徐景藩三型论治慢性萎缩性胃炎癌前病变186例临床观察

Clinical Observation of Treatment Based on Three Syndrome Types Divided by Prof.XU Jingfan for 186 Cases of Chronic Atrophic Gastritis with Precancerous Lesions

目的观察徐景藩三型论治慢性萎缩性胃炎(CAG)癌前病变的临床疗效及其对生活质量的影响。方法将186例CAG癌前病变患者按徐景藩教授三型辨证分为中虚气滞证86例、肝胃不和证70例、胃阴不足证30例,分别给予相应中药治疗6个月。观察患者临床、胃镜、病理疗效及治疗前后中医脾胃系疾病之慢性胃炎患者报告的结局指标量表(CM-SSPRO)评分。结果中虚气滞证、肝胃不和证、胃阴不足证临床总有效率分别为89.54%、92.85%、70.00%,3种证型临床疗效比较差异有统计学意义(P<0.05);各证型患者胃镜疗效、腺体萎缩疗效、肠上皮化生疗效、腺体异型增生疗效比较差异均无统计学意义(P>0.05);各证型患者患者治疗前后CM-SSPRO评分比较,在生理、心理、独立性、社会环境4个领域及总积分上差异均有统计学意义(P<0.05);3种证型治疗后4个领域及总积分组间比较差异均无统计学意义(P>0.05)。结论徐景藩三型论治CAG癌前病变可以显著改善患者临床症状、胃镜及病理表现,提高患者生活质量。

Objective To observe the therapeutic effect of treatment based on three syndrome types divided by Prof.XU Jingfan for chronic atrophic gastritis （C AG） with precancerous lesions and its effect on quality of life （Q OL） .Methods Totally 186cases of CAG with precancerous lesions were divided into three syndrome types , i.e.center-deficiency qi-stagnation syndrome（ 86cases） , liver-stomach disharmony syndrome （7 0cases） and stomach-yin deficiency syndrome （3 0cases） .Three kind of relevant Chinese medications were used for patients with different syndrome types respectively for 6months.The clinical efficacy , gastroscope , pathological efficacy and Chinese medicine-spleen-stomach patients reported outcomes sacle （ CM-SSPRO ） were observed before and after treatment.Results The total effective rate of center-deficiency qi-stagnation syndrome , liver-stomach disharmony syndrome and stomach-yin deficiency syndrome was 89.54% , 92.85% and 70.00% respectively , with a significant difference between syndrome types （ P〈0.05 ） .There were no significant differences in efficacy of gastroscope , glandular atrophy , intestinal metaplasia , and the glandular dysplasia between syndrome types of center-deficiency qi-stagnation syndrome , liver-stomach disharmony syndrome and stomach-yin deficiency syndrome4 （ P〈0.05 ） .The scores of physiology , psychology , independence , social environment and CM-SSPRO were significantly decreased after treatment （ P〈0.05 ）, but with no significant difference between syndrome types （ P〈0.05 ） .Conclusion The treatment based on three syndrome types divided by Prof. XU Jingfan could obviously improve the clinical efficacy , gastroscope , patholog and QOL for CAG with precancerous lesions.