Effect Of Yiqi Huoxue Jiedu Decoction On The Expression Of Notch 1 And Dll4 In Patients With Chronic Atrophic Gastritis

ObjectiveTo observe the effect of Yiqi Huoxue Jiedu Decoction on the histopathology of gastric mucosa and the expression of notch homolog 1(Notch 1)and delta like ligand 4(Dll4)protein in patients with chronic atrophic gastritis(CAG),and to explore the therapeutic mechanism of Yiqi Huoxue Jiedu Decoction on CAG.MethodFrom September 2017 to December 2019,we collected the gastric mucosa of CAG patients(31 cases)and chronic non atrophic gastritis(CNAG)patients(30 cases)who were hospitalized in the digestive department of the Affiliated Hospital of Chengdu University of traditional Chinese medicine and confirmed by electronic gastroscopy and histopathology.The expression of Notch1 and Dll4 protein in the gastric mucosa of the two groups was detected by immunohistochemistry.The patients,general data,results of histopathology and immunhistochemistrry were collected:patients in CAG group were treated with Yiqi Huoxue Jiedu Decoction.After16 weeks of treatment,the safety index,gastroscope and pathological examination of gastric mucosa at the same site were rechecked.The expression of Notch1 and Dll4 protein was detected by immunohistochemistry.The histopathology,safety index and immunohistochemistry results before and after treatment were collected.The above data were collected in Excel table and analyzed by spss24.0.Result1.The expression of Notch1 and Dll4 protein in CAG group and cnag group: the expression of Dll4 protein in CAG group was high,while that in cnag group was low or negative,the difference was statisticallysignificant(P < 0.01);the expression of Notch1 protein in both groups was low or negative,the difference was not statistically significant(P >0.05);2.The expression of Notch1 and Dll4 protein in the gastric mucosa of CAG group before and after treatment: the expression of Dll4 protein in the gastric mucosa after treatment was significantly lower than that before treatment(P < 0.01);there was no negative or low expression of Notch1 protein before and after treatment,and there was no significant difference between before and after treatment(P > 0.05);3.The histopathological effect of gastric mucosa in CAG group before and after treatment: after treatment,the total score of pathological simulation score,the score of main variables(atrophy,intestinal metaplasia,dysplasia),the score of secondary variables(inflammation,inflammatory activity,HP)were lower than before treatment,the difference was statistically significant(P < 0.05);after treatment,the score of atrophy and intestinal metaplasia was improved,the difference was statistically significant(P < 0.05)There was statistical significance(P < 0.05);4.No serious adverse events occurred in CAG patients before and after treatment,and no abnormality was found in safety indexes before and after treatment.Conclusion1.Yiqi Huoxue Jiedu Decoction can improve the histopathology of gastric mucosa in CAG patients,reverse atrophy and partial intestinal metaplasia,no serious adverse reactions were observed during the treatment,and the safety is good;2.Yiqi Huoxue Jiedu Decoction can improve the histopathology of gastric mucosa in CAG patients,and its therapeutic mechanism may be related to down regulating the expression of Dll4 protein and inhibitingthe angiogenesis of gastric mucosa;3.Notch1 protein may not be the effective target of Yiqi Huoxue Jiedu Decoction in the treatment of CAG.