北京中医药大学学报2025，Vol.48Issue(2)：280-290,11.DOI:10.3969/j.issn.1006-2157.2025.02.018
脾胃培源丸联合艾灸治疗慢性萎缩性胃炎脾胃虚弱证的临床研究
Clinical study on the treatment of chronic atrophic gastritis with spleen and stomach weakness syndrome by Piwei Peiyuan Pill combined with moxibustion
摘要
Abstract
Objective To determine the clinical efficacy and mechanism of Piwei Peiyuan Pill(PPP)combined with moxibustion for treating patients with chronic atrophic gastritis(CAG)with spleen and stomach weakness syndrome.Methods Ninety-six CAG patients with spleen and stomach weakness syndrome who met the inclusion and exclusion criteria were enrolled at the Department of Spleen and Stomach Diseases of the Second Affiliated Hospital of Anhui University of Chinese Medicine from June 2022 to December 2023.The patients were randomly divided into a control,a Chinese medicine,and a combined group using a random number table method,with 32 cases in each group(two cases per group were excluded).The control group was treated with rabeprazole combined with folic acid tablets(both thrice daily),the Chinese medicine group was treated with PPP(8 g,thrice daily),and the combined group was treated with moxa stick moxibustion(once daily)on the basis of the Chinese medicine group for 12 consecutive weeks.Gastric mucosa atrophy in the three groups was observed before and after treatment.The gastric mucosal pathological score was evaluated.The Patient Reported Outcome(PRO)scale was used to evaluate the patients' physical and mental health status and quality of life.An enzyme-linked immunosorbent assay was used to detect serum tumor necrosis factor(TNF)-α,interleukin(IL)-1β,IL-4,IL-10,IL-37,and transforming growth factor(TGF)-β levels in each group.Real-time fluorescence PCR was used to detect the relative expression levels of signal transducer and activator of transcription 3(STAT3)and mammalian target of rapamycin(mTOR)mRNA in each group.Western blotting was used to detect the relative expression levels of proteins related to the STAT3/mTOR signaling pathway,and the adverse drug reactions and events were recorded and compared.Results There was no statistical difference in age,gender,disease duration,family history of gastrointestinal tumors,alcohol consumption history,and body mass index among the three groups of patients.The total therapeutic efficacy rates of the control,Chinese medicine,and combined groups in treating gastric mucosal atrophy were 66.67%(20/30),86.67%(26/30),and 90.00%(27/30),respectively(P<0.05).Compared to before treatment,the pathological and PRO scale scores of gastric mucosa in each group decreased after treatment,and TNF-α,IL-1β,IL-37,and TGF-β levels decreased.The relative STAT3 and mTOR mRNA expression levels,as well as the relative STAT3,p-STAT3,mTOR,and p-mTOR protein expression levels decreased(P<0.05),whereas the IL-4 and IL-10 levels increased(P<0.05).After treatment,compared to the control group,the pathological score of gastric mucosa,PRO scale score,TNF-α,IL-1β,IL-37,TGF-β content,relative STAT3 and mTOR mRNA expression levels,and relative STAT3,p-STAT3,mTOR,and p-mTOR protein expression levels in the Chinese medicine and combined groups after treatment were reduced(P<0.05),whereas the IL-4 and IL-10 levels increased(P<0.05).After treatment,compared to the Chinese medicine group,the combined group showed a decrease in relative STAT3,mTOR mRNA expression levels,and STAT3,p-STAT3,mTOR,and p-mTOR protein expression levels(P<0.05).Conclusion The combination of PPP and moxibustion may regulate the inflammatory mechanism of the body by inhibiting the abnormal activation of the STAT3/mTOR signaling pathway,upregulating related anti-inflammatory factor levels,downregulating pro-inflammatory factor expression,and increasing related repair factor expression,thereby promoting the recovery of atrophic gastric mucosa,reducing discomfort symptoms,and improving the physical and mental state of CAG patients with spleen and stomach weakness syndrome.关键词
脾胃培源丸/慢性萎缩性胃炎/信号转导和转录激活因子3/哺乳动物雷帕霉素靶蛋白信号通路/炎症机制/身心状态Key words
Piwei Peiyuan Pill/chronic atrophic gastritis/signal transducer and activator of transcription 3/mammalian target of rapamycin signaling pathway/inflammatory mechanism/physical and mental state分类
医药卫生引用本文复制引用
吴凯瑞,叶宇,裴蓓,宋标,张艺,李婷婷,杨琦,刘云,李学军..脾胃培源丸联合艾灸治疗慢性萎缩性胃炎脾胃虚弱证的临床研究[J].北京中医药大学学报,2025,48(2):280-290,11.基金项目
安徽省重点研究与开发项目(No.2022e07020023) （No.2022e07020023）
安徽省卫生健康科研项目(No.AHWJ2023BBa20018) （No.AHWJ2023BBa20018）
安徽省重大疑难疾病中西医协同攻关项目(No.0708-2021) Key Research&Development Project of Anhui Province(No.2022e07020023) （No.0708-2021）
