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Objective To analyze the metabolomics characteristics of chronic atrophic gastritis(CAG)patients with liver-stomach qi stagnation and spleen-stomach weakness syndromes based on non-targeted metabolomics technology,and to identify the serum differentiated metabolites related to traditional Chinese medicine(TCM)syndrome of CAG patients,so as to provide a reference for the objectification of syndrome differentiation.Methods Sixty patients with CAG were included,including 30 cases of liver-stomach qi stagnation syndrome and 30 cases of spleen-stomach weakness syndrome.Fasting blood of 5 mL was collected from the cubital vein of patients in the two groups,and the serum levels of metabolites were detected by ultra-high-performance liquid chromatography-mass spectrometry(UPLC-MS)methods.The principal component analysis(PCA),orthogonal partial least squares-discriminant analysis(OPLS-DA),and cluster analysis were used to screen the differentiated metabolites of CAG patients with liver-stomach qi stagnation syndrome and spleen-stomach weakness syndrome.Finally,metabolite pathway analysis was performed for the obtained differentiated metabolites using the KEGG database.Results The results for the screening of differentiated metabolites showed that significant differences of amino acid derivatives and small peptide metabolites were presented between CAG patients with liver-stomach qi stagnation syndrome and CAG patients with spleen-stomach weakness syndrome.The amino acid derivatives consisted of N-acetylglycine,histamine,O-phosphoserine,selenomethylselenocysteine,and methyl-tyrosine.And the small peptide metabolites consisted of tyrosine-leucine-phenylalanine,histidine-alanine-glutamate-lysine,L-asparagine-L-proline-L-serine,and L-isoleucine-L-isoleucine.Conclusion Differences in amino acid metabolism exist between CAG patients with liver-stomach qi stagnation syndrome and those with spleen-stomach weakness syndrome,and metabolites such as N-acetylglycine,intermethyltyrosine,and O-phosphoserine may be the potential biomarkers for distinguishing liver-stomach qi stagnation syndrome from spleen-stomach weakness syndrome in CAG patients.
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Objective::To evaluate theclinical efficacy of Zhiwei pills combined with Hperadication programme for gastritis with liver and stomach Qi stagnation syndrome caused by helicobacter pylori (Hp) and to investigate its effect on antioxidant stress. Method::One hundred and sixty patients were randomly divided into control group (80 cases) and observation group (80 cases) by random number table. Patients in control group gotHperadication programme, and esomeprazole magnesium enteric-coated tablets, 20 mg/time, 1 time/day. Bismuth potassium citrate tablets, 0.3 g/time, 2 times/days. Amoxicillin capsules, 1.0 g/time, 2 times/days. Furazolidone tablets, 0.1 g/time, 2 times/days, all for 14 days. Based on the treatment in control group, the patients in observation group additionally got Zhiwei pills, 6 g/time, 3 times/day. The course of treatment was 8 weeks in both groups. After treatment, eradication of Hp was detected. Before and after treatment, scores of liver and stomach Qi stagnation syndrome were graded. After treatment, patients received gastroscopy and pathological review, and patient report outcome indicators (PRO) both before and after treatment were discussed. The levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-8, oxidative dismutase (SOD), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) were detected both before and after treatment. Result::Negative conversion rate of Hp was(70/75) 93.33% in observation group, higher than(58/71) 81.69% in control group (P<0.05). In the analysis of rank sum test, effect of traditional Chinese medical(TCM) syndrome in observation group was better than that in control group (Z=2.183, P<0.05), and clinical efficacy was also better than that in control group (Z=2.175, P<0.05). Scores of liver and stomach Qi stagnation syndrome and total PRO score in observation group were all lower than those in control group (P<0.01). Levels of TNF-α, IL-1β, IL-8 and MDA were lower than those in control group (P<0.01), while levels of SOD and GSH-Px were higher than those in control group (P<0.01). Conclusion::Zhiwei pills combined with Hperadication programme can improve the eradication rate of Hp, alleviate clinical symptoms, improve the quality of life of patients, inhibit inflammatory reaction and anti-oxidative stress, and improve the curative effect and clinical efficacy of TCM syndromes in the treatment of gastritis with liver and stomach Qi stagnation syndrome, so it is worth for further study and use.
