【作者】 洪耀珑；

【导师】 林吉；

【作者基本信息】 广州中医药大学 ， 中药学， 2012， 硕士

【摘要】 慢性胃炎(chronic gastritis)是指由多种原因引起的胃黏膜弥漫性或局限性慢性炎症,是临床常见病、多发病,发病率较高。其临床特点是病程长、缠绵难愈,给病人的生活和工作带来了诸多不便,个别还可发展到胃癌前病变甚至胃癌,危及生命健康。近几年来,现代医学的研究认为本病的发生与幽门螺杆菌感染、自身免疫、十二指肠液反流及其他年龄和饮酒等因素有关。然而事实上,采用抑杀幽门螺杆菌、促胃动力和胃粘膜保护等治疗,也不能完全解除症状和根治本病。这是因为慢性胃炎的病因非常复杂,西医药不但缺乏特效的疗法,而且抑杀幽门螺杆菌的抗生素或铋剂(较长期使用)会产生副作用和耐药性,病人接受此治疗的依从性低。因此慢性胃炎的治疗有冀于中医药、中西医结合的方法。中医药治疗慢性胃炎具有巨大优势,用中药汤剂或中成药治疗本病能显著地改症状,部分萎缩性胃炎或轻度的胃癌前病变可获逆转。因此中医药治疗慢性胃炎疗效是确切的。本课题所选药物和胃片具有益气健脾、活血化瘀、清热解毒、散结止痛功效,其组方配伍独特,多年临床运用疗效显著,临床用于治疗慢性胃炎,症见胃脘疼痛,腹胀纳差,恶心,口粘腻,大便不畅,舌赤,苔黄腻等。试验时动物随机分组,设正常对照组或模型对照组,选择三九胃泰为中药阳性药物对照,相关试验设雷尼替丁为西药阳性药物对照,以保证试验方法的可靠性。受试药物按临床剂量的2.5倍、5倍、10倍分别设不同剂量组(大鼠),为了考察和胃片对慢性胃炎的防治作用,采用阿司匹林致胃粘膜损伤和盐酸-乙醇所致大鼠急性胃粘膜损伤进行实验；为了进一步考察治疗慢性胃炎的作用,选择复合因素(胆酸+乙醇法)致大鼠慢性胃炎及免疫法慢性胃炎动物模型。实验结果显示,和胃片对胃粘膜的急性损伤有较好的保护作用；对大鼠阿司匹林胃致溃疡和盐酸-乙醇所致大鼠急性胃粘膜损伤有明显的抑制作用。因此推测和胃片的抗溃疡作用可能是通过提高对胃粘膜屏障的保护作用。和胃片可明显降低胃液中总酸度,抑制胃蛋白酶活性。提示和胃片具有抑制胃液酸度和胃蛋白酶活性的作用。复合因素致慢性胃炎病理报告结果表明,和胃片高、中、低各剂量组胃粘膜病理改变较模型组减轻,其中高剂量组疗效明显,疗效优于三九胃泰。和胃片对大鼠胃炎有一定的疗效作用。免疫法致慢性胃炎病理报告结果表明,和胃片高、中、低各剂量组胃粘膜病理改变较模型组减轻,其中高剂量组疗效明显。和胃片对大鼠胃炎有一定的疗效作用。综上所述,和胃片对大鼠慢性胃炎有防治作用,研究结果为和胃片益气健脾、活血化瘀、清热解毒、散结止痛功效,用于治疗慢性胃炎所致的胃脘疼痛,腹胀纳差,恶心,口粘腻,大便不畅,舌赤,苔黄腻等症提供了一定的药理学依据。更多还原

【Abstract】 Chronic gastritis is the chronic inflammation of the gastric mucosa commonly caused by, but not limited to, Helicobacter pylori infection, autoimmunity, duodenal regurgitation, aging and alcohol consumption. Western Medicine generally prescribes treatments such as antibiotics and Colloidal Bismuth Subcitrate, which have been only effective in mitigating isolated symptoms, but with side effects and eventual drug resistance. Recent studies and clinical trials in Chinese Medicine have made significant leaps in the treatment of chronic gastritis with potential to treat precancerous gastritis lesions.In search of alternative treatments, the Hewei tablet was formulated specifically for clinical treatment of the disease by using ingredients that boost Qi, improve digestion, facilitate blood circulation, remove stasis, calm fevers, detoxify, and dissipate stagnation. To prove the effectiveness of Hewei tablet, the study compares it to San Jiu Wei Tai capsule and Ranitidine. Trials conclude that the Hewei Tablet does indeed provide better gastro protection and faster recovery in Sprague Dawley (SD) rats, which have been pre-exposed to acetylsalicylic acid and hydrochloric acid-alcohol (acute case study).Three different treatment dosages (2.5x,5x,10x) were applied to two models:complex factor (bile acid&alcohol), and immunifact ion. Utilizing San Jiu Wei Tai capsule as the Chinese Medicine benchmark and Ranitidine as the Western Medicine benchmark, comparative results revealed that mucosal pathologic alterations of test rats treated with5x and10x dosages of the Hewei tablet are much less; the10x dosage group demonstrated high effectiveness suggesting that Hewei tablet may be an ideal treatment for mucosal gastritis. The results also reveal that the anti-ulcer function of Hewei tablet considering the enhanced protection it provides for the gastric mucosal barrier. Furthermore, the results indicate that the tablet reduces the total acidity of gastric juice and inhibits the activity of pepsin. In conclusion, the Hewei tablet has preventive and therapeutic action against chronic gastritis in SD rats.更多还原