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目的:研究消化性溃疡并幽门螺杆菌(H.pylori)感染初治失败患者血浆网膜素-1(Omentin-1)水平的变化及中西医结合干预治疗的效果。方法:选择2011年9月~2015年9月在我院进行诊治的消化性溃疡患者82例观察组,采用阿莫西林,奥美拉唑、拉霉素和清幽口服液等中西医结合治疗,并选择20例健康体检者为对照组。采用ELISA法检测血浆Omentin-1水平,分析血浆Omentin-1水平与一氧化氮(NO)、白细胞介素-2(IL-2)、内皮素-1(ET-1)、肿瘤坏死因子α(TNF-α)的关系。观察中西医结合治疗前后病例组血浆Omentin-1水平的变化并评价H.pylori根除的疗效及安全性。结果:进行中西医结合治疗后,H.pylori根除率达88.6%;有34例溃疡痊愈,22例显效,33例有效,3例无效,愈合率为68.29%(56/82),有效率为96.34%(79/82);观察组血浆Omentin-1水平为(18.15±3.96)ng/m L,明显低于对照组的(23.12±6.03)ng/m L(P<0.05);与对照组相比,观察组的NO、IL-2水平明显降低(P<0.05),ET-1,TNF-α和IL-6水平明显升高(P<0.05);与治疗前相比,经中西医结合治疗后NO、IL-2水平明显降低(P<0.05),ET-1,TNF-α和IL-6水平明显升高(P<0.05);观察组血浆Omentin-1与IL-2、NO呈明显正相关(r=0.412,P<0.05和r=0.382,P<0.05),与IL-6和TNF-α呈明显负相关(r=-0.246,P<0.05和r=-0.258,P<0.05)。结论:中西医结合治疗能升高血浆Omentin-1水平,有效提高溃疡愈合率及H.pylori根除率,抑制炎性因子的分泌,增强内源性NO保护作用和机体免疫功能。
Objective: To study the changes of plasma levels of Omentin-1 in peptic ulcer patients with initial failure of H.pylori infection and the effects of intervention by traditional Chinese and western medicine. Methods: A total of 82 patients with peptic ulcer diagnosed and treated in our hospital from September 2011 to September 2015 were selected and treated with the combination of traditional Chinese and Western medicine such as amoxicillin, omeprazole, Twenty healthy subjects were selected as the control group. The level of Omentin-1 in plasma was measured by ELISA. The levels of serum Omentin-1 were compared with those of NO, IL-2, ET-1 and tumor necrosis factor alpha TNF-α). To observe the changes of plasma Omentin-1 level before and after the combination of traditional Chinese and Western medicine and evaluate the efficacy and safety of H.pylori eradication. Results: The rate of H.pylori eradication was 88.6% after the combination of TCM and WM treatment. 34 cases of ulcer healed, 22 cases markedly effective, 33 cases effective, 3 ineffective, and the healing rate was 68.29% (56/82). The effective rate was The level of Omentin-1 in the observation group was (18.15 ± 3.96) ng / m L, which was significantly lower than that in the control group (23.12 ± 6.03 ng / m L, P <0.05) (P <0.05). The levels of ET-1, TNF-α and IL-6 in the observation group were significantly higher than those before treatment (P <0.05) The levels of NO and IL-2 were significantly decreased (P <0.05), and the levels of ET-1, TNF-α and IL-6 were significantly increased in combination group (P <0.05) (R = -0.422, P <0.05 and r = 0.382, P <0.05), but negatively correlated with IL-6 and TNF-α <0.05). Conclusion: The combination of traditional Chinese and Western medicine can increase plasma Omentin-1 level, effectively improve the ulcer healing rate and H. pylori eradication rate, inhibit the secretion of inflammatory cytokines, enhance endogenous NO protection and immune function.