| Part one: Experimental researchPurpose: In this study,rhubarb feed combined with MNNG mixed anhydrous ethanol was used to study the establishment of the model of spleen-kidney Yang deficiency CAG rats,and to explore the effect of "Jiangfu fuwei granule" on serum G-17,PGI and PGII of spleen-kidney Yang deficiency CAG rats,as well as the pathological effect on mucosa of gastric body and gastric antrum mucosa.Methods: establishment and grouping of raw rhubarb feed combined with mixed method of MNNG anhydrous ethanol to make the CAG model of spleen and kidney Yang deficiency: The rats were divided into blank control group and Yang-deficiency group and the latter group was fed special fodder(each 3g of normal fodder contains the equivalent of 1g of rhubarb decoction)used to build the model for ten days.Then,the general conditions of weight,diet,defecation,mental state and hair color were observed and recorded to judge whether the model was successful.After the success of model building,the CAG model of spleen-kidney yang-deficiency rats was created by freely drinking 170 g/ml MNNG mixed anhydrous ethanol solution in the yang-deficiency group.Then,the success of the model was determined by HE staining of the stomach.The rats were then randomly divided into a blank control group,a model group,highdose group(34.2g/kg),medium-dose group(17.1g/kg)and low-dose group(8.55g/kg),and the rat models were copied by following the steps.After intragastric administration,blood samples were collected at week 8 and 12 to detect G-17,PGI and PGII in each group.Two rats were randomly selected from each group at week 4,8 and 12 for sampling,gastric tissue sections were taken for HE staining,and the degree of gastric body,gastric antrum inflammation and atrophy was scored to detect the degree of glandular disorder.Results: the weight of the rats in the yang-deficiency group was smaller than that in the control group(P<0.05),the duration of chills at 4? was significantly less than that of the control group(P<0.05),the activity of the dark chamber experiment in the yangdeficiency group was weaker than that in the control group(P<0.05),and the rats in the yang-deficiency group all had the cases of loose stool,anal prolapse and haggard hair color.After MNNG mixed anhydrous ethanol modeling,the verification was successful.Compared with the blank control group after the feeding medicine for 12 weeks,the serum G-17 expression in the model group was significantly increased(P<0.01),the expression of PGI was significantly decreased(P<0.01),and the expression of PGI/PGII was significantly decreased(P<0.05).Compared with the rats in the model group,the serum g-17 expression was significantly decreased in the high,medium and low dose groups(P<0.01),the expression of PGI was significantly increased(P<0.01),and the expression of PGI/PGII was significantly increased(P<0.05 or P<0.01).PGII values in each group were not statistically significant.In terms of histopathology,compared with the blank control group after feeding medicine for 12 weeks,the gastric body and gastric antrum mucosa of the model group showed atrophy,and the scores of gastric body and gastric antrum were significantly higher than those of the blank group(P<0.05).Compared with the model group,the degree of mucosa atrophy in gastric body was reduced in the high-dose,medium-dose and low-dose groups.The degree of gastric antrum mucosa atrophy was reduced in the high,medium and low dose groups,and the pathological score of gastric antrum in the three treatment groups was significantly lower than that in the model group(P<0.05).Conclusion: The rat model of spleen-kidney Yang deficiency can reflect the manifestation of spleen-kidney Yang deficiency described in traditional Chinese medicine,and the CAG model has proven to be successfully established by histopathology."Jiangfu fuwei granules" can significantly improve the gastric body and gastric antrum mucosal lesions in the CAG model of spleen-kidney Yang deficiency rats.It can inhibit the atrophy of gastric mucosa by restoring the mucosal thickness and increasing the number of glands.It can have a positive effect on G-17,PGI and PGI/PGII of rat serum,indicating that " Jiangfu fuwei granules" has a good effect on spleen-kidney Yang deficiency type CAG model rats.Part two: Clinical researchObjective: The clinical efficacy of "Jiangfu fuwei decoction" in the treatment of chronic atrophic gastritis(spleen-kidney Yang deficiency type)was studied by using the method of "self-comparison",and the clinical value of this prescription in the treatment of chronic atrophic gastritis was preliminarily discussed.Methods: Thirty-six cases of patients with chronic atrophic gastritis who met the standards in the outpatient and ward were collected.The traditional Chinese medicine "Jiangfu fuwei decoction" was taken orally for 3 months.The TCM symptoms and gastroscopic pathological changes of the patients were observed and recorded before and after the treatment.After the completion of the treatment,a comparative analysis was conducted and the clinical efficacy was evaluated.Results: After 3 months of treatment,the total score of TCM symptoms was lower than that before treatment,and the difference was statistically significant(P < 0.01).The score of primary symptom of TCM after 3 months' treatment was lower than that before treatment,and the difference was statistically significant(P < 0.01).Except for heartburn or cauterization,the score of secondary symptoms of TCM after 3 months of treatment was lower than that before treatment,and the difference was statistically significant(P < 0.01).In terms of gastroscopic pathology,the scores of atrophy and metaplasia of intestinal skin after 3 months of treatment were lower than before treatment,and the difference was statistically significant(P < 0.05).According to the efficacy evaluation of TCM symptoms,3 cases(9.1%)recovered after 3 months of treatment,11 cases(33.3%)showed obvious effects,19 cases(57.6%)were effective and 0 cases invalid;the total efficiency rate is 100%.In terms of pathological efficacy evaluation,22 cases were cured of atrophy,accounting for 66.6%;3 cases were effective,accounting for 9.1%;8 cases were invalid,accounting for 24.2%;and total efficiency rate was 75.8%.Intestinal metaplasia recovered in 8 cases,accounting for 57.1%;1 case obviously effect,accounting for 7.1%;2 cases were effective,accounting for 14.3%;3 cases with no effect,accounting for 21.4%;total efficiency rate was 78.6%.Conclusion: The self control study showed that "Jiangfu fuwei decoction" can obviously improve the spleen-kidney-Yang-deficiency type of TCM clinical symptoms in patients with chronic atrophic gastritis.On this basis,it can have a positive effect on its pathological atrophy,produce certain effect on the intestinal metaplasia.Its clinical efficacy is basically as expected. |
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