| 1 Objective 1 To observe the distribution regulation of TCM syndromes in patients with chronic atrophic gastritis.2 To explore the effect of Piweipeiyuan Decoction on the expression of Shh,Gli-1 and Ptch in CAG rats.2 Method 2.1 Clinical research: Through consulting relevant literature to make a questionnaire of CAG TCM syndromes.Selecting 105 CAG patients' dates of the Second Hospital Affiliated to Anhui University of Chinese Medicine,such as the general informations(including name,age,sex,dietary habits,etc.),gastroscopy and pathological examinations and four diagnostic methods in TCM.These informations were collated and analyzed to observe the distribution regulation of TCM syndromes in CAG patients.2.2 Animal experiment: 50 male SD rats were randomly divided into normal group and model group.The CAG rats model was established by 3 methods: fill stomach with the mixed solution of 0.2% sodium deoxycholate and 30% alcohol,drink freely ammonia water at a concentration of 0.1% and feed with the method of irregular diet.Then the rats were randomly divided into Model roup,Weifuchun group,Piweipeiyuan Decoction large,medium and small dose group.After 5 weeks of intragastric administration of drugs,begin to observe the changes of general conditions(including hair,body shape,appetite,mental state,etc.)of rats in every group.And observe the morphological lesions of stomach by naked eyes and the pathological lesions of gastric mucosa by HE staining.Smo protein was detected by immunohistochemistry and Shh,Gli-1 and Ptch in gastric tissue were detected by Western blot method.3 Result 3.1 Clinical study: Chronic atrophic gastritis mostly occurs in patients over 40 years old.The course of the disease is mostly 1~5 years old.Most of the symptoms of TCM are epigastric fullness,epigastric pain,belching and so on.The pattern of syndromes mostly appears by liver-stomach qi stagnation.The gastric mucosa gradually atrophies and the colour changes accompanied by intestinal epithelial metaplasia or atypical hyperplasia.The TCM syndromes of chronic atrophic gastritis have statistical significance with course of disease,etiology,dietary habits and Hp infection(P < 0.05),but there were no statistical significance with age,sex,gastroscopy,degree of atrophy of gastric mucosa,degree of intestinal metaplasia and degree of atypical hyperplasia(P > 0.05).3.2 Experimental study 3.2.1 Pathological changes: The gastric tissue structure of rats in blank group was normal,and the rats in model group change in accordance with the pathological changes of CAG.The manifestations were thinning of gastric mucosa,thickening of muscular layer,disordering structure of inherent glands in gastric mucosa,decreasing number,atrophy of glands,exfoliation of gastric epithelial cells,occasional intestinal epithelial cells,a large number of inflammatory cells,obvious edema of mucosa,and patchy hemorrhage.After the intervention,the pathological lesions of gastric tissues in each treatment group were better than those in the model group.3.2.2 The expression of Smo protein in gastric tissue of rats was detected by immunohistochemical method.Compared with the blank group,the IOD value of Smo in gastric tissue of model group was higher,the difference was statistically significant(P < 0.05);compared with the model group,the IOD value of Shh?Gli-1?Ptch were lower,the difference was statistically significante(P < 0.05).3.2.3 Western Blot detected the expression of shh,Gli-1 and PTCH protein: the expression of Shh,Gli-1 and Ptch protein in every group was significantly different;compared with the blank group,the expression of Shh,Gli-1 and Ptch protein in the model group was significantly higher,the difference was statistically significant(P < 0.05);compared with the model group,the expression of Shh,Gli-1 and Ptch protein in the four groups was significantly lower,the difference was statistically significant(P < 0.05).4 Conclusion 4.1 In this investigation,the main type of CAG is liver-stomach Qi stagnation,spleen-stomach weakness,liver-stomach stagnation-heat,spleen-stomach dampness-heat and Stomach-yin deficiency are followed and the stomach collateral stasis type is the least.The distribution of TCM syndromes in CAG is closely related to the course of disease,etiology,dietary habits and Hp infection,but there were no statistical significance with age,sex,gastroscopy,degree of atrophy of gastric mucosa,degree of intestinal metaplasia and degree of atypical hyperplasia 4.2 Piweipeiyuan Decoction can improve the quality of life and the pathological changes of gastric mucosa in CAG rats,and reduce the expression levels of Shh,Gli-1,Ptch and Smo proteins in gastric tissue of CAG rats,thus inhibiting the activation of Sonic Hedgehog pathway,promoting the secretion of gastric mucosal glands,repairing the damaged gastric mucosa and playing a therapeutic role in CAG rats. |
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