• 대한한의학방제학회지
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• 제30권1호
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• pp.11-18
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• 2022

Objectives: In this study, we aim to demonstrate an effect of crab water extract (CWE) on reflux esophagitis (RE) using lipopolysaccharide (LPS)-induced Raw 264.7 cell and rat model. Methods: To investigate on LPS-induced Raw 264.7 cell, CWE was co-treated with LPS. CWE suppressed Nitric Oxide (NO) production which increased by LPS treatment. Also, CWE showed no cytotoxicity at the concentrations range from 500 ㎍/㎖ to 2000 ㎍/㎖. Next, to investigate the protective effects of CWE on RE rat model, eighteen rats were divided in to three groups: sham group, reflux esophagitis group, and reflux esophagitis pre-treated with 100 mg/kg CWE 1 h before surgery. RE was induced by a pylorus and forestomach ligation operation and all rats were sacrificed after 4 h 30 min from surgery. Results: In gross examination, the CWE administration attenuated esophageal mucosal injury upon histological evaluation of reflux esophagus of rats. The CWE downregulated the expression levels of proteins related to inflammation, such as COX-2 and TNF-α in the esophagus tissue. In addition, the CWE suppressed the NF-κB and IκB-α activation. Conclusions: Based on these findings, we concluded that CWE could possess protective effect against damage to the esophagus due to reflux esophagitis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권2호
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• pp.103-109
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• 2008

목 적: 소아에서 식도염은 성인과 달리 나이별로 다양하고, 비특이적인 증상이나 징후를 보인다. 또한 식도염을 진단하기 위한 상부 위장관 내시경과 조직 생검을 시행하는 것도 쉽지 않다. 이에 본 연구에서는 소아에서 식도염의 유병률과 조직 검사의 필요성 및 위험 인자에 대해 알아보고자 하였다. 방 법: 2006년 1월부터 2007년 12월까지 가천의대 길병원 소아과에 내원하여 급만성 상복부 복통을 보인 환자들 266명을 대상으로 문진 및 신체 검사, 상부 위장관 내시경과 함께 식도 및 위 조직 생검을 시행하였다. 식도염의 진단은 조직 검사로 확진 하였으며, H. pylori 감염 여부는 CLO 검사, H&E 염색과 Giemsa 염색 혹은 요소호기검사로 확인하였다. 식도염과 관련된 위험인자 및 내시경 소견과 조직학적 소견의 관련성을 비교분석하였다. 결 과: 상부 내시경과 조직 생검을 시행 환자 266명 중 조직학적 식도염 환자는 전체 266명 중 53명(19.9%)이었으며, 남자 18명(34.0%), 여자 35명(66.0%)으로 평균 나이는 11.6${\pm}$0.87세였다. 내시경 소견의 민감도는 41.5%, 특이도는 77.0%, 양성 예측도 31.0%였다. 조직학적 식도염 환자 중 역류성 식도염은 50명, 호산구성 식도염은 2명, 캔디다 감염증에 의한 식도염은 1명이었다. 모든 연령에서 복통이 가장 흔한 증상으로 나타났으며, 8세 이하 환아들에서 구토가 의미 있게 많았다(p<0.05). 봄에 좀더 많이 내원하는 것으로 나타났으며(OR 2.5, 95% CI 1.2544 to 4.8286), H. pylori 감염군에서 식도염의 가능성이 의미 있게 높게 나타났다(OR 2.5, 95% CI 1.1598 to 4.2798). 결 론: 상부 위장관 증상이 있는 환자에서 상부 위장관 내시경 검사를 시행할 때, 특히 학령 전기 환자에서 구토를 동반한 위장관 증상이 있거나, 봄에 내원시, H. pylori 감염이 있을 경우 식도염의 가능성이 더욱 높으므로 식도 조직 생검을 고려해야 할 것으로 생각된다.

• 대한본초학회지
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• 제30권4호
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• pp.37-44
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• 2015

Objectives : The present study was designed to evaluate the anti-inflammatory and anti-oxidative stress activities through regulation of Nrf2-mediated genes by Rhei rhizoma and Glycyrrhiza rhizoma combined extract (RGE) in reflux esophagitis.Methods : The antioxidant activity of RGE in vitro was measured in terms of radical scavenging capacity such as DPPH and ABTS. RGE was administered at 350 mg/kg body weight prior to induction of reflux esophagitis. Reflux esophagitis was induced that tied the pylorus and the transitional junction between the forestomach and the corpus in Sprague-Dawley rats.Results : RGE scavenged DPPH and ABTS effectively and IC₅₀of RGE each were 4.9 μg/ml and 45.6 μg/ml. Our results show that RGE administration markedly ameliorated mucosal damage upon histological evaluation. In serum and esophagus tissue, RGE significantly suppressed the oxidative stress biomarkers. Reflux esophagitis induced rats exhibited down-regulation of antioxidant-related proteins in the esophagus; however, the levels with treatment of RGE were significantly higher than those of vehicle reflux esophagitis rats. RGE treatment caused significant reductions in activation of NF-κB transcription factor. Thus, RGE significantly exhibited potent anti-inflammatory activities by suppressing the protein expression levels of pro-inflammatory proteins such as COX-2 and iNOS and inflammatory cytokines such as TNF-αin the esophagus tissue.Conclusions : Reflux esophagitis caused considerable levels of oxidative stress in the esophageal mucosa and the administration of RGE reduced the esophageal mucosa damage through the regulation of Nrf2 and NF-κB pathways. Our findings can considered as supplementary therapy in the prevention or treatment of reflux esophagitis.

• 대한본초학회지
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• 제34권2호
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• pp.15-23
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• 2019

Objective : Reflux esophagitis (RE) is a disease that caused gastric acid reflux and inflammation due to unstable gastroesophageal sphincter, as increasing worldwide respectively. This study was conducted to evaluate the effect of Evodiae Fructus (EF) extract on chronic reflux esophagitis in rats. Methods : The EF was measured antioxidant activity, such as total polyphenol and total flavonoid contents, 1, 1-diphenyl-2-picrylhydrazyl (DPPH) and 2, 2'-azinobis-3-ethyl-enzothiazoline-6-sulfonic acid (ABTS) radical scavenging activity. Rats were divided into 3 groups; Nor (normal group), Con (chronic acid reflux esophagitis rats treatment with water), EF (chronic acid reflux esophagitis rat treatment with EF 200 mg/kg body weight group). A surgically-induced chronic acid reflux esophagitis (CARE) model was established in SD rats, and treated with water or EF 200 mg/kg body weight for 14 consecutive days. Results : Administration of EF to rats of induction of chronic acid reflux esophagitis was found to reduce esophagus tissues injury. Reactive oxygen species (ROS) and produces peroxynitrite ($ONOO^-$) levels of esophagus tissues were significantly decreased in EF compared to Con group. As results of esophagus protein analyses, EF effectively reduce inflammatory-related factors ($NF-{\kappa}Bp65$, $p-I{\kappa}B{\alpha}$, iNOS, $TNF-{\alpha}$, IL-6), and increase anti-oxidant enzyme (Nrf2, HO-1, SOD, catalase, GPx-1/2). Conclusions : These results suggest that EF administration comfirmed that decreased esophagus tissues injury, oxidantive stress, anti-inflammation effect, and increased anti-oxidant effect. Therefore, EF was the potential to be used as a natural therapeutic drug.

• 대한본초학회지
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• 제34권1호
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• pp.117-124
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• 2019

Objective : Chronic acid reflux esophagitis (CARE), one of gastroesophageal reflux disease (GERD) is increasing worldwide. Coptidis rhizoma extract (CRE) is a traditional herb that cures a variety of diseases. This study was conducted to evaluate the protective effect of CR on rats with chronic acid reflux esophagitis. Methods : The antioxidant activities were evaluated through radical scavenging assays using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis (3-ethylbenzothiazolin-6-sulfonic acid) (ABTS) radical scavenging assays. CARE was surgically induced in 5-week-old male SD rats by ligating the border between forestomach and glandular portion with a 2-0 silk tie and covering the duodenum using 18-Fr $N{\acute{e}}laton$ catheter. To evaluate the esophageal protective effect of CRE, rats were divided into 3 groups: Nor (normal rats), Veh (chronic acid reflux esophagitis induced rats), CR (chronic acid reflux esophagitis induced rats treated with CRE 200 mg/kg body weight). Results : The administration of CRE significantly prevented the mucosal injury of the esophagus tissue and histological findings improved the esophageal lesion. It has been shown that inflammation is prevented by the increase of antioxidant-related factors (Nrf-2, HO-1, SOD, catalase, and GPx-1/2) through the antioxidant pathway of esophageal tissue. The administration of CRE reduced the increase of serum peroxynitrite ($ONOO^-$) and markedly reduced the protein expression of inflammatory mediator such as $NF-{\kappa}Bp65$, $p-I{\kappa}B{\alpha}$, iNOS, and IL-6. Conclusions : Overall, these results suggest that CRE administration confirmed the protective effect of esophageal mucosa, suggesting that it is a potential treatment for chronic acid reflux esophagitis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권1호
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• pp.46-50
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• 2009

Cowden 증후군으로 진단되어 추적 관찰 중인 21세 여자에서 위장관 용종의 정기적 관찰을 위하여 시행한 내시경 검사 중 캔디다 식도염이 발견되어 문헌 고찰과 함께 보고한다. 면역학적 이상, 진균 식도 감염의 선행 질환, 투약의 병력이 없었고, 뚜렷한 식도 감염의 임상 증상도 없었다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.2185-2191
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• 2012

Background: Prevalence of Barrett's esophagus (BE) in Luoyang, China, has not been reported, and its pathogenesis is controversial. The aim of this study was therefore to investigate the prevalence of BE and its underlying factors in the city of Luoyang. Method: This was a prospective study in one center. Many patients were analyzed using endoscopy who showed upper gastrointestinal symptoms between August 2006 and June 2007. In addition, the effect of apoptosis-related proteins and heat shock proteins upon BE's pathogenesis were also investigated by an immunohistochemical protocol. Results: Prevalence of BE was at 4.55% and the mean age of those affected was about 10 years older than for esophagitis. Typical reflux symptoms were significantly lower than with esophagitis, whereas signs of caspase-3 and HSP105 elevation were significantly higher. Expression of TERT, HSP70 and $HSP90{\alpha}$ in BE cases was significantly lower than in esophagitis. However, there was no statistical difference between the two groups in expression of HSP27. Conclusions: The prevalence of BE is high in Luoyang, which could result from esophagitis despite typical reflux symptoms being relatively uncommon. Initiation and development of BE might be the result of accelerated proliferation, apoptosis and differentiation of original cells to intestinal epithelium.

• 동의생리병리학회지
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• 제18권6호
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• pp.1933-1937
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• 2004

Gastroesophageal reflux disease(GERD) refers to the varied clinical manifestations of reflux of stomach and duodenal contents into the esophagus and is preferable to the 'reflux esophagitis'. Clinical symptoms of reflux esophagitis are heartburn, dysphagia, blood loss, abdominal pain, nocturnal wheezing, coughing, hoarseness. We applied oriental medicines to patient who had reflux esophagitis. we treated them with herb-medication, acupuncture, moxa therapy and aroma therapy for about 2 months. During this period, we observed that symptoms had been improved.

• 대한한방내과학회지
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• 제32권1호
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• pp.75-86
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• 2011

Objectives : This study investigated oriental diagnosis and treatment of reflex esophagitis (RE) such as syndrome differentiation and herbal medicine by reviewing Chinese journals. Methods : A journal search was performed using China National Knowledge Infrastructure (CNKI) from January 2006 to December 2010. The keywords were the various combinations of 'reflex esophagitis', 'Chinese medicine', 'syndrome differentiation', and 'herbal medicine'. All types of journal entries that explained or referred to herbal medicines and definite syndrome differentiations were included. The Types of the journals were randomized clinical trials (RCT), reviews, essays, case series and reports. Vague syndrome differentiations and experimental studies were excluded. Selected journals were extracted and summarized by two researchers independently. Results : 47 Chinese entries were finally selected. 61% of them were case-control trials that had non-randomized, active controlled clinical trials. 36 kinds of syndrome differentiations about RE were investigated. We summarized and divided them into 10 syndrome differentiation groups. 肝胃不和(syndrome of liver qi invading the stomach) in syndrome differentiation, 和胃降逆 (harmonize the stomach and direct qi downward) in method of treatment, and Jwa kum-whan (左金丸) were cited with high frequency in RE. Conclusions : We find that many kinds of syndrome differentiation groups and herbal medicines for reflex esophagitis are used in China, compared with Korea. Further studies will be required about oriental syndrome differentiation and treatment of this disease.

• 대한한방내과학회지
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• 제42권5호
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• pp.800-807
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• 2021

Objectives: This study investigated the efficacy of Korean medical treatment for reflux esophagitis. Methods: We used Korean medical treatment (herbal medicines, acupuncture, herbal acupuncture, and therapy) to treat a hospitalized patient with reflux esophagitis. To evaluate the treatment, we measured the symptoms using the Reflux Symptom Index (RSI) and the Visual Analogue Scale (VAS) for heartburn, acid reflux, chest pain, foreign body sensations in the throat, chronic cough, hoarseness, and bronchial asthma. The generic health status was evaluated using the European Quality of Life Five-Dimension (EQ-5d) Scale. Results: The RSI and EQ-5d scores improved following treatment, but the VAS scores showed that only heartburn, acid reflux, and chest pain symptoms were relieved. Conclusions: This study suggests that Korean medicine may be effective for treating reflux esophagitis.