二参三草汤治疗慢性萎缩性胃炎癌前病变的临床观察及其对PTEN、ERK、AKT表达影响的研究

The Curative Effect of Ershen Sancao Decoction on Precancerous Lesion of Cronic Atrophic Gastritis and Expressions of PTEN,ERK and AKT

目的:观察二参三草汤对慢性萎缩性胃炎癌前病变的治疗效果及对PTEN、ERK和AKT表达的影响。方法:40例符合纳入标准的患者随机分为两组,每组20例,治疗组给予二参三草汤,对照组给予胃复春片,疗程均为6个月。观察两组患者临床疗效、内镜、病理疗效及治疗前后PTEN、AKT、ERK表达积分的变化。结果:临床症状缓解总有效率:治疗组95%,对照组65%;内镜下黏膜表现及病理组织学改善情况:治疗组愈显率70%,对照组30%;两组间比较差异显著(P<0.05)。免疫组化结果:治疗组治疗前后PTEN、AKT、ERK的表达差异具有显著统计学意义(P<0.01),而对照组治疗前后AKT、ERK表达水平变化不明显。结论:二参三草汤能明显改善CAG癌前病变的临床症状、内镜下表现及病理组织学表现,其上调抑癌基因PTEN和下调癌基因AKT、ERK的表达可能是二参三草汤治疗慢性萎缩性胃炎癌前病变的部分作用机理。

Objective： To observe the curative effect of Ershen Sancao decoction on precancerou lesions of atrophic gastritis and to observe the expressions of PTEN,AKT and ERK before and after treatment. Methods：40 patients were divided into two groups randomly： a treatment group and a control group. The patients in the treatment group received Ershen Sancao decoction and the patients in the control group were with Weifuchun tablets,and the courses of treatment for both groups were 6 months. The clinical symptoms,endoscopy and pathologic change and PTEN,ERK and AKT expressions were observed. Results： The clinically total effective rates of symptom improvement in the treatment group and the control group were 95% and 65%,respectively;for the endoscopic characteristic of gastric mucosa and the situation of histopathology,the curative rate was70% in the treatment group and 30% in the control group,and there was a significant difference between two groups （P 〈 0.05 ）. Before and after treatment, the expressions of PTEN, ERK and AKT were remarkably dif-ferent in the treatment group （P 〈 0.01 ）, but it was without significant difference in the control group. Conclu- sion： Ershen Sancao decoction can significantly improve the clinical symptoms, gastroscopic and pathological changes in CAG precancerous lesion. It suggests that increasing the expressions of PTEN and effectively inhib- iting the expressions of ERK and AKT are the partial mechanism of precancerous lesion of atrophic gastritis by Ershen Sancao decoction.