| Systematic ReviewObjective:To evaluate the efficacy of traditional Chinese medicine(TCM)in the treatment of drug-resistant helicobacter pylori infection by using evidence-based medicine systematic review method,and to provide support for further research on the treatment of drug-resistant helicobacter pylori by jianpiqinghua decoction.Methods:CBM,CNKI,VIP,wanfang,The Cochrane Library and PubMed databases were retrieved from The database construction period to 2018,and randomized controlled trials(RCTS)of traditional Chinese medicine for The treatment of drug-resistant helicobacter pylori infection were collected.Two researchers independently screened and extracted data according to inclusion and exclusion criteria,used the improved Jadad scale to evaluate the quality of the literature,and used Revman5.3 software for Meta analysis.Results:A total of 11 Chinese randomized controlled trials involving 1021 patients were included.Meta analysis results showed that Chinese medicine combined with western medicine was superior to western medicine alone in terms of eradication rate of drug-resistant helicobacter pylori,clearance rate of drug-resistant helicobacter pylori,clinical total effective rate,incidence of adverse reactions and recurrence rate of drug-resistant helicobacter pylori.Conclusion:In the clinical treatment of drug-resistant helicobacter pylori infection,the combined effect of Chinese and western medicine is better than that of western medicine alone,so it is more suitable for the treatment of drug-resistant helicobacter pylori infection.Experimental studyObjective:through the in vitro experiment research to prove that jianpi qinghua decoction can inhibit metronidazole resistance of helicobacter pylori growth,from the perspective of active efflux pump at the same time,discusses jianpi qinghua decoction treatment of metronidazole resistance molecular mechanism of helicobacter pylori,for treatment of traditional Chinese medicine drug resistance provides scientific theory basis of helicobacter pylori infectionMethods:(1)By the Beijing Chinese medicine hospital affiliated to the capital university of medical sciences,endoscopy center for helicobacter pylori infection in patients with gastric mucosa specimens,the isolation culture,strain identification,the E-test of drug sensitive test strains drug susceptibility,and The minimum inhibitory concentration(MIC)of jianpiqinghua decoction against drug-resistant helicobacter pylori was determined by AGAR dilution method.(2)Collect fresh cultivate helicobacter pylori bacteria liquid resistant 6 ml,on average,are divided into 6 pipe,each tube by 8 mg/ml metronidazole to join pipe,blending,five pipe and then join different concentrations of jianpiqinghua decoction,make each tube jianpiqinghua decoction concentration followed by 1/2,1/4,1/8,1/16,1/32 times,6 pipe,add 1 ml saline,blending,aerobic environment culture micro 3 hours after washing to refuse drugs,ultrasonic grinding under 0?,centrifugal,using enzyme-linked immunoassay(Elisa)to detect helicobacter pylori resistance,the change of the content of metronidazole in the body(3)Drug-resistant helicobacter pylori liquid was collected from normal saline and jianpi qinghua decoction at different concentrations for 3 hours.RNA was extracted according to the instructions of the kit,and the purity and concentration of RNA were detected by the od260/280.Reverse transcription was performed according to the instructions of the kit,and finally the expression of hefABC was detected by fluorescence quantitative PCR.Results:(1)All the 4 strains of helicobacter pylori isolated in clinic were resistant to metronidazole.AGAR dilution method showed that jianpi qinghua decoction could inhibit the growth of metronidazole resistant helicobacter pylori at 1 times,1/2 times,1/4 times and 1/8 times concentrations,among which the minimum inhibitory concentration was 1/8 times(0.3 71 g/ml)and the minimum bactericidal concentration was 1/4 times(0.742g/ml).(2)Compared with the control group,the concentration of 1/2,1/4,1/8,1/16 and 1/32 times of jianpi qinghua decoction can promote the absorption of metronidazole by drug-resistant helicobacter pylori,among which the concentration of 1/2 times has the most significant effect.(3)Compared with the control group,the expression levels of hefA and hefC in drug-resistant helicobacter pylori efflux genes with different concentrations of jianpi qinghua decoction were significantly decreased(all P<0.05)Conclusion:Jianpi qinghua decoction can inhibit or kill metronidazole resistant helicobacter pylori,and its mechanism may be related to the down-regulation of the expression levels of hefA and hefC,the efflux genes of drug-resistant helicobacter pylori. |
PDF Full Text Request