| Objective: To observe the clinical therapeutic effect of Huazhuojiedufang on Bile Reflux Gastritis(BRG) and the changes of pathological morphology of gastric mucosa,gut hormone of bile reflux gastritis rats by constructing rat model of BRG model. its mechanisms and discuss the therapeutic mechanism of Huazhuojiedufang in treating BRG.Method: 1 Clinical study: The randomized controlled trial was adopted. All of the BRG patients are from traditional chinese medicine hospital of hebei province.The cases met the inclusion criteria were randomly divided into two groups according to"Randomly Number Scale": treatment group and control group .The sex,age,duration,are no significant difference between two groups(P>0.05). 30 patients in treatment group were administered with Huazhuojiedufang (including,kushen,pugongying,huangqin,huanglian,zikou, sharen,yunling,baizhu,banzhilian,baihuasheshecao) ,daily,and patients in control group were administered with motilium tablets for each 10mg 3 times daily. Four weeks are one therapy course in both groups.During the therapy, no other pro-motility medicines were taken. After the end of a course,observated the clinical symptoms and gastroscopy before and after treatment respectively to evaluate the therapeutic effects.Recorded the side effects of the medicine during therapy. 2 Experimental study: 60 cleaning male Wistar rats were randomly divided into six groups, each group 10 rats,named normal group,model group, high-dose group of Huazhuojiedufang, medium-dose of Huazhuojiedufang, low-dose group of Huazhuojiedufang and motilium control group. Reflux liquid was given to each group through the means of watering stomach except for normal group,once a day sustained 5 weeks. From the second week to the fifth week each treatment group was given medicine through the means of watering stomach,the groups were dealt with high-dose, medium-dose,and low-dose huazhuojiedufang, motilium respectively,meanwhile normal group and model group were given equal volume physiological saline. 5 weeks later, each group was stopped given food but water for 24hs after administration for the last time,then the head of rat was cut off to obtain blood and cut the belly open to obtain stomach by aseptic technique,then observe the following index: pathomorphology of gastric mucosa,serum gastrin(GAS),plasma Motilin(MTL), Leptin.Results: 1 Clinical study (1) Clinical symptoms therapeutic effect: In treatment group the total efficiency is 93.33%,which is higher than that of control group. In control group the total efficiency is 73.33%.There was a significant difference between two groups(P﹤0.05). (2) Compared the gastroscopy changes before and after treatment: In treatment group the total efficiency is 90%, In control group the total efficiency is 66.7%.There was significant meaning between treatment and control group on the changing of gastroscopy(P﹤0.05). (3) Assess therapeutic safety in two groups: There were neither significant change in blood,urine,stool rules nor in Electrocardiogram and liver-renal function before and after treatment. In the course of the treatment ,all patients had no adverse reactions,which pointed that both the two groups have no side effects.2 Experimental study (1)Lesions of the pathomorphology of gastric mucosa: compared with model group, the lesions of the pathomorphology of gastric mucosa in high-dose(P﹤0.01) , medium-dose(P﹤0.01) and low-dose(P﹤0.05) huazhuojiedufang groups were obviously improved. Compared with motilium group , high-dose, medium-dose huazhuojiedufang groups (p﹤0.01), low-dose huazhuojiedufang group(P﹤0.05). (2) Level of serum GAS, plasma MTL and Leptin: After treatment, the GAS,plasma MTL and Leptin of model group was markedly lower than that of nomal group(P﹤0.01) . The levels of the GAS,plasma MTL and Leptin in high-dose, medium-dose and low-dose huazhuojiedufang groups were markedly higher than in model group(P﹤0.01).Conclusion: 1. Clinical study: This clinical trial indicates that the traditional chinese herb medicine Huazhuojiedufang can improve patient,s cliniical symptom significantly,which has a significant difference from motilium .The mechanism of the function is probably to soothing the liver and gallbladder-heat, transforming turbidity and detoxification.This finding embodyed that traditional chinese medicine has conspicuous ascendency on this disease and without side effects. 2. Experimental study: (1) This study indicated that Huazhuojiedufang could improve the changes of pathomorphology in gastric mucosa, relieve the inflammatory cell infiltration of gastric mucosa and protect gastric mucosa of bile reflux gastritis rats.(2)This study also indicated that Huazhuojiedufang could improve the content of GAS, plasma MTL and Leptin. This kind of gut hormone could adjust the movement of stomach intestine ,speed up the clearance of reflux liquid , strengthen the nutrition and the defence function of gastric mucosa, then could alleviate the damage of gastric mucosa. |
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