Clinic Research And Mechanism Study Of Strengthening Spleen And Soothing Liver Decoction On Reflux Esophagitis

Objective: To investigate the clinical effect on reflux esophagitis of Strengthening Spleenand Soothing Liver Decoction, and to explore further mechanism of effection of the Deco-ction on reflux esophagitis by animal experiment.Method: Clinic study: 45 reflux esophagitis patients whose TCM syndrome are spleendeficiency and liver stagnation were divided into two groups randomly: treatment group arecured by Chinese Medicine and positive group by western medicine. The two groups wererespectively given Strengthening Spleen and Soothing Liver Decoction and MosaprideCitrate Tablets for 4 weeks. We study the change of major and secondary symptoms beforeand after the treatment. Furthermore, we followed up all cases for 2 months and comparedrecurrence ratio and make records of side effects.Experiment study: The rat models of reflux esophagitis were established by "receivingpartial pylori ligation plus cardiomyotomy". They were divided into 7 groups, includingregular group、model group, placebo group, positive group, Chinese Medicine of high-dose,middle-dose and low-dose group. The regular group was not given any medicine, while theother groups were respectively given normal saline (NS), Oryzanol Tablets, MosaprideCitrate Tablets, high-dose, middle-dose and low-dose Chinese medicine by gastroperfusion.Treatment lasted for 3 weeks. After 3 weeks, pH of lower esophagus was detected. Weexplore improvement of esophageal mucous membrane under microscope, changes of HEdyeing, Serum NO and study the test of immunity-histochemistry coloration, observing theexpression of cyclooxygenase 2(COX-2) and prolifeating cell nuclear antigen (PCNA).Result: The two clinic groups all had no significant difference of major and secondarysymptoms(P＞0.05). Treatment group cured by Chinese Medicine had significant change ofsome symptoms, such as degree of heartburn, frequency of chest pain, belch, chest pain,irritable compared with positive group. Strengthening Spleen and Soothing LiverDecoction have low recurrence ratio and less side effects.Animal result show that Spleen and Soothing Liver Decoction could improve pH of loweresophagus, lighten pathology injure, reduce the expression of PCNA and COX-2 and adjustSerum NO. The effect between the two groups have no significant difference (P＞0.05). Conclusion: Strengthening Spleen and Soothing Liver Decoction, based on the TCMtheory of holism and treatment according to the differentiation of syndromes, can adjust thehuman body as a whole and the effect is obvious. Strengthening Spleen and Soothing LiverDecoction adjust LESP by regulating NO and GAS, improve pH of low esophagus,promote evacuating and alleviated the symptoms and endsocopic manifestation of refluxesophagitis, and had the curative effect of alleviating esophagus inflammation. And it couldreduce the high expression of COX-2 and PCNA. It also can base for manufacturingChinese traditional medicine of reflux esophagitis.