消痞和胃胶囊治疗胃癌前病变32例临床研究

Xiaopi Hewei Capsules Treatment on 32 Cases with Precancerous Lesions of Gastric Carcinoma

目的:观察消痞和胃胶囊治疗胃癌前病变(PLGC)(肝胃气滞证)的临床疗效及对血清内皮素(ET-1)、胃泌素(GAS)和生长抑素(SST)水平的影响。方法:64例PLGC患者采用随机按数字表法分为观察组和对照组各32例。两组均采用奥美拉唑镁肠溶片口服,20 mg/次,2次/d;口服枸橼酸铋钾片,2粒/次,2次/d;口服克拉霉素片,0.25 g/次,2次/d,疗程为2周。对照组同时加服胃复春片,4片/次,3次/d。观察组同时加服消痞和胃胶囊,6粒/次,3次/d。两组疗程均为6个月。进行肝胃气滞证评分;进行胃镜及病理检查,评价胃黏膜萎缩、肠化及异型增生程度;检测幽门螺杆菌(HP);检测治疗前后ET-1,GAS和SST水平。结果:经有序资料卡方检验,观察组胃镜和病理学疗效均优于对照组(P<0.05);经卡方检验,两组治疗后胃黏膜萎缩改善情况优于治疗前(P<0.01),观察组胃黏膜萎缩改善优于对照组(P<0.05);治疗后第3,6个月,观察组肝胃气滞证评分均低于对照组(P<0.01);治疗后观察组肠化或(和)异型增生评分低于对照组(P<0.01);治疗后1个月,对照组HP清除率为79.2%,观察组为84%,两组比较差异无统计学意义;治疗后6个月,对照组HP感染率40%,观察组为17.14%,观察组HP感染率低于对照组(P<0.05);治疗后观察组血清ET-1和GAS水平低于对照组,SST水平高于对照组(P<0.01)。结论:消痞和胃胶囊能改善PLGC(肝胃气滞证)患者临床症状、降低了HP的复发,对PLGC向胃癌的进展有一定的阻断作用,其机制可能与升高血清SST水平,降低ET-1和GAS有关。

Objective：To discuss the curative efficacy of Shugan Tiaoxin decoction and its influence to on serous inflammatory factors in treating malignant tumor combined with depression.Method：One hundred and ten eligible patients were randomly divided into control group （55 cases） and observation group （55 cases） by random number table.Patients in control group received Fluoxetine capsules （starting dose was 20 mg/day,taken after breakfast,and the dose was adjusted according to patients＇ state after 2 weeks）.Based on the treatment of control group,patients in observation group added 1 dose Shugan Tiaoxin decoction daily.Patients in two groups received a 8-week period of treatment.Before and after treatment,the Hamilton depression rating scale （HAMD） and the self-rating depression scale were graded.The quality of life scale （QLQ-BR30） of European Organization for Research and Treatment of Cancer （EORTC） was graded.Levels of serous interleukin-1β （IL-1β）,interleukin-2 （IL-2）,interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） were detected.Result：The depressant action in observation group was superior to that in control group （P 〈 0.05）,and depression symptom in observation group was better than that in control group （P 〈0.01）,and scores of HAMD and SDS in observation group were lower than those in control group （P 〈 0.01）.Scores of role function,emotional function and global quality of life in observation group were all higher than those in control group （P 〈 0.05,P 〈 0.01）.Scores of pain,insomnia,appetite loss,constipation and diarrhea in observation group were lower than those in control group （P 〈0.05,P 〈0.01）.Levels of IL-1β,IL-6 and TNF-α in observation group were lower than those in control group,and level of IL-2 was higher than that in control group （P 〈 0.01）.Conclusion：Shugan Tiaoxin decoction could ameliorate depression symptom,reduce symptoms of depression and improve patients＇ quality of life in treating malignant tumor combined with depression.Its mechanism of action may be related to the regulation of serous inflammatory factors.