Preliminary Study On Regulation Of CYP2C19 Enzyme Activity And Pharmacodynamic Substances By Piwei Formulal

Pepticulcer(pepticulcer,PU)is a common chronic disease,spleen and stomach disease division scope of disease spread all over the world.Western medicine believes that the reason of its formation is the gastric mucosa injury caused by various attack factors.The most common sites are the duodenal intestine and stomach,and the lesions can invade the mucous membrane and even penetrate the serous membrane.Peptic ulcer can also occur in esophagus,Meckel diverticulum,anastomosis after gastrointestinal surgery and adjacent intestinal loops.The global incidence of peptic ulcer is about 10%,which has a certain self-healing rate and is prone to recurrent attacks.Peptic ulcers can occur at any age,but gastric ulcers occur at a higher age than duodenal ulcers.The advent of proton pump inhibitors is of great significance in improving the efficacy of peptic ulcer,but it still cannot completely avoid the occurrence of complications such as bleeding,perforation and even canceration.As proton pump inhibitors(ppis)have been used in clinic for a long time,their side effects are becoming more and more prominent.Chinese medicine also has a good curative effect in the treatment of peptic ulcer,and the use of Chinese medicine syndrome differentiation treatment for patients with individualized drug regimen,clinical efficacy is stable,but the treatment mechanism is not completely clear.Most Chinese medicines are compound preparations,which can be used for multi-target treatment and have an overall regulating effect on the human body.Western medicine has single target,clear mechanism and strong local efficacy.Therefore,whether the combined use of Chinese and western medicine can futher improve the efficacy,and whether the combination of Chinese and western medicine can make up for their shortcomings,is an important direction of future research.As the first proton pump inhibitor,omeprazole has been widely used in clinical practice,and patients with peptic ulcer benefit a lot.However,clinical observation found that omeprazole had "different effects with the same disease and the same medicine" in the treatment of peptic ulcer,and some patients could not get the expected effect even after increasing the dose.At present,it has been found that omeprazole is affected by the P450 enzyme system when it is metabolized in human body,among which CYP2C19 is the main enzyme to metabolize omeprazole,and the efficacy of omeprazole is affected by the polymorphism of CYP2C19 gene.Specifically,because the CYP2C19 gene is expressed differently in different people,the efficacy of omeprazole in treating peptic ulcer is quite different in different people.The metabolism of omeprazole was enhanced in patients with moderate and strong metabolism,which led to the decreased efficacy of omeprazole.However,although omeprazole has a better efficacy in patients with weak metabolism,it is easy to cause drug accumulation in the human body and may increase the risk of adverse reactions.Therefore,the clinical efficacy of patients with different gene expressions will be greatly different.Western medicine currently has no specific effective means to intervene this phenomenon.After thousands of years of practice in Chinese medicine,traditional Chinese medicine can also effectively treat digestive ulcer,its curative effect is stable,and there are fewer adverse reactions in the treatment process.In this study,the selected piwei formula 1 was combined with omeprazole in the treatment of peptic ulcer in clinical application,which could effectively improve the treatment effct,reduce the recurrence rate of ulcer and adverse drug reactions.In the experimental study,it was also proved that piwei formula 1 combined with omeprazole could effectively improve the quality of ulcer healing in acetic acid rat peptic ulcer model,thus reducing the recurrence of ulcer.Increasing the number of neovascularization is the main functional characteristic[2-3]Therefore,this project studies the effect of piwei formula 1 combined with omeprazole on the activity of CYP2C19,the major metabolic enzyme of omeprazole.It is of great positive significance to adjust the clinical program of combined application of Chinese and western medicine,improve the curative effect of peptic ulcer,reduce the recurrence rate of ulcer,reduce adverse drug reactions,and finally achieve individualized drug administration.