应用定标活组织检查评价替普瑞酮联合叶酸治疗慢性萎缩性胃炎的疗效

Efficacy of tepronone and folic acid in the treatment of chronic atrophic gastritis evaluated by the markingtargeting biopsy

目的应用定标活组织检查技术评价替普瑞酮联合叶酸治疗慢性萎缩性胃炎（CAG）的疗效。方法选取H．pylori阴性的CAG患者224例，将其分为A组（96例，替普瑞酮50mg／次，叶酸10mg／次，每日3次）、B组（23例，替普瑞酮50mg／次，每日3次）、C组（74例，非特异性治疗）、D组（31例，不治疗），疗程均为1年。观察治疗前后各组患者临床症状的改善情况。观察治疗前后各组患者定标活组织检查取材点的胃黏膜组织病理学改善情况。组间比较行卡方检验。结果A、B、C、D组临床症状方面的总有效率分别为43．8％（42／96）、39．1％（9／23）、33．8％（25／74）、32．3％（10／31），组间比较差异无统计学意义（X^2=2．328，P=0．507）。在胃黏膜组织病理学显效率方面，A组和D组比较、A组和C组比较、B组和D组比较，差异均有统计学意义（X^2=14．520、14．628、8．995，P均〈0．01）。在胃黏膜组织病理学总有效率方面，A组和D组比较[49．8％（131／263）比24．2％（16／66）]、A组和C组比较[49．8％（131／263）比35．9％（66／184）]、B组和D组比较E44．7％（21／47）比24．2％（16／66）]，差异均有统计学意义（X^2=13．953、8．535、5．207，P均〈0．05）。结论单用替普瑞酮或替普瑞酮联合叶酸可显著改善cAG患者胃黏膜组织学病变。

Objective To explore the efficacy of tepronone and folio acid in the treatment of chronic atrophic gastritis （CAG） evaluated by the marking targeting biopsy （MTB）. Methods A total of 224 H. pylori negative CAG patients were selected and divided into group A （n= 96, tepronone 50 mg/time, folic acid 10 rag/time, three times/day）, group B （n=23, tepronone 50 rag/time, three times/day）, group C （n= 74, unspecific treatment） and group D （n=31, no treatment）. The treatment course lasted for one year. The clinical symptoms improvement of each group was observed before and after treatment. The pathological improvement of gastric mucosa by MTB was inspected before and after treatment. The chi-square test was performed for the comparison between groups. Results The total efficacy rates of group A, B, C and D were 43. 80% （42/96）, 39. 1% （9/Z3）, 33.8% （25/74） and 32.3 % （10/31） respectively, there was no significant difference between groups （X^2= 2. 328, P= 0. 507）. For the significant efficacy rate of gastric mucosa pathological improvement, group A was compared with group D, group A was compared with group C and group B was comparedwith group D, the differences were significant （X^2= 14. 520, 14. 628 and 8. 995, all P〈0.01）. In the total efficacy rate of gastric mucosa pathological improvement, group A （49.8%, 131/263） was compared with group D （24. 2%, 16/66）, group A was compared with group C （35.9%, 66/184） and group B （44. 7%, 21/47） was compared with group DI the differences were significant （X^2 = 13. 953, 8. 535 and 5. 207, all P〈0.05）. Conclusion Teprenone alone or teprenone and folic acid combination can obviously improve pathological changes of CAG patients.