Effect Of The Chinese Traditional Medicine And Western Medicine On The Quality Of Gastric Ulcer Healing

Gastric ulcer is a common disease, although a variety of anti-ulcer drugs can reach more than 80% healing rate, but recurrence after healing remains a clinical problem. The continuous existence of Helicobacter pylori (HP) and poor quality of ulcer healing are the major reasons. In 1991, Tarnawski, et al. proposed the concept of quality of ulcer healing for the first time in a experimental ulcer research, noting that the healing of an ulcer requires not only the repair of mucosal defect with epithelial cells but also the reconstruction and functional restoration of the connective tissues and gastric glands. The poor quality of ulcer healing is the pathological basis of ulcer recurrence. Currently the anti-ulcer medicine is mainly acid-inhibition medicine, which can achieve a higher healing rate after short-term treatment, but the recurrence rate is high after drug withdrawal. Some researchers suggest that the high recurrence rate is related to the poor quality of ulcer healing. In recent years, studies have shown that much Chinese traditional medicine can improve the quality of ulcer healing and reduce the recurrence rate of ulcer through a variety of mechanisms. To explore the effect of the Chinese traditional medicine and the Western medicine on quality of the gastric ulcer healing, we established the rat model of acetic acid induced gastric ulcer, evaluated the histological and functional maturity of the restored mucosa of treatment groups.Materials & Methods72 healthy, sexual-mature, and male Wistar rats were adpopted to our research.Acetic acid-induced ulcers were prepared as follows:The animals were deprived of food but allowed to drink water for 24h prior to experiment. After anesthesia, a midline epigastric laparotomy was made. After removing the stomach, acetic acid solution (0.02 ml) was injected into the submucosal layer at the posterior of the region between the fundus and the pylorus. Then the abdomen was closed. The concentrations of acetic acid solution used were 99.5%. The rats were divided into 6 groups as follows at the 3rd day after ulcer induction. Model group:the rats was killed; Control group:the rats received intragastrically (gavage) normal saline 1 ml twice daily for 14 days; Omeprazole group: the rats received intragstrically (gavage) lml Omeprazole (4mg/kg·d) twice daily for 14 days; JianWeiYuYang group:the rats received intragstrically (gavage) JianWeiYuYang lml(600mg/kg·d) twice daily for 14 days; Omeprazole+ JianWeiYuYang group:the rats received intragstrically (gavage) equal Omeprazole lml plus equal JianWeiYuYang lml twice daily for 14 days; 28 days spontaneous healing group:the rats was fed without any drug. We observed the common clinical manifestation and mucosal morphology of the rats, measured and calculated the ulcer index and ulcer inhibition rate. After that, the blood samples were obtained to measure the PGE2 and EGF concentration, the gastric tissue samples were obtained to measure the hexosamine level. Perpendicularly oriented paraffin sections of gastric ulcer samples were stained with HE. The thickness of mucosa,the number of cyst-like dilated glands and the number of micro vessels in connective tissue were determined.Statistical analyses of data were performed by T-test (two-independent sample test),P<0.05 was considered as statistically significant.ResultThe ulcer index of saline, Omeprazole, JianWeiYuYang and JianWeiYuYang plus Omeprazole group were 25.24±16.44 mm2,16.05±13.20 mm2,26.11±23.60 mm2,18.39±13.14 mm2 respectively. The inhibition rate of saline, Omeprazole, JianWeiYuYang and JianWeiYuYang plus Omeprazole group were 74.11%,83.54%, 73.22%and 81.13%. Histologically, restored mucosa thickness of saline, Omeprazole, JianWeiYuYang and JianWeiYuYang plus Omeprazole group were respectively 4.56±0.82 mm,4.01±0.93 mm,4.85±1.41 mm,4.99±1.20 mm and no significant difference between groups. The number of cyst-like dilated glands of saline, Omeprazole, JianWeiYuYang and JianWeiYuYang plus Omeprazole group were 10.11±4.91,5.22±3.31,9.64±3.53,8.00±2.41 respectively. In contrast to control group, the number of cyst-like dilated glands decreased in Omeprazole group (P<0.01).The number of microvessels in connective tissue of saline, Omeprazole, JianWeiYuYang and JianWeiYuYang plus Omeprazole group were respectively 19.89±6.55,22.33±6.87,25.18±7.70 and 28.67±3.77. In contrast to control group, the number of microvessels in connective tissue increased in Omeprazole plus JianWeiYuYang group (P<0.01). The level of the hexosamine in saline, Omeprazole, JianWeiYuYang and JianWeiYuYang plus Omeprazole group were respectively 28.25±5.87 mg/g protein,110.21±70.28 mg/g protein,38.14±22.68 mg/g protein,41.72±19.35 mg/g protein, and the higher secretion level of the hexosamine was observed in Omeprazole group and JianWeiYuYang plus Omeprazole group compared to control group (P<0.05).The concentration of PGE2 in saline, Omeprazole, JianWeiYuYang and JianWeiYuYang plus Omeprazole group were respectively 91.70±37.76pg/ml,99.18±64.04pg/ml,126.18±76.84 pg/ml,85.86±28.60 pg/ml,and the concentration of EGF in saline, Omeprazole, JianWeiYuYang and JianWeiYuYang plus Omeprazole group were respectively 80.25±22.60 pg/ml,89.65±33.23 pg/ml,111.97±44.97 pg/ml,101.82±46.26 pg/ml.In contrast to control group, the differences of the concentration of prostaglandin E2(PGE2) and epidermal growth factor(EGF) in treatment groups had no significance.In 28 days spontaneous healing group, the ulcer inhibition rate was 93.23%,the thickness of restored mucosa (5.08±0.85 mm), the number of microvessels in connective tissue (40.17±7.47) and the concentration of EGF (176.99±55.33 pg/ml) were higher than treatment groups and the secretion of hexosamine(47.86±11.24 mg/g protein) also increased.ConclusionsOmeprazole treatment can rapidly accelerate the gastric ulcer healing, stimulate the secretion of hexosamine and reduce the number of cyst-like dilated gland. The Chinese medicine JianWeiYuYang treatment cannot achieve the ulcer healing in a short period, and the long-time effect need further investigation. Omeprazole plus JianWeiYuYang treatment can stimulate the secretion of mucin, enhance the condition of microcirculation by promoting angiogenesis during gastric ulcer healing. If there are no persistent predisposing factors for ulcers, the ulcers can possibly achieve a spontaneous healing of higher quality without drug intervention.