| Part1.Clinical ResearchObjective:To observe the therapeutic effect of Huazhuojiedu prescription intreating the Zhuoduneiyun type of Bile Reflux Gastritis patients.Method:The selected cases according to Randomized Number Scale wererandomly divided into two groups:30cases in treatment group(1caselosed)were administered with Huazhuojiedu Prescription(kushen6gpugongying12g huangqin9g huanglian6g doukou12g sharen6g fuling12gbaizhu6g chuipencao9g dijincao9g tianjihuang9g);30cases in the control groupwere administered with Motilium.Both groups were treated for sixweeks.Clinical symptoms changes,gastroscopychanges,recurrence conditionbefore and after treatment were detected to evaluate the therapeutic effects.Result:(1)Clinical symptom therapeutic effect:The total efficiency of thetreatment group was82.8%,which was higher than that of the controlgroup`s56.7%(P<0.05).(2)Total scores of main clinical symptoms:thesymptoms were improved after treatment in both the treatment and the controlgroup(P<0.05),wihle after treatment,total scores of main clinical symptoms incontrol group were lower than that in treatment group,there was a significantlydifference between these two groups,(P<0.05).(3)Gastroscopic therapeuticeffect:the total efficiency of the treatment group was86.2%while the controlgroup63.3%,there was a significantly difference between two groups(P<0.05).(4) recurrence condition:the recurrence of treatment group was11.11%,whichwas significantly lower than the control group`s66.67%(P<0.05).(5) Safetyevaluation:the blood routine,urine routine,ECG,liver and renal function whichwere examed before and after the treatment of59cases were not significantlychanged during medication,it indicated that there was no toxic effects in themedicine of two groups. Conclusion:Clinical study indicated that the therapeutic effect of theHuazhuojiedu Prescription was better than the control group.HuazhuojieduPrescription can significantly improve the clinical symptoms of theZhuoduneiyun type of Bile Reflux Gastritis patients,and reduced therecurrence rate of BRG.Part2.Experimental ResearchObjective:To study the mechanism of Huazhuojiedufang in treating theBRG through the production of Zhuoduneiyun type of BRG rat modle andanalysis the relevant indicators.While to provide the evidence for clinicalresearch.Method:60male Wistar rats were divided randomly into6groups:A(blankcontrol group),B(model group),C(Domperidone group),Da(Huazhuojiedufanglow dose group),Db(middle dose group),Dc(large dose group),10rats in eachgroup.The rats of A group were feed distilled water until the end of theexperiment.Give the rats of B,C,D group gastric lavage by Bile simulationmixed liquid for5weeks,while from the second week to the fifth week,wegive B group rats distilled water,C group Domperidone and D groupHuazhuojiedufang after half an hour of the gastric lavage of Bile simulationmixed liquid.To the end of the experiment,all rats were killed by guillotine inthe condition of fasting to restrain water for24hours.Each rat were blood2mlfor CGRP and ET testing.After blooding,anatomy the stomach rapidly and cutthe gastric antrum tissue for histological observation.Result:(1)The mental state of the normal control group rats was verygood,the hair of all the rats was clean,white and bright,water and diet of ratswas nomal and the same to the excreta.In model group,the mental of rats wasobviously bad,most rats were quiet,settled here,their hair was yellow,lackinggloss,which adhered as bundles occasionally,their appetite lessens,and theirstool was thin,even diarrhoea.Rats' mental state,diet,water and excreta in thethree Huazhuojiedufang groups was a little worse than the nomal controlone,while better than the model and domperidone one.(2)Pathology of gastricmucosa(Hematoxylin-Eosin staining):The parietal cells in control group were arranged in rows,while the structure of the gastric mucosal layer and laminapropria was intact,there was no infiltration of inflammatory cells and nocongestion and edema in intercellular substance.In model group,the gastricmucosal cells significantly deformed,there were a large mount ofinflammatory cells which were infiltrated into the lamina propria,with atrophicand scarce glands.The pathological changes of Motilium group and low doseHuazhuojiedufang group was similar,the injury of gastric mucosal wasmoderate,inflammatory cells were infiltrated into no one player but mucousaplayer,there was no intestinal metaplasia.While,in the middle and large doseHuazhuojiedufang group,the injury of the gastric mucosa was mild,there was asmall amount of inflammatory cells infiltrated,without congestion and edemain intercellular substance,intestinal metaplasia and atypicalhyperplasia.(3)index:serum CGRP(calcitonin generelated peptide):Level ofthe middle and large-dose Huazhuojiedufang group was higher than that ofMotilium group which was indifferent compared with the low-doseHuazhuojiedufang group,there was a statistically significant differencebetween them(P<0.05).The CGRP level of middle and large-doseHuazhuojiedufang was lower than the low-dose one(P<0.05),while there wasno statistical significance between middle-dose and large-doseHuazhuojiedufang groups(P>0.05).Serum ET (endothelin):Except thelarge-dose Huazhuojiedufang group,the ET of the other four groups werehigher than control group(P<0.05).The level of serum ET in middle andlarge-dose Huazhuojiedufang groups was significantly lowher than that ofMotilium one(P<0.05),while there was no statistical significance betweenLow-dose Huazhuojiedufang group and Motilium group(P>0.05).Comparedwith the middle-dose Huazhuojiedufang group,the ET of the low-dose one wasmarkly higher(P<0.05),while the large-dose one indicated no significantlydifference(P>0.05).Conclusion:When reaching a special dose,Huazhuojiedufang can improvethe blood flow in gastric mucosa,protect the gastric mucosa tissue,inhibite thesecretion of gastric acid,reduce gastric mucosa attack factors while increase defensive one by regulating the level of serum CGRP and serum ET,andimprove the cure rate of BRG further. |
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