胃复春片联合兰索拉唑肠溶片对慢性萎缩性胃炎患者血清胃肠激素、炎症因子及免疫功能的影响

摘要 目的：胃复春片联合兰索拉唑肠溶片对慢性萎缩性胃炎（CAG）患者血清胃肠激素、炎症因子及免疫功能的影响。方法：选取62例CAG患者,根据门诊挂号奇偶性分为对照组（n=31,兰索拉唑肠溶片治疗）和研究组（n=31,胃复春片联合兰索拉唑肠溶片治疗）。比较两组患者疗效、胃肠激素[胃泌素(GAS)、胃动素(MTL)]、炎症因子[超敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）]、免疫功能及不良反应。结果：研究组治疗2个月后的总有效率为87.10%（27/31）,高于对照组的64.52%（20/31）,差异有统计学意义（P<0.05）。治疗2个月后,研究组hs-CRP、TNF-α、IL-6、GAS、CD8P低于对照组,MTL、CD4P、CD4⁺/CD8⁺高于对照组（P<0.05）。两组不良反应发生率对比未见明显差异（P>0.05）。结论：胃复春片联合兰索拉唑肠溶片治疗CAG疗效确切,可有效改善机体胃肠激素、炎症因子水平及免疫功能,且安全可靠,具有一定应用价值。     

胃康胶囊联合兰索拉唑肠溶胶囊对胃溃疡患者胃肠激素、炎症反应和T淋巴细胞亚群的影响

摘要 目的：观察胃康胶囊联合兰索拉唑肠溶胶囊治疗胃溃疡的疗效及对胃肠激素、炎症反应和T淋巴细胞亚群的影响。方法：选择2018年9月~2021年5月在中国人民解放军31694部队医院消化内科接受治疗的80例胃溃疡患者作为观察对象,根据信封抽签法分为对照组和观察组,各为40例。对照组患者接受兰索拉唑肠溶胶囊治疗,观察组患者接受胃康胶囊联合兰索拉唑肠溶胶囊治疗,连续治疗6周。对比两组临床疗效、幽门螺杆菌（Hp）根除率和溃疡愈合率,观察治疗期间不良反应发生情况,对比两组治疗前、治疗6周后的胃肠激素、血清炎症因子和T淋巴细胞亚群指标水平的变化。结果：观察组的临床总有效率较对照组高（P<0.05）。观察组的Hp根除率和溃疡愈合率均高于对照组（P<0.05）。治疗6周后,两组CD3⁺、CD4⁺、CD4⁺/CD8⁺较治疗前升高,CD8⁺ 较治疗前下降,且观察组的改善效果优于对照组（P<0.05）。治疗6周后,两组胃动素（MTL）水平较治疗前升高,胃泌素（GAS）水平较治疗前下降,且观察组的改善效果优于对照组（P<0.05）。治疗6周后,两组高迁移率族蛋白B1（HMGB1）、白介素-6（IL-6）、C反应蛋白（CRP）水平较治疗前下降,且观察组的改善效果优于对照组（P<0.05）。两组不良反应发生率对比无统计学差异（P>0.05）。结论：兰索拉唑肠溶胶囊联合胃康胶囊可提高胃溃疡患者的溃疡愈合率和Hp根除率,其作用机制可能与调节胃肠激素、炎症反应和T淋巴细胞亚群指标水平有关。     

Immunoelectron microscopic study for histamine in the gastric enterochromaffin-like cells of rats treated with the proton pump inhibitor lansoprazole

The enterochromaffin-like (ECL) cells of the gastric mucosa in animals play an important role in gastric acid secretion. They contain few granules and numerous secretory vesicles and microvesicles. They operate under the control of circulating gastrin. In the present study, we conducted an immunoelectron microscopic study for histamine (HA) in the ECL cells of rats given the proton pump inhibitor lansoprazole (LP), which is known to induce hypergastrinemia. The pre-embedding indirect immunoperoxidase procedure utilized a mouse monoclonal antibody AHA-2 against glutaraldehyde-conjugated HA. Rats received LP (50 g/kg per day, subcutaneously) over a period of a month, and developed hypertrophy of the ECL cells in the stomach. It was clearly demonstrated that HA was located to a much higher degree in the cytoplasm of ECL cells of LP-treated rats than in normal rats. HA immunoreactivity was observed in the cores of the granules and secretory vesicles of the ECL cells in all the rats, but in the LP-treated rats it was observed in the cores of the newly developed vacuoles as well. These results may suggest that HA may be actively generated in the cytoplasm of the hypertrophic ECL cells of LP-treated rats. Also suggested in the present study is that HA is instrumental in the transformation of granules into secretory vesicles and in their consequent enlargement, and that vacuoles are formed by the fusion of large secretory vesicles. Furthermore, the finding that relatively little HA immunoreactivity existed in the vacuoles may suggest that the vacuoles actively degrade superfluous secretory products (for example, HA) through enhanced autophagocytosis and/or oxidative stress. Another possibility may be that the membrane-bounded structure regarded as the vacuoles in this study might actually be an invagination structure produced as a result of successive series of exocytosis through which the secretory vesicles actively and rapidly release HA.     

Short-term therapy with celecoxib and lansoprazole modulates Th1/ Th2 immune response in human gastric mucosa

Background: Selective cyclooxygenase‐2 (COX‐2) inhibitors and proton pump inhibitors may exert immune‐mediated effects in human gastric mucosa. T‐cell immune response plays a role in Helicobacter pylori‐induced pathogenesis. This study evaluated effects of celecoxib and lansoprazole on T‐helper (Th) 1 and Th2 immune response in human gastric mucosa. Methods: Dyspeptic patients with or without osteoarticular pain were given one of the following 4‐week therapies: celecoxib 200 mg, celecoxib 200 mg plus lansoprazole 30 mg, and lansoprazole 30 mg daily. Expression of COX‐2, T‐bet, and pSTAT6 and production of prostaglandin E₂ (PGE₂), interferon (IFN)‐γ, and interleukin (IL)‐4 were determined in gastric biopsies before and after therapy. Histology was evaluated. Results: Cyclooxygenase‐2 expression and PGE₂ production was higher, and Th1 signaling pathway was predominant in H. pylori‐infected vs. uninfected patients. T‐bet expression and IFN‐γ production increased, while STAT6 activation and IL‐4 production decreased following therapy with celecoxib and celecoxib plus lansoprazole, respectively. Th1 and Th2 signaling pathways down‐regulated after therapy with lansoprazole, and this was associated with an improvement of gastritis. Effect of therapy was not affected by H. pylori status. Conclusion: Celecoxib and lansoprazole modulate Th1/Th2 immune response in human gastric mucosa. The use of these drugs may interfere with long‐term course of gastritis.     

埃索美拉唑治疗幽门螺杆菌阳性十二指肠球部溃疡疗效观察

目的：比较埃索关拉唑与兰索拉唑、奥美拉唑三联疗法治疗幽门螺杆菌（Hp）阳性十二指肠球部渍疡疗效观察。方法：将84例Hp阳性的十二指肠球部溃疡随机分为三组。埃索美拉唑组（28例）：埃索美拉唑20mg＋阿莫西林1g＋呋喃唑酮100mg,每日2次,共7日,后服用埃索美拉唑20mg,每日一次,共21天;兰索拉唑组（28例）：兰索拉唑15mg＋阿莫西林1g＋呋喃唑酮100mg,每日2次,共7日,后服用兰索拉唑15mg,每日一次,共21天;奥美拉唑组（28例）：奥美拉唑20mg＋阿莫西林1g＋呋喃唑酮100mg,每日2次,共7日,后服用奥美拉唑20mg,每日一次,共21天。疗效结束4周后复查胃镜并检测Hp,观察腹痛缓解率、溃疡愈合率,Hp根治率及药物不良反应。结果：埃索美拉唑组、兰索拉唑组和奥关拉唑组溃疡愈合率分别为100％,85．7％,82．1％,HP根治率为85．7％,60．7％,64.3％,埃索美拉唑组溃疡愈合率及Hp根除率高于兰索拉唑组及奥美拉唑组,差异具有统计学意义（P〈0．05）。兰索拉唑组及奥美拉唑组溃疡愈合率及Hp根除率无明显差异（P〉0．05）。三组用药后不良反应少,具较好的安全性。结论：埃索关拉唑三联疗法治疗Hp阳性的消化性溃疡疗效优于兰索拉唑及奥美拉唑三联疗法,值得临床广泛应用。     

埃索美拉唑治疗幽门螺杆菌阳性十二指肠球部溃疡疗效观察

目的:比较埃索美拉唑与兰索拉唑、奥美拉唑三联疗法治疗幽门螺杆菌(Hp)阳性十二指肠球部溃疡疗效观察。方法:将84例Hp阳性的十二指肠球部溃疡随机分为三组。埃索美拉唑组(28例):埃索美拉唑20mg+阿莫西林1g+呋喃唑酮100mg,每日2次,共7日,后服用埃索美拉唑20mg,每日一次,共21天;兰索拉唑组(28例):兰索拉唑15mg+阿莫西林1g+呋喃唑酮100mg,每日2次,共7日,后服用兰索拉唑15mg,每日一次,共21天;奥美拉唑组(28例):奥美拉唑20mg+阿莫西林1g+呋喃唑酮100mg,每日2次,共7日,后服用奥美拉唑20mg,每日一次,共21天。疗效结束4周后复查胃镜并检测Hp,观察腹痛缓解率、溃疡愈合率,Hp根治率及药物不良反应。结果:埃索美拉唑组、兰索拉唑组和奥美拉唑组溃疡愈合率分别为100%,85.7%,82.1%,HP根治率为85.7%,60.7%,64.3%,埃索美拉唑组溃疡愈合率及Hp根除率高于兰索拉唑组及奥美拉唑组,差异具有统计学意义(P<0.05)。兰索拉唑组及奥美拉唑组溃疡愈合率及Hp根除率无明显差异(P>0.05)。三组用药后不良反应少,具较好的安全性。结论:埃索美拉唑三联疗法治疗Hp阳性的消化性溃疡疗效优于兰索拉唑及奥美拉唑三联疗法,值得临床广泛应用。     

兰索拉唑联合奥曲肽治疗急性非静脉曲张性上消化道出血的临床效果及安全性分析

目的:探讨兰索拉唑联合奥曲肽治疗急性非静脉曲张性上消化道出血的临床疗效以及安全性。方法:选取自2014年1月到2017年1月我院收治的急性非静脉曲张性上消化道出血患者102例,随机分为A组、B组和C组,每组各34例。A组使用兰索拉唑进行治疗,B组使用奥曲肽进行治疗,C组联合使用兰索拉唑和奥曲肽进行治疗。对比三组患者的临床疗效、止血时间、血压稳定时间、胃管引流量、胃液PH值以及不良反应的发生情况。结果:治疗后,C组的显效率为61.76%,显著高于A组和B组(均P0.05);C组的总有效率为97.06%,显著高于B组(P0.05);C组的止血时间为(15.37±4.38)h,血压稳定时间为(7.23±1.18)h,胃管引流量为(236.59±29.81)mL,均显著少于A组和B组,而胃液PH值为(5.91±0.57),显著高于A组和B组(均P0.05)。三组患者不良反应发生率的对比差异均没有统计学意义(P0.05)。结论:兰索拉唑联合奥曲肽治疗急性非静脉曲张性上消化道出血可显著提高止血效果,临床疗效明显优于单用兰索拉唑或奥曲肽治疗,且安全性相当。     

兰索拉唑与奥美拉唑治疗活动期胃溃疡的效果及对血清抗氧化因子的影响

目的:观察和比较兰索拉唑与奥美拉唑治疗活动期胃溃疡的临床效果及其对患者血清抗氧化因子水平的影响。方法:选取2016年1月至2017年1月我院收治的活动期胃溃疡患者88例,将其随机分成研究组和对照组,每组各44例。对照组给予奥美拉唑于睡前口服治疗,一次20mg,每日1次。研究组给予兰索拉唑于睡前口服治疗,一次30mg,每日1次。两组患者均以7d为一个疗程,连续治疗8个疗程。比较两组患者的临床总有效率和治疗前后血清超氧化物歧化酶(Superoxide dismutase,SOD)、丙二醛(Methylene dioxyamphetamine,MDA)、内皮素-1(Endothelin-1,ET-1)和一氧化氮(Nitric oxide,NO)水平的变化。结果:(1)研究组治疗总有效率为97.73%,对照组治疗总有效率为79.55%,研究组治疗总有效率显著高于对照组(P0.05);(2)治疗前,两组患者血清SOD、MDA、ET-1和NO水平比较差异无统计学意义(P0.05),研究组患者治疗后血清MDA、ET-1水平均明显低于对照组,血清SOD、NO水平均显著高于对照组(P0.05)。结论:兰索拉唑治疗活动期胃溃疡的临床效果明显优于奥美拉唑,可能与其显著提高患者血清SOD、NO水平及降低血清MDA、ET-1水平有关。     

兰索拉唑与奥美拉唑对胃溃疡患者氧化应激水平和内皮功能的影响

目的:探讨兰索拉唑(LAN)与奥美拉唑(OME)治疗胃溃疡的临床效果及对患者血浆氧化应激水平和血管内皮功能的影响。方法:选取我院2014年1月~2016年10月收治的138例胃溃疡患者,按照随机数字表法均分为LAN组和OME组,并选取我院同期69例健康体检者为对照组。对照组不用任何药物,LAN组予以LAN治疗,OME组给予OME治疗。记录比较LAN组和OME组的临床疗效、Hp根除率及胃镜疗效;对照组与LAN组、OME组两组治疗前后血浆氧化应激指标、血管内皮功能指标水平;并评价LAN组与OME组的用药安全性。结果:总疗程结束后,LAN组总有效率、Hp根除率分别为94.2%、89.9%,较OME组(91.3%、87.0%)相比差异无统计学意义(P0.05)。经4个疗程后,LAN组胃镜总有效率为95.7%,明显高于OME组的85.5%(P0.05)。与对照组相比,LAN组、OME组治疗前血浆MDA、ET-1水平均显著上升(P0.01),SOD、NO水平均显著降低(P0.01)。与本组治疗前对比,LAN组、OME组治疗后血浆MDA、SOD、NO及ET-1水平均显著改善(P0.01),且LAN组治疗后各血浆因子水平改善效果均显著优于OME组(P0.01)。结论:LAN治疗胃溃疡改善患者临床症状、根除Hp的效果及安全性与OME相当,但LAN更能有效降低机体的氧化应激水平,调节血管内皮功能,促进溃疡愈合。     

The alternating current polarographic behavior and determination of lansoprazole and omeprazole in dosage forms and biological fluids

The alternating current (AC_t) polarographic behavior of lansoprazole (LNS) and omeprazole (OMP) was studied in Britton Robinson buffers (BRb) over the pH range 4.1–11.5. In BRb of pH 9.6 and 10.5, well-defined AC_t peaks were obtained for both LNS and OMP, respectively. The current–concentration plots were rectilinear over the ranges of 0.4–20 µg mL^− 1 and 0.2–10 µg mL^− 1 for LNS and OMP respectively. The minimum detection limits (S/N = 2) were 0.02 µg mL^− 1 (5.4 × 10^− 8 M) and 0.01 µg mL^− 1 (2.9 × 10^− 8 M) for LNS and OMP, respectively. The proposed method was successfully applied to the analysis of the two drugs in their commercial capsules. The average percent recoveries were favorably compared to those obtained by reference methods. Co-administered drugs such as naproxen and methotrexate did not interfere with the proposed method. The proposed method was further extended to the in-vitro determination of the lansoprazole in spiked plasma, the percentage recoveries was 98.47 ± 1.29 (n = 4). The pathway for the electrode reaction for both drugs involved reduction of the sulphonyl group into the corresponding thiol group at the Dropping Mercury Electrode. The advantages of the method were time saving and more sensitive than the other published voltammetric method. Yet The present study is the first report on the use of alterating current polarography (AC_t) in this respect.