| The first departmentObjective: To observe the therapeutic effect of Huazhuo jiedu Xiaokui Jian decoction on peptic ulcer(PU) patients with retention of turbid toxins syndrome.Method: The case-control study was adopted. The selected cases according to"Randomized Number Scale"were randomly divided into two groups: 40 patients in treatment group were treated with Huazhuojiedu Xiaokui Jian decoction; 40 patients in control group were treated with Ranitidine. Both groups were treated for six weeks. Observe the changes of Clinical symptoms', gastroscopy and Helicobacter pylori(Hp) before and after treatment .Result:(1)Comparison of clinical symptom therapeutic effect: In treatment group the total efficiency is 87.5%,which is significantly higher than that of control group(P<0.05).In control group the total efficiency is 75.0 %. (2) Comparison of the main clinical symptoms before and after treatment: After 6 weeks of treatment, all the main clinical symptoms were improved after treatment in treatment group and control group(P<0.05). There was a significantly difference between treatment group and control group after treatment (P<0.05). (3) Comparison of Gastroscopic therapeutic effect: In treatment group the total efficiency is 95%,which is significantly higher than that of control group(P<0.05).In control group the total efficiency is 72.5%. (4) Comparison of the effect on HP: In treatment group Hp positive patients were 31 before treatment, the patients were 8 after treatment; the clearance rate is 74.2%, which is significantly higher than that of control group (P<0.05).In control group Hp positive patients were 30 before treatment, the patients were 16 after treatment; the clearance rate is 46.7% (5) Comparison of prostecdtive efficacy: The ulcer recurrence rate in treatment group was 9.5% while in control group was 38.9%.There was a significantly difference between two groups(P<0.05). (6) Evaluation of therapeutic safety in the two groups: There were neither obvious changes in blood, urine or stool rules nor in Electrocardiogram or liver-renal function before and after treatment. In the course of the treatment, all patients had no undesirable response, which pointed the fact that the drug of two groups have no toxic and side effect.Conclusion: The study indicates that Huazhuojiedu Xiaokui Jian decoction can improve the clinical syndrome of peptic ulcer patients with retention of turbid toxins syndrome, restrain or eliminate Hp, improve the quality of ulcer healing and decrease the recurrence rate of Peptic Ulcer. Its curative effect is better than that of Ranitidine. It is verified that Huazhuojiedu Xiaokui Jian decoction is feasible and practicable in treating Peptic Ulcer from clinical curative effective aspect.The Second DepartmentObjective: To study the mechanism of Huazhuojiedu Xiaokui Jian decoction in treating gastric ulcer by feeding drugs and observing correlated indexes in rat model. To provide experimental evidence for clinical research.Method: 40 healthy male Wistar rats were selected randomly and divided into five groups: normal group(A), model group(B), ranitidine group(C), Huazhuojiedu Xiaokui Jian low dose group(D), Huazhuojiedu Xiaokui Jian large dose group(E) , each group had 8 rats. Rats models were made by using acetic acid to erode the gastric mucosa except the normal group. After 24 hours of the operation, the drug was given. The amount of Huazhuojiedu Xiaokui Jian decoction given to group E and group D was22.1g/( kg?d ) and 5.5g/( kg?d ) respectively. The amount of ranitidine given to group C was 31.25mg/( kg?d ). The distilled water was given to group A and group B respectively. Ten days later, all the rats were killed to observe the following index: platelet activating factor(PAF), calicitonin gene related peptide(CGRP), gastric mucosa, ulcer index(UI) and pathology of gastric mucosa tissue.Result: (1)Observation of gastric mucosa: Through calculating ulcer index and ulcer inhibition ratio, we found that there was therapeutic effect on ranitidine group, lower dose group and large dose group, but it was the most manifestion in large dose group.(2)observation of gastric mucosa tissue: HE tincted microtome section: Model group: ulcer in progression period, some ulcer reached to muscular layer, inflammatory necrosis, exfiltration, inflammatory cell infiltration. Ranitidine group: ulcer in convalescent period, some regenerated glandular organ in borderline showed crytomere distension and neogenesis vascellum was abundance in granulated tissue. granulated tissue. Low dose Group: ulcer in convalescent period, necrotic tissue was decreased in ulcer surface, regenerated glandular organ was irregularly distented, mucus secretion was abundance, granulationtissue hyperblastosised, inflammatory cell infiltration and abundanced in micrangium. Large dose group: ulcer in convalescent period, ulcer diminished, regenerated glandularorgan in borderline showed cryptomere distension, quantity of regenerated glandular organ was increased, tela cellulose diminished, quantity of collagenous fibrils was increased and abundance in micrangium. (3)Level of CGRP in low dose group, large dose group and ranitidine group was increased significantly than that of model group(P<0.05),while PAF level was dropped significantly in those groups than that of in model group(P<0.05).Conclusion: Huazhuojiedu Xiaokui Jian may improve the microcirculation of gastric mucosa by increasing the level of protective factors such as CGRP and decreasing the level of aggressive factors such as PAF to cure peptic ulcer.
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