Clinical Observation And Study Of Wuhua Qinqian Decoction In Treating Gallbladder Heat Invading Stomach Syndrome Of Non-Erosive Gastro-Esophageal Reflux Disease

Objective To treat gallbladder heat invading stomach Syndrome of gastroesophageal reflex disease with Wuhua Qinqian Decoction,observe the clinical effect,study the effect of Wuhua Qinqian Decoction on NF-?B signal channel in esophageal tissue of rats with reflex esophagitis and explore the possible mechanism of Wuhua Qinqian Decoction in treating gastroesophageal reflex disease.Method Clinical Study:First of all,114 patients diagnosed as gallbladder heat invading stomach Syndrome of gastroesophageal reflex disease through gastroscopy and/or 24-hour esophageal impedance-pH monitoring were selected,among which 60 patients were diagnosed as nonerosive reflex disease(NERD)and 54 patients were diagnosed as reflex disease(RE).Secondly,they were divided into the treatment group and the control group according to the random number table,30 NERD patients in each group and 27 RE patients in each group.Thirdly,patients in the treatment group were given Wuhua Qinqian Decoction,while patients in the control group were given omeprazole enteric capsules(20mg/d)for 8 weeks respectively.After treatment,the improvement of TCM syndromes and the change of 24-hour MII-pH monitoring results before and after treatment were compared between the treatment group and the control group in the NERD group.At the same time,the improvement of TCM syndromes and endoscopic improvement before and after treatment were compared between the treatment group and the control group in the RE group.Experimental Study:Firstly,60 wistar rats were divided into 4 groups randomly:normal group,model group,Wuhua Qinqian Decoction group and omeprazole group,15 rats in each group.Secondly,rats in the model group,Wuhua Qinqian Decoction group and omeprazole group were treated with esophago-duodenal anastomosis to reproduce RE rat model.Thirdly,rats were put to execution after days of continuous administration and specimens were preserved.Then,the expressions of NF-?B and iNOS in esophageal tissue were detected by WestemBIot,and the levels of IL-6 and IL-1? in esophageal tissue were detected by ELISA.Result According to the results of clinical study,the total effective rate of TCM syndrome change in NERD patients was 93.33%after treatment with Wuhua Qinqian Decoction,which was better than that in the control group(P<0.05).Moreover,the treatment group was superior to the control group(P<0.05)in improving the symptoms of bitter mouth and dry pharynx,stalking rib pain,vexation and insomnia.After 24-hour esophageal impedance-pH monitoring,it was found that the acidity and alkalinity and DeMeester score of the reflux were improved after treatment with Wuhua Qinqian Decoction(P<0.05).Compared with the control group,the improvement of the treatment group was better than that of the control group in the aspect of weak base reflux(P<0.05),and there was no statistical difference between the two groups in the improvement of acid reflux and weak acid reflux(P>0.05).The improvement of DeMeester score in the treatment group was better than that of the control group(P<0.05).After treatment with Wuhua Qinqian Decoction,the total effective rate of TCM syndrome change in RE patients was 92.59%,which was better than that in the control group(P<0.05),and the treatment group was superior to the control group(P<0.05)in improving the symptoms of chest and back pain,vexation and insomnia.Gastroscopy showed that the total effective rate in the treatment group was 86.19%,which is better than that in the control group(P<0.05).The experimental results showed that Wuhua Qinqian Decoction could change the pathological changes of esophageal mucosa in RE rat model.Compared with the model group,the expressions of of NF-?B and iNOS protein in esophageal tissue cell decreased significantly in the Wuhua Qinqian Decoction group and omeprazole group when Western Blot was used to detect the expressions of of NF-?B and iNOS protein in esophageal tissue,the iNOS protein in omeprazole group decreased significantly(P<0.05),and the NF-?B protein in Wuhua Qinqian Decoction group decreased very significantly(P<0.01).When the expression levels of IL-6 and IL-1? were detected with ELISA,it indicated that the levels of IL-6 and IL-1? in serum of rats in the Wuhua Qinqian Decoction group and omeprazole group were significantly lower than those in model group,but the Wuhua Qinqian Decoction group(P-0.018,P=0.023)had a better effect in inhibiting inflammation of rats than that of the omeprazole group(P=0.021,P=0.036).Conclusion 1.Wuhua Qinqian Decoction can significantly improve the clinical symptoms of gallbladder heat invading stomach Syndrome of gastroesophageal reflex disease,neutralize the acid-base of reflux and repair the esophageal mucosa,which has good clinical value.2.Combined with experiments,it is proved that Wuhua Qinqian Decoction can alleviate the inflammation of esophageal mucosa and help mucosal repair,which may be related to the sphincter dilatation under the influence of NF-?B signal channel on esophagus.