermic injection indomethacin, the rats of the model group can be seen damage on the gastric mucosa, the damage chief locat on the sinus ventriculi. The most damage is trabsous hemorrhage on the mucosa. There' re extensive spot film and streak like hemorrhage or erosion, a few or a little ulcer on the gastric mucosa. The rats of JZYYP , Codonopsis pilosula and famotidine group can be seen the different degree erosion and hemorrhage on the gastric mucosa, but obviously decrease than the model group. It' s showed on the histopathology that the cell degeneration, amotion of surface epithelium, and erosion, exudation, congestion and dropsy in the mucosa. There are hemorrhage accompany a small quantity cellular necrosis of deep layer in the middle and substratum of the gastric gland. The rats of medication administration group only have the cellula epithelialis desquamate, break off the gastric gland or hemorrhage on the upper layer. The medication administration group contain the famotidine group, Codonopsis pilosula 1 group, Codonopsis pilosula 2 group, JZYYP 1 group, JZYYP 2 group, whose injure index number of gastric and histopathology score are all lower than the model group(P<0. 01). The Codonopsis pilosula 2 group and JZYYP 2 group are lower than that of the famotidine group, Codonopsis pilosula 1 group, JZYYP 1group(P<0. 05).Seven days after hypodermic inject indomethacin, the rats of the model group can be seen a bit of damage on the gastric mucosa, which obviously attenuation, mucosal fold decrease and flat, gastric wall elasticity attenuated. The damage on the gastric mucosa of medication administration groups were decreased than that of the model group. Those rats of the model group, the famotidine group, Codonopsis pilosula 1 group, Codonopsis pilosula 2 group, JZYYP 1 group, JZYYP 2 group, are respectively significant improve than that of 7 days before (P<0. 01) . The Codonopsis pilosula 2 group and JZYYP 2 group have an advantage than that of the model group (P<0.05) . The famotidine group, Codonopsis pilosula 1 group, JZYYP 1 group are not statistically significant than the model group (P>0.05) .2. The influence on gastric mucosa tissue PGE2 of the indomethacin ratsSeven hours after hypodermic inject indomethacin, the prostaglandin E2 density of the model group is obviously lower than that of the blank control group (P<0.01) . The prostaglandin E2 density of the famotidine group, Codonopsis pilosula 1 group, Codonopsis pilosula 2 group, JZYYP 1 group, JZYYP 2 group are lower than of the blank control group (P<0. 01) ,but higher than that of the model group (P<0. 01). Seven days later, the prostaglandin E2 density of the famotidine group, Codonopsis pilosula 1 group, Codonopsis pilosula 2 group, JZYYP 1 group, JZYYP 2 group, are respectively significant increase than that of 7 days before (P<0. 01) , and the medication administration groups are all higher than the model group (P<0.05) .3. The regulated expression on cycloxygenase in gastric mucosa of the indomethacin ratsThe detection of the immunohistochemistry and western blotting showed that it is obviously express of cox-1 in the blank control group rats seven hours after hypodermic inject indomethacin. The expression of cox-1 in the model group rats is obviously weak. The expression of cox-1 decrease than the blank control group in the rats of groups of the famotidine group, Codonopsis pilosula 1 group, Codonopsis pilosula 2 group, JZYYP 1 group, JZYYP 2 group, which increase than the model group. Seven days later, the expression of cox-1 is not change in the rats of the blank control group, the expression is...