Basic Study Of "Jianpi Tongluo Jiedu" On Clinical Patients With CAG And PLGC Result On Expression By NF-Kb, Bcl, And Bax.

In our population, Chronic Atrophic Gastritis (C AG) and Precan-cerous Lesions of Gastric Cancer (PLGC) are Clinical high incidence rate, they develop to gastric cancer by going through a lengthy, multi-stage, and multi-gene mutation accumulation. At present, this mode "NGM�'CSG�'CAG、IM�'dys�'CG (intestinal)" has been widely accepted. Chinese medicine treatment of PLGC has a large advantage, actively and effectively carry out PLGC interference blocking (secondary prevention), that is important prevention of gastric cancer. Of Traditional Chinese Medicine in Treating the PLGC has reliable efficacy and a clear advantage.Under the guidance of my professor, long-term study, he thinks "pixu luozu dusun" that is basic pathogenesis of PLGC, the basic rule of Chinese medicine treatment "Jianpi tongluo jiedu "is to obtain reliable results in clinical."Jianpi tongluo jiedu " composition has taizishan, shengbaizhu, fuling, erzhu, tengligen, baihuasheshecao, zhebeimu, gancao, etc... Taizishan、shengbaizhu、fuling、gancao can help people to tonify spleen qi, tengligen、baihuasheshecao、zhebeimu can phlegm Detoxification, upon of those components show "jianpi yiq、huoxue tongluo、xiaocheng jiedu". Early observations show that the agent not only can obviously improve PLGC patients clinical symptoms, also can promote the microscopically and part of the gastric mucosa lesion in patients with pathologic to heal. All parties reflected "jianpi tongluo jiedu" treatment principle obtains the good curative effect in clinic.Purpose:The observed "Jianpi tongluo jiedu " intervenes of the PLGC the clinical efficacy; The explored "Jian pi tongluo jiedu " impacts on of PLGC cells apoptosis; The revealed "Jianpi tongluo jiedu " by regulating the expression of Bcl-2, Bax, NF-kappaB molecules are such as protein targets PLGC apoptosis mechanism; analysis the PLGC syndromes of the correlation is between the relevant factors, apoptosis, Bcl-2, Bax, NF-kappaB and other indicators.Method:Into the group of40PLGC patients based on clinical diagnosis and inclusion criteria had to treatment them by "Jianpi tongluo jiedu "(taizisen、fuling、baizhu. danshenerzhu、tengligen、etc..) to interference in the six months. By immunohistochemistry, RT-PCR, in situ end labeling (TUNEL) method technology, they could detect histopathological changes, apoptotic index (AI), apoptosis signaling pathway (NF-κB/Bcl-2) gene and protein expression before and after treatment (Bcl-2, Bax, NF-κB) and other indicators of change; acquisition the PLGC patients before and after treatment had to change in symptoms and endoscopic features, sta-tistical analysis, to investigate the efficacy and syndromes related factors, and pathological, apoptosis the correlation between in each index.Result:(1) Symptoms:In this study said "Jianpi tongluo jiedu" method after treatment, the overall primary symptom, syndrome and symptom integral were significantly lowered (P<0.01). Patients with "Jianpi tongluo jiedu" method has to treatment after six months, main symptoms improved significantly with the diagnosis the new full is given priority to, the diagnosis of pain and symptoms of modern integral were also improved significantly. From first diagnosis to the patients3months after treatment, the overall symptom score has to improvement rate of about46.6%. From first diagnosis to the patients6months after treatment, the overall symptom score has to improve the rate of about69%.(2) Syndrome factors:According to clinical at four diagnostic information,40cases of PLGC patients mainly evidence syndrome factor distribution to qi deficiency, qi stagnation, blood stasis, dampness, poison, qi depression, etc. Among them, the qi deficiency of97.5%～100%, and the qi stagnation of95%～97.5%, blood stasis97.5%～100%, moisture55%～70%, poison17.5%～47.5%, qi depression25%～40%. After treatment with "Jianpi tongluo jiedu" method, he proportion of "poison" the syndrome factors had obvious drop, in patients with tongue, pulse condition, such as mucosa under gastroscope signs were obviously improved.(3) Gastroscope:Gastroscopy in patients with mucosa under gastroscope contraction ratio after6months after treatment were obviously improved; There are7patients before treatment mucosa under gastroscope contraction ratio reached Ⅲ level (22.2%), patients after treatment under gastroscope mucosa atrophy Ⅲ level not seen. Into the group of cases before and after treatment under gastroscope signs integral change obviously, gastric antrum and angle of the stomach have the lateral changes, there were significantly lowered (P<0.01).(4) Pathology:Into the group of cases the pathological integral before and after the treatment had obvious changes, in gastric antrum is little part, after statistics analysis, there were significantly lowered (P<0.01). Gastric antrum and angle of stomach before treatment after treatment under gastroscope signs integra were significantly lowered,(P<0.05). Before and after treatment in patients with pathological atrophy and intestinal proportion had the obvious change, shrinking degree before treatment there were16cases of severe (44.4%), intestinal degree of23cases of severe (63.9%), and there were4cases of severe atrophy after treatment (11.1%), intestinal degree there are13cases of severe (36.1%). There were17patients before treatment with mild atypical hyperplasia (47.2%), after treatment the patients with atypical hyperplasia were reduced to5cases (13.9%).(5) Immunohistochemical expression:After treatment with "Jianpi tongluo jiedu" method, the nf-kappa B positive expression rate dropped to80.6%, the Bel-2positive expression rate dropped to50%, Bax positive expression rate of slightly higher86.6%. Through statistical analysis, before and after treatment the nf-kappa B integral with the Bcl-2points have obvious changes, both exist differences before and after treatment, the nf-kappa B was significantly lowered (P<0.01), the Bcl-2was significantly lowered (P <0.01), Bax integral rise slightly change, but there was no significant difference (P>0.05).(6) Apoptosis index (TUNEL method):After treatment with "Jianpi tongluo jiedu" method apoptosis index (AI) decrease compared with before treatment, but after statistics analysis, there was no significant difference between to them (P>0.05).(7) Rt-pcr mRNA expression:the Bcl-2expression mRNA transcription level before treatment was0.27±0.18. After6months treatment, the Bcl-2expression mRNA transcription level was0.18±0.12,there were significant differences (P<0.05). (8) Syndrome factors relationship between with immunohistochemistry:(1) the nf-kappa B in qi deficiency, and qi stagnation, blood stasis and dampness syndrome factors of patients, the positive expression rate of difference before and after the treatment, there were significantly lowered (P<0.01); In the poison the syndrome factors, the positive expression rate of difference before and after the treatment was significantly lowered (P<0.05).(2) the Bcl-2within the qi deficiency, blood stasis and dampness syndrome factors of patients, the positive expression rate of difference before and after the treatment, there were significantly lowered (P<0.01); In and qi stagnation syndrome factors, the positive expression rate of difference before and after the treatment were significantly lowered (P<0.05); In the "poison" syndrome factor, there was no statistically significant difference of positive expression ratio before and after the treatment (P>0.05).(Bax in qi deficiency, and qi stagnation, blood stasis and dampness syndrome factors of patients, there was no statistically significant difference of positive expression ratio before and after the treatment (P>0.05); In poisonous syndrome factors, the positive expression rate of difference before and after the treatment with statistical significance (P<0.05).(9) Symptoms relationship between with immunohistochemical:"Piweixuluo","piweishire","weiluoyuzu" had nf-kappa B and Bcl-2positive expression difference before and after therapy, there were significantly lowered (P<0.01). In "gangweibuhe" with the nf-kappa B, the Bcl-2in the positive expression rate in the differences before and after treatment, there were significantly lowered (P<0.05). Additionally, Bax in "gangweibuhe" had positive expression ratio in the differences between of before and after treatment, there were significantly lowered (P<0.05); But in "Piweixuluo","piweishire","weiluoyuzu" the positive expression of Bax ratio before and after treatment were compared, the difference is not significant (P>0.05).Conclusion:1. The syndrome factors of PLGC patients characteristics and "Pixu luozu dusun " were at the core of the pathogenesis.2."Jianpi tongluo jiedu "could significantly improve the main clinical symptoms of PLGC patients, also improve patient’s quality of life.3."Jianpi tongluo jiedu" could be obviously improved gastric mucosal atrophy, intestinal PLGC patients and atypical hyperplasia tissue pathological changes. Judging from observation cases analysis, the party had a reverse pathological changing before gastric carcinoma atypical hyperplasia.4."Jianpi tongluo jiedu" could be by promoting apoptosis in the CAG with IM or accompanied by Dys achieve in a therapeutic effect; therefore reaching the role could help patients to prevention of PLGC to GC.5."Jianpi tongluo jiedu" and its syndromes could be reduced by adjusting nf-kappa B, Bcl-2contents in gastric mucosa cells. They also could regulate the Bcl-2and the ratio of Bax, which could effectively inhibit gastric mucosa cell proliferation and apoptosis in Dys and other harmful enhancement.