降逆清熱化濁方對非糜爛性胃食管反流病大鼠模型食管組織降鈣素基因相關肽的影響

邱新萍　陳瑞琳　周滔　李長新　牛柯敏　楊仲婷　殷秀雯　馬萬千

摘要?目的：觀察降逆清熱化濁方對非糜爛性胃食管反流病（NERD）大鼠模型食管組織降鈣素基因相關肽（CGRP）的影響。方法：選取SD雄性大鼠60只并將其分為正常組、模型組、西藥組和中藥組。以雞卵清蛋白/氫氧化鋁基礎致敏聯合食管酸灌注的方法制備NERD大鼠模型，藥物干預14 d后，觀察各組大鼠食管組織的病理改變及高敏感性相關信號分子CGRP的表達情況。結果：與正常組比較，模型組大鼠食管組織上皮細胞間隙增寬，有少量炎性細胞;與模型組比較，中藥組、西藥組大鼠食管組織CGRP表達明顯降低，且中藥組降低更為顯著。結論：降逆清熱化濁方通過抑制CGRP的表達，下調食管高敏感性，從而對NERD起到治療作用。

關鍵詞?胃食管反流;降逆清熱化濁方;食管高敏感性;大鼠;降鈣素基因相關肽;上皮細胞

Study of Effects on Jiangni Qingre Huazhuo Prescription on Calcitonin Gene Related Peptide in Rats with Non-erosive Gastroesophageal Reflux Disease

Qiu Xinping1，Chen Ruilin2，3，Zhou Tao2，Li Changxin1，Niu Kemin1，Yang Zhongting2，3，Yin Xiuwen2，3，Ma Wanqian1

（1 Beijing Hospital of Traditional Chinese Medicine Shunyi Branch，Beijing 101300，China; 2 Beijing Hospital of Traditional Chinese Medicine，Capital Medical University，Beijing 100010，China; 3 Beijing University of Chinese Medicine，Beijing 100029，China）

Abstract?Objective：To observe the effects of Jiangni Qingre Huazhuo Prescription on the esophageal tissue CGRP in rats with non-erosive gastroesophageal reflux disease（NERD）. Methods：Sixty male SD rats were divided into the normal group，model group，western medicine group and Chinese medicine group. The NERD rat model was prepared by chicken ovalbumin/aluminum hydroxide sensitization combined with esophageal acid perfusion. After 14 days of drug intervention，the pathological changes of esophageal tissue and the calcitonin gene related peptide（CGRP）of high-sensitivity-related signaling molecule was observed. Results：Compared with the normal group，the esophageal tissue epithelial cells in the model group were widened and a small amount of inflammatory cells were present. Compared with the model group，the expression of CGRP in the esophageal tissue of the rats in the Chinese medicine group and the western medicine group was significantly reduced. The decreased range of Chinese medicine group was more significant than that of the western medicine group. Conclusion：Jiangni Qingre Huazhuo Prescription can get therapeutic effects of non-erosive gastroesophageal reflux disease by inhibiting expression of CGRP and down-regulate the high sensitivity of esophagus.

Key Words?Gastroesophageal reflux; Jiangni Qingre Huazhuo Prescription; Esophageal hypersensitivity; Rats; Calcitonin gene related peptide; Epithelial cells

中圖分類號：R289.5;R573.9文獻標識碼：Adoi：10.3969/j.issn.1673-7202.2019.03.019

胃食管反流病（Gastroesophageal Reflux Disease，GERD）是胃內容物反流入食管、口腔所引起的，以反酸、燒心、吞咽疼痛為主要不適癥狀的一種疾病[1]。其中，具有胃食管反流引起的不適癥狀，且近期未予以抑酸治療，內鏡下未發現食管黏膜損傷的一種GERD亞型為非糜爛性胃食管反流病（Non-erosive Gastroesophageal Reflux Disease，NERD），又稱內鏡陰性胃食管反流病，占GERD的50%～70%[2-3]。NERD的發病機制較為復雜，目前多認為與酸反流、非酸相關性刺激、內臟高敏感等相關[4-5]。NERD根據其臨床特征可歸入中醫學“反酸”“嘈雜”等范疇。中醫認為其主要病機為“胃氣上逆、胃火熾盛、濁邪上泛”，故治療當以降逆清熱化濁為主[6]。……