Effects of Jieyu Huatan Xiaoyu Formula on Clinical Efficacy and Nrf2-Keap Signaling Pathway in Patients with Gastric Precancerous Lesions of Liver-Stomach Disharmony Type
10.13359/j.cnki.gzxbtcm.2025.11.011
- VernacularTitle:解郁化痰消瘀方对肝胃不和型胃癌前病变患者临床疗效及Nrf2-Keap信号通路的影响
- Author:
Yuxin CHEN
1
;
Kuo YANG
;
Huayi LIU
Author Information
1. 天津中医药大学,天津 301617
- Keywords:
Jieyu Huatan Xiaoyu Formula;
liver-stomach disharmony;
gastric precancerous lesions(GPL);
Nrf2-Keap signaling pathway;
TCM syndrome score
- From:
Journal of Guangzhou University of Traditional Chinese Medicine
2025;42(11):2697-2704
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy of Jieyu Huatan Xiaoyu Formula(JYHTXYF)in patients with gastric precancerous lesions(GPL)of liver-stomach disharmony type and to observe its effects on the nuclear factor erythroid 2-related factor 2(Nrf2)-Kelch-like ECH-associated protein 1(Keap1)signaling pathway.Methods A prospective study enrolled 100 GPL patients with liver-stomach disharmony syndrome treated at the Department of Gastroenterology,Affiliated Hospital of Tianjin Academy of Chinese Medicine from August 2023 to August 2024.Participants were randomized into control group(n=50,treated with Moluodan Pills)and trial group(n=50,treated with JYHTXYF decoction)for 6 months.Traditional Chinese medicine(TCM)syndrome scores,gastroscopic pathological scores,serum superoxide dismutase(SOD)and malondialdehyde(MDA)levels,along with Nrf2-Keap pathway-related gene/protein expressions were assessed before and after treatment.Results(1)Regarding clinical efficacy,after 6 months of treatment,the total effective rate was 94.00％(47/50)in the trial group and 76.00％(38/50)in the control group.Intergroup comparison(by chi-square test)showed that the efficacy of the trial group was significantly superior to that of the control group(P＜0.05).(2)In terms of traditional Chinese medicine(TCM)syndrome scores,after treatment,the scores for TCM syndromes such as epigastric pain,gastric distension,belching,and poor appetite decreased in both groups compared to those before treatment(P＜0.05),and the reduction in the trial group was significantly superior to that in the control group(P＜0.01).(3)Regarding gastroscopic pathological scores,after treatment,the scores for gastric mucosal atrophy,intestinal metaplasia,dysplasia,and chronic inflammation decreased in both groups compared to those before treatment(P＜0.05),and the reduction in the trial group was significantly greater than that in the control group(P＜0.01).(4)In terms of oxidative stress indicators,after treatment,SOD levels increased in both groups compared to before treatment(P＜0.05),while serum MDA levels decreased(P＜0.05).The magnitude of increase in serum SOD levels and the magnitude of decrease in serum MDA levels in the trial group were significantly greater than those in the control group(P＜0.05 or P＜0.01).(5)Regarding the expression levels of genes related to the Nrf2-Keap signaling pathway,after treatment,the relative mRNA expression levels of Nrf2,NAD(P)H quinone dehydrogenase 1(NQO1),and heme oxygenase-1(HO-1)in gastric mucosal tissue increased in both groups compared to those before treatment(P＜0.05),and the increase in the trial group was significantly greater than that in the control group(P＜0.01).(6)Regarding the expression levels of proteins related to the Nrf2-Keap signaling pathway,after treatment,the relative protein expression levels of Nrf2,HO-1,and mitochondrial superoxide dismutase(SOD2)in gastric mucosal tissue increased in both groups compared to those before treatment(P＜0.05),and the increase in the trial group was significantly greater than that in the control group(P＜0.01).Conclusion JYHTXYF effectively improves TCM syndromes and gastroscopic pathology in GPL patients of liver-stomach disharmony type,elevates serum antioxidant enzyme levels,and upregulates the expression of genes and proteins associated with the Nrf2-Keap1 signaling pathway,thereby enhancing clinical efficacy.The study will provide novel insights and approaches for the treatment of gastric precancerous lesions.
