Yiqi Huoxue Prescription In The Treatment Of Peptic Ulcer With Qi Deficiency And Blood Stasis Syndrome Clinical Observation And Effect On Serum Bile Acid Spectrum

Objective:Through the analysis of high performance liquid chromatography-mass spectrometry,the metabonomics of the serum bile acid spectrum of patients with peptic ulcer Qi deficiency and blood stasis syndrome before and after treatment was analyzed,the relationship between the serum bile acid spectrum and the pathological process of peptic ulcer was explored,and the influence of Yiqi Huoxue Prescription on the serum bile acid spectrum was studied,hoping to find specific metabolites of bile acid spectrum for patients with peptic ulcer and find out The new mechanism of Yiqi Huoxue Prescription in the treatment of peptic ulcer provides a new direction for the clinical diagnosis and treatment of peptic ulcer.Methods:44 cases of peptic ulcer with Qi deficiency and blood stasis syndrome were randomly divided into two groups:Traditional Chinese medicine group and Western medicine group,and 27 healthy subjects were included as control group.In the traditional Chinese medicine group,Yiqi Huoxue Prescription was orally taken(1 dose/day,warm half an hour after breakfast in the morning and evening);in the western medicine group,omeprazole(20mg,twice/day,taken on an empty stomach)was orally taken for 8 weeks.Two groups of H.pylori positive subjects were first treated with tetralogy for two weeks:bismuth potassium citrate(220mg,bid,7 days in total)+omeprazole(20mg,bid)+amoxicillin(1000mg,bid)+clarithromycin(500mg,bid).After eradicating Hp,continue to treat according to the above methods.Before and after treatment,TCM symptom score,ulcer healing under gastroscope and Hp eradication rate were observed and recorded,and fasting blood samples were taken to detect bile acid spectrum.The healthy group only needs to take fasting blood sample once.Results:In the aspect of TCM clinical symptom score,the effective rate of the two groups after treatment was 100%,in which the number of effective people(16 people)was the most in TCM group,and the number of effective people(14 people)was the most in western medicine group.After treatment,the clinical symptoms of the Chinese medicine group were significantly improved,while the western medicine group had no significant improvement in the two clinical symptoms of chilly limbs and fatigue.In the aspect of bile acid profile,UDCA,THCA,TMCA,HDCA,GUDCA,GLCA,LCA and TUDCA in the serum bile acid profile of patients with peptic ulcer were lower than those in the healthy group(P<0.05),while those in the serum bile acid profile of patients with duodenal ulcer were lower(P<0.05)The contents of UDCA and GCA were lower than those of patients with gastric ulcer(P<0.05);the contents and differences of serum bile acid spectrum in Chinese medicine group and Western medicine group were similar before and after treatment(P>0.05);the contents of 7-ketodeoxycholic acid(7-KDCA)in Chinese medicine group increased slightly after treatment(P=0.0673,close to 0.05,statistically significant difference accorded with the margin);the contents of taurine in western medicine group after treatment The contents of bile acid TLCA and GDCA were lower than those before(P<0.05).Conclusions:Compared with healthy people,the level of bile acid spectrum in patients with Qi deficiency and blood stasis syndrome of peptic ulcer is decreasing,and UDCA plays a certain role in the pathological process of peptic ulcer;Yiqi Huoxue Prescription has the advantage of improving patients’ systemic symptoms,which can play a role through G-protein-coupled receptor-5(TGR5),and it can improve the content of 7-KDCA.