传统中药联合标准三联疗法治疗幽门螺杆菌诱发的慢性非萎缩性胃炎及其作用机制

摘要

目的：以传统中药清胃止痛微丸联合标准三联疗法治疗幽门螺杆菌诱发的慢性非萎缩性胃炎，采用高通量 PCR 芯片技术检测炎症相关基因的差异表达情况，阐明其作用机制。方法：选取10例慢性非萎缩性胃炎并发幽门螺杆菌感染患者为治疗组，以清胃止痛微丸联合三联疗法对患者进行治疗14 d；随机选取健康者10人作为健康对照组。分别于治疗前后采集研究对象的外周血，应用 QIAGEN 人类抗菌应答 PCR 芯片进行外周血总RNA 检测，分析治疗前后84个炎症相关基因的差异表达情况。结果：筛选出20个炎症相关基因差异表达。与健康对照组比较，治疗组患者治疗前差异表达的20个基因表达水平明显上调（Fold-change＞2）；与治疗前比较，治疗后该20个基因表达水平下调，且11个基因接近健康对照组水平（Fold-change＜2）。差异表达基因中包括 NLRP3炎性复合体相关基因，其中治疗组患者治疗前 CASP1、IL1B、NLRP3和 PYCARD 基因表达水平与健康对照组比较明显上调（P ＜0.05），治疗组患者治疗后 CASP1、IL1B、NLRP3和 PYCARD 基因的表达水平与治疗前比较明显下调（P ＜0.05）。结论：清胃止痛微丸联合三联疗法治疗幽门螺旋杆菌诱发的慢性非萎缩性胃炎的机制可能是通过抑制慢性非萎缩性胃炎患者 NLRP3炎性复合体相关基因的表达，干扰机体与抗菌应答相关的先天性免疫应答，从而起到治疗作用。%Objective:To treat the chronic non-atrophic gastritis patients induced by Helicobacter pylori with Qingweizhitong Weiwan combined with standard triple therapy,and to detect the differential expression of related immflammation genes with PCR array,and to clarify its mechanism.Methods: Ten patients with chronic non-atrophic gastritis complicated with Helicobacter pylori infection were used as treatment group and 10 health people were used as health control group. The patients in treatment group were treated with Qingweizhitong Weiwan combined with standard triple therapy for 14 d. The blood samples of the subjects in treatment group and health control group were collected before and after treatment,and QIAGEN human antibacterial response PCR array was performed to test the total RNA inperipheral blood and to analyze the differential expressions of 84 inflammation-related genes.Results:The differential expressions of 20 inflammation-related genes were found.Compared with health control group,the expression levels of 20 genes in treatment group before treatment were up-regulated (Fold-change>2);after treatment,the expression levels of 20 genes were down-regulated,and 11 of them were similar to the level in health control group (Fold-change< 2).More specifically,part of 20 genes was related to NLRP3 inflammasome.Compared with health control group,the gene expression levels of CASP1,IL1B,NLRP3,and PYCARD in treatment group before treatment were up-regulated (P <0.05).Compared with before treatment,the expression levels of CASP1,IL1B,NLRP3,and PYCARD in treatment group after treatment were down-regulated (P <0.05).Conclusion:The mechanism of Qingweizhitong Weiwan combined with standard triple therapy in the treatment of chronic non-atrophic gastritis patients induced by Helicobacter pylori may be related to inhibiting the expressions of NLRP3 inflammasome-related genes and interfering the antimicrobial innate immune response.