叶酸联合胃复春治疗萎缩性胃炎癌前病变的疗效

Therapeutic effects of folic acid against precancerous lesions in patients with chronic atrophic gastritis

目的:观察叶酸联合胃复春对萎缩性胃炎伴肠上皮化生(intestinal metaplasia,IM)及异型增生(atypical hyperplasia,ATP)的逆转作用.方法:101例慢性萎缩性胃炎(chronic atrophic gastritis,CAG)患者,经内镜及病理学检查证实伴有不同程度的IM及ATP,其中幽门螺杆菌阳性者常规根除治疗,随机分为两组,治疗组(叶酸联合胃复春)及对照组(胃复春),疗程均为6 mo,观察治疗后患者临床症状及病理学改变.结果:治疗组患者临床症状、IM及ATP的总有效率分别为84.91%、70.27%及68.75%;对照组分别为41.67%(P<0.001)、45.45%(P<0.05)及33.33%(P<0.05),两组总有效率比较差异均有统计学意义.结论:叶酸联合胃复春治疗对萎缩性胃炎伴肠上皮化生及异型增生有良好的逆转作用,同时能很好改善患者临床症状,应进一步推广应用.

AIM： To evaluate the therapeutic effect of folic acid against intestinal metaplasia （IM） and atypical hyperplasia （ATP）. METHODS： One hundred and one patients with chronic atrophic gastritis （accompanied with IM and ATP） were randomly divided into either a trial group or a control group. Before treatment, Helicobacter pylori （H. pylori） carriers received eradication treatment with routine quadruple chemotherapy for ten days. Patients of the trial group received treatment with folic acid and traditional Chinese medicine Weifuchun, while patients of the control group were treated with Weifuchun only. The treatment duration was 6 mo in both groups. The improvement in clinical symptoms and histological findings was compared between the two groups. RESULTS： Compared to the control group, the trail group had significantly improved clinical symptoms and histological findings for IM and ATP （84.91% vs 41.67%, 70.27% vs 45.45%, 68.75% vs 33.33%; P 〈 0.001, P 〈 0.05, P 〈 0.05）. CONCLUSION： Combination therapy with folic acid and Weifuchun is safer and more effective than Weifuchun alone in the treatment of precancerous gastric lesions IM and ATP.