| Objective:To probe into the pharmacodynamic mechanism of Qilian Shupi recipe by way of researching on its treatment on precancerous lesion of chronic atrophic gastritis (CAG) and experimental research on its effect on expression of Syk?Survivin?p53 in Wistar rats, hoping to bring the molecular biological possible connotation of pathogenesis and treatment method to light.Methods:72 patients with precancerous lesions of CAG were divided randomly into two groups, 36 of them were treated with QLSP Tablet and the other with Wei Fuchun Tablet. Treated for three months, the total effective rate, clinical symptoms, and gastroscopic images, pathological changes of gastric mucous membranes and Hp-eradicating rates were observed. In experiments, models of precancerous lesions of gastric cancer were induced by cancerogenic agent in Wistar rats, which were divided randomly into six groups (normal group, model group, WeiFuchun group and big, middle and small dose QLSP group) according to their weights. After treated with QLSP and WeiFuchun for 12 weeks, main outcome measures: laser Doppler flowmetry was used to determine gastric mucosal blood flows; optical microscope was used to measure the thickness of gastric mucosal; Immunohistochemical S-P method and ELISA were used to monitor the expression of Syk, immunohistochemical S-P method was used to monitor the expressions of p53 and Survivin. Results:Data of clinical trial showed that in QLSP group the notable effective rate was 38.9%,and the total effective rate was 88.9%,while the notable effective rate was 27.8% and the total effective rate was 63.9% in Wei Fuchun group, there were notable differences between them(P<0.01); The improvements of clinical symptoms and symptom integral are difference between QLSP group and Wei Fuchun group (P<0.01); QLSP could improve gastroscopic images and pathological results of gastric mucous membrane, they were notable differences to Wei Fuchun group(P<0.01); the HP-eradicating rate of QLSP group was 72%, while Wei Fuchun group was 43.5%, there were notable differences between them(P<0.01). Animal experimental research showed that the gastric mucosal blood flows(GMBF) were increased in big and middle doses QLSP group, with notable differences to model control group and Wei Fuchun group(P<0.01); The gastric mucous membrane thicknesses in big doses QLSP group and Wei Fuchun group were notable more thickened than model group, there were notable differences between them(P<0.01); The expressions of Syk were increased in big and middle doses QLSP group, while they were increased slightly in Wei Fuchun group and lower greatly in model group, there were notable differences among them(P<0.01); The expressions of Survivin and p53 were decreased in big and middle doses QLSP group, while they were decreased slightly in Wei Fuchun group and higher greatly in model group, there were notable differences among them (P<0.01).Conclusions:Splenogastric asthenia,accumulation of stagnant pathogenic factors in the body, and involvement of the kidney functions at the advanced stage are the main causes leading to the pathogenesis of precancerous lesions of chronic atrophic gastritis. Therefore, invigorating spleen and tonifying kidney, regulating qi to disperse stagnation,and dispersing accumulation of pathogenic factors to resolve masses are the principles in the management of the condition. The excellent clinical effect of QLSP, the index from experimental research reveals its mechanism at the systemic, cellular and molecular levels in treating precancerous lesions of chronic atrophic gastritis. The QLSP recipe acts on many chains and targets of the disease to produce a comprehensive therapeutic effect,the therapeutic mechanism may have much to do with an overall effect of inhibition of expression of Survivin, p53 and inhancing the expression of Syk. And thus the study enriched the knowledge of pathology and treatment of precancerous lesions of chronic atrophic gastritis. |
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