OBJECTIVETo study the effects of tongjiang granule (TJG) on reflux esophagitis (RE) in rats.

METHODSTwo rat models of RE were established respectively by cardioplasty + pyloric ligation + Roux-en-Y gastro-jejunum anastomosis and by placed a fixed steel ring into the gastric cardia, and the model rats were treated with various dosages of TJG or cisapride by gastric perfusion.

RESULTSRat models were established successfully by both methods. The score of pathological changes of esophagus mucosa in the model rats, made by either method, after high-dosage TJG treatment was lower than that in the model rats (P < 0.05), but equal to that in the cisapride treated model rats. High and moderate dosages of TJG were shown by transmission electron microscope to have effects of alleviating heckle cells and inflammatory reaction. They could reduce the level of gastric acid, more significant in high and moderate dosage groups (P < 0.05), while cisapride couldn't.

CONCLUSIONTJG is effective in treating experimental RE in rats to a certain extent.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Esophagitis, Peptic ; drug therapy ; pathology ; Esophagus ; drug effects ; pathology ; Female ; Male ; Phytotherapy ; Powders ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo screen and optimize the extraction of Dingxiangjiangqi granules.

METHODThe extraction route was screened by using pharmacodynamic experiment and the extraction conditions were optimized by orthogonal design and taking extract yield, content of naringin and tetrahydropalmatine as indexes.

RESULTThe pharmacodynamic result showed that aqueous extract had the best effect to cure the esophagitis of rats and the optimized extraction technique was adding 12 times water, extracting 0. 5 hour for 3 times.

CONCLUSIONThe optimum extraction was simple, reasonable, stable and useful for further development.

Animals ; Berberine Alkaloids ; analysis ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Esophagitis, Peptic ; drug therapy ; pathology ; Esophagus ; drug effects ; pathology ; Flavanones ; analysis ; Male ; Phytotherapy ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Syzygium ; chemistry ; Technology, Pharmaceutical ; methods

OBJECTIVETo study the mechanism of Tongjiang granule on treating GERD.

METHODThe rats in the model group received steel wire ring-cardiamyopexy. A steel wire ring was fixed firmly on cardia. The rats in the control group underwent the cardia-plasty plus pylori ligation plus stomach-empty intestine Roux-en-Y anastomosis. The rats were divided into six groups after operations at random, which were fed up respectively with Tongjiang granule of different dosage and perpulsid. No treatment groups were taken as control.

RESULTThe experiment showed that Tongjiang granule could lighten or cure RE in the pathology, decrease the hydrochloric acid in gastric juice, in the meantime, increase the motilin in the animal blood. This study indicated that the effect of Tongjiang granule group from experimental research was better than that of the control group (perpulsid).

CONCLUSIONThe effects of Tongjiang granule on treating GERD can be achieved by decreasing the hydrochloric acid in gastric juice, increasing the motilin in blood and promoting the gastric impetus in the animal experiment.

Animals ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Esophagitis, Peptic ; drug therapy ; physiopathology ; Esophagus ; pathology ; Female ; Gastric Acid ; metabolism ; Gastric Emptying ; drug effects ; Hydrochloric Acid ; metabolism ; Male ; Motilin ; blood ; Phytotherapy ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo explore the effect of aluminum phosphate gel and Kangfuxin on esophageal pathology and expressions of interleukin-8 (IL-8) and prostaglandin E2 (PGE2) in rats with reflux esophagitis and explore the possible mechanisms.

METHODSSixty SD rats were randomized into aluminum phosphate gel group (n=10), Kangfuxin group (n=10), aluminum phosphate gel+Kangfuxin group (n=10), model group (n=20), and control group (n=10). Except for those in the control group, all the rats were subjected to infusion of diluted lysolecithin with hydrochloric acid in the esophagus for 14 days. Ten rats in the model group and those in the control group were sacrificed to examine the pathological changes and contents of IL-8 and PGE2 in the esophagus using optical and electron microscopes and radioimmunoassay. The next day the rest rats were given corresponding treatments (saline in model group) administered into the esophagus on a daily basis for 14 days, after which esophageal pathologies and IL-8 and PGE2 contents were examined.

RESULTSThe model rats showed obvious esophageal pathologies including inflammatory cell infiltration, vacuolar degeneration of the epithelial cells, esophageal erosion and even ulceration, with severe detachment of the epithelial cells. The rats in all the intervention groups showed lessened esophageal pathologies and lowered esophageal IL-8 and PGE2 contents compared with those in the model group. Esophageal mucosal injury index and IL-8 and PGE2 contents were all significantly lower in rats receiving combined treatment with aluminum phosphate and Kangfuxin than in those receiving either of the treatments (P<0.05).

CONCLUSIONSBoth Kangfuxin and aluminum phosphate gel are effective in the treatment for reflux esophagitis induced by lysolecithin and hydrochloric acid, and their therapeutic effects are achieved possibly by reducing IL-8 and PGE2 levels in the esophagus.

Aluminum Compounds ; pharmacology ; Animals ; Dinoprostone ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Esophagitis, Peptic ; drug therapy ; metabolism ; Esophagus ; drug effects ; pathology ; Gels ; Interleukin-8 ; metabolism ; Phosphates ; pharmacology ; Rats ; Rats, Sprague-Dawley

BACKGROUND/AIMS: Proton pump inhibitors (PPI) and H2-receptor antagonists (H2RA) are commonly prescribed for the treatment of mild to moderate reflux esophagitis (MMRE). There remains great controversy in their usefulness as the first choice and the appropriateness. We prospectively compared the efficacy and safety of the 8-week low-dose PPI vs. standard-dose H2RA in MMRE. METHODS: One hundred patients with MMRE were randomized to receive either low-dose of omeprazole (L-OMP: 10 mg, q.d.) or standard-dose of ranitidine (S-H2RA: 150 mg, b.i.d.) for 8 weeks. The H. pylori status using rapid urease test, histological examination and culture, reflux esophagitis (RE) grading, gastrointestinal symptoms using 4-point scale, adverse event and the standard laboratory examination were assessed at baseline and 8-week end point of therapy. RESULTS: Improvement rate of RE [intention to treat (n=82)/per protocol (n=72)] were shown in 69.1%/63.9% for L-OMP and 65.0%/63.9% for S-H2RA group (p=0.697, p=1.000). Complete healing rates of RE were 54.7%/50.0% for L-OMP and 42.5%/41.7% for S-H2RA. No significant difference in healing rate, the rapidity of symptom resolution, adverse events, and laboratory monitoring was found between the two groups. CONCLUSIONS: The low-dose omeprazole therapy produced similar healing rates and safety in the treatment of MMRE. In addition, L-OMP is advantageous in its once-a-day dosing and might be an alternative to S-H2RA, especially in Korean patients with MMRE.
Adolescent ; Adult ; Aged ; Anti-Ulcer Agents/*administration & dosage ; Comparative Study ; English Abstract ; Esophagitis, Peptic/*drug therapy/pathology ; Female ; Histamine H2 Antagonists/*administration & dosage ; Humans ; Male ; Middle Aged ; Omeprazole/*administration & dosage ; Ranitidine/*administration & dosage

BACKGROUNDGastroesophageal reflux disease (GERD) is a common disorder. Dilation of intercellular spaces of esophageal epithelium has been revealed at transmission electron microscopy both in the rabbit acid-perfused esophagus and in esophageal biopsies from GERD patients. This study aimed to observe the changes of the intercellular spaces of squamous epithelium of lower esophagus in patients with GERD and the changes of intercellular spaces of patients with erosive esophagitis (EE) before and after omeprazole treatment.

METHODSOutpatients having GERD symptoms for more than 3 months and volunteers were collected. All of them underwent gastroendoscopy and 24-hour ambulatory pH monitoring. Biopsies were taken from the lower esophagus (2 cm above Z-line) for electron microscope examination. Five healthy volunteers, six non-erosive reflux disease (NERD) patients, and five EE patients were enrolled. Intercellular spaces of GERD patients and controls were calculated. Then we selected 20 patients with EE diagnosed by gastroendoscopy. All of them were treated with omeprazole (Losec, 20 mg bid) for 4 weeks then underwent gastroendoscopy again. Biopsies were taken from 2 cm above Z-line for electron microscope examination. All the patients completed the questionnaire about reflux symptoms before and after treatment.

RESULTSIntercellular spaces of esophageal epithelial cell in volunteers, NERD patients and EE patients were (0.37 +/- 0.07) microm, (1.31 +/- 0.08) microm, and (1.33 +/- 0.14) microm, respectively, with significant differences between the control group and the NERD group (P = 0.000). In the 20 EE patients, the mean intercellular space before treatment was (1.14 +/- 0.15) microm. After treatment the intercellular space was (0.51 +/- 0.18) microm, a significant difference compared with pre-treatment measurements (P = 0.000).

CONCLUSIONSDilated intercellular spaces (DIS) were seen in both NERD and EE cases. The dilated intercellular spaces of esophageal epithelium in EE patients could be recovered after a short time of treatment with omeprazole.

Adult ; Anti-Ulcer Agents ; pharmacology ; therapeutic use ; Esophageal pH Monitoring ; Esophagitis, Peptic ; drug therapy ; pathology ; Extracellular Space ; drug effects ; Female ; Gastroesophageal Reflux ; drug therapy ; pathology ; Gastroscopy ; Humans ; Intercellular Junctions ; drug effects ; ultrastructure ; Male ; Microscopy, Electron, Transmission ; Middle Aged ; Omeprazole ; pharmacology ; therapeutic use