| Objective:1.Explore the main syndrome types and corresponding prescriptions of Professor Yuan Hongxia in treating of esophageal precancerous lesions;2.Based on the above research results,explore the regulatory effect of Jiawei Xuanfu Daizhe Decoction on the Caspase-3/Bcl-2/Bax signaling pathway in rats with precancerous lesions of the esophagus.Method:Collecting the cases of Professor Yuan Hongxia who treated esophageal precancerous lesions in the Department of Traditional Chinese Medicine,Baokang Hospital Affiliated to Tianjin University of Traditional Chinese Medicine and the Tianjin Nankai Hospital from October 2012 to October 2020,and were finally included 108 cases according to the acceptance criteria and standardized treatment.Using the method of double recording to enter the collected information into the Excel table,and upload it to the ancient and modern medical case cloud platform(V2.2.3)software after verification,and use the data mining analysis module to perform frequency statistics,TCM disease analysis and complex network analysis on the prescription data.48 male SD rats were divided into 4 groups randomly.Except for the blank group,a compound modeling method was used to make a rat model of precancerous lesions of the esophagus.The blank group was given,the Chinese medicine group was given Jiawei Xuanfu Daizhe decoction and the western medicine group was given Western medicine(rabeprazole + mosapride)by gavage for 8 weeks.The morphological changes of esophageal epithelial tissue were observed with naked eyes and optical microscope;Western-blot method and PCR method were used to detect the expression of Caspase-3,Bcl-2 and Bax in esophageal epithelial tissue.Result:Study One:1.(1)Among 108 patients with precancerous lesions of the esophagus,72 are males and36 are females,with a male-female ratio of 2:1;they are more distributed in the two age groups of 50-59 and 60-69;(2)Among 108 prescriptions,Chinese medicines with a frequency of ≥30 have core components of Xuanfu Daizhe Decoction,Zhizhu Decoction,and Xiao Chaihu Decoction;(3)The statistical results of TCM syndromes show that among the 6 core syndromes of precancerous lesions of the esophagus,the deficiency of Qi in the middle burner is the most common syndrome,accounting for 45.87%,followed by the syndrome of stagnation of heat in the liver and stomach,accounting for 20.18%,and gallbladder-heat invading the stomach syndrome ranked third,accounting for 10.09%,Qi stagnation and phlegm obstruction syndrome and blood stasis blocking collaterals syndrome ranked fourth,accounting for 9.17%,Jin-deficiency-heat syndrome ranked fifth,accounting for 4.59(summarized as: Deficiency of Qi in the middle burner syndrome> stagnation of heat in the liver and stomach syndrome>gallbladder heat invading the stomach syndrome> Qi stagnation and phlegm obstruction syndrome = blood stasis blocking collateral syndrome> Jin-deficiency-heat syndrome).Combined with the complex network analysis of "Chinese medicine-syndrome type",the first-ranked syndrome type and corresponding basic prescriptions is Deficiency of Qi in the middle burner syndrome,composed of Banxia,Gancao,Xuanfuhua,ginger,Dazao,Daizheshi,Dangshen,Fuling,and Huangqin.Study Two:2.(1)The general conditions of rats in each group: The blank group is generally in good condition,and the weight gradually increase without other abnormalities;the rest of the groups have varying degrees of reduced appetite,weight loss,restfulness,trembling,and sluggish eyes.Blurring,the fur standing,falling off,yellowing and dull,yellow liquid(reflux)around the mouth,some rats have a large abdomen.After 8 weeks of drug intervention,the general condition of the rats in the traditional Chinese medicine group and the western medicine group were improved and their body weight gradually increased,there is little perioral reflux and abdominal enlargement.(2)Compared with the blank group,the macroscopic and pathological scores of the esophageal epithelium of the model group increased,and the difference was statistically significant(P<0.01);compared with the model group,the macroscopic and pathological scores of the esophageal epithelium of the rats in the traditional Chinese medicine group and the western medicine group decreased.The difference was statistically significant(P<0.01).Compared with the western medicine group,the macroscopic and pathological scores of the esophageal epithelium in the traditional Chinese medicine group were not statistically significant(P>0.05).(3)The statistical results of PCR and Western-blot method showed that compared with the blank group,the expression of Caspase-3 m RNA and protein in the model group was reduced,and the difference was statistically significant(P<0.01);compared with the model group,the traditional Chinese medicine and western medicine group rats The expressions of Caspase-3 m RNA and protein increased,and the difference was statistically significant(P<0.01);compared with the western medicine group,the expression of Caspase-3 m RNA and protein in the traditional Chinese medicine group was slightly higher,but not statistically significant(P>0.05).The content of Bcl-2 in the esophageal tissue of the model group was significantly higher than that of the traditional Chinese medicine group and the western medicine group,and the difference was statistically significant(P<0.05);compared with the blank group,the model group,the traditional Chinese medicine group,and the western medicine group all increased to different degrees High,the difference is statistically significant(P<0.05);compared with the western medicine group,the traditional Chinese medicine group is slightly lower,and the difference is not statistically significant(P>0.05).Compared with the blank group,the expression of Bax m RNA and protein in the model group was significantly reduced,and the difference was statistically significant(P<0.01);compared with the model group,the expression of Bax m RNA and protein in the traditional Chinese medicine group increased,and the difference was statistically significant Scientific significance(P<0.05,P<0.01);Compared with the model group,the expression of Bax protein in the western medicine group was increased,and the difference was statistically significant(P<0.05);compared with the western medicine group,the expression of Bax m RNA and protein in the traditional Chinese medicine group was slightly higher,But not statistically significant(P>0.05).Both levels showed that the ratio of Bcl-2/Bax in the traditional Chinese medicine group and the western medicine group was down-regulated and the content of Caspase-3 was up-regulated compared with the model group.The difference was statistically significant(P<0.05).There was no statistical difference between the traditional Chinese medicine group and the western medicine group.Academic significance(P>0.05).Conclusion:1.Precancerous lesions of the esophagus are more common in the syndrome of deficiency of Qi in the middle burner,and the corresponding basic prescription is Xuanfu Daizhe Decoction and Zhizhu Decoction;2.Modified Xuanfu Daizhe Decoction can help the Qi machanism in ascending and descending,down-regulate the Bcl-2/Bax ratio,increase the permeability of the outer mitochondrial membrane,release apoptotic factors,activate Caspase-3,cause the diseased tissue to undergo apoptosis,and reverse the esophageal epithelium Dysplasia,which plays a role in the treatment of precancerous lesions of the esophagus. |
PDF Full Text Request