参枳消萎汤对慢性萎缩性胃炎癌前病(肝胃气滞证)变转归的影响

Effect of Shenzhi Xiaowei Decoction on Outcomes of Precancerous Lesions of Gastric Cancer in Patients with Chronic Atrophic Gastritis(Qi-stagnation Syndrome of Liver and Stomach)

目的:探讨参枳消萎汤对慢性萎缩性胃炎(CAG)胃炎癌前病(PLGC)(肝胃气滞证)转归和血清三叶因子3(TFF3)及胃泌素-17的影响。方法:89例PLGC随机按数字表法以1∶1原则分为对照组44和观察组45例。对照组口服胃苏颗粒,15 g/次,3次/d。观察组采用参枳消萎汤内服,1剂/d。两组疗程均为16周。进行治疗前后胃黏膜组织病理学检查;进行治疗前后胃脘疼痛、饱胀、痞闷、嗳气、纳差评分;检测治疗前后TFF3和胃泌素-17水平。结果:观察组治疗后胃镜、胃黏膜临床病理疗效总有效率为100%,高于对照组的84.1%(P<0.05);治疗后观察组萎缩程度,肠上皮化生(IM)和异型增生(Dys)病理评分均低于对照组(P<0.01);观察组胃脘疼痛、饱胀、痞闷、嗳气、纳差等主要症状评分均低于对照组(P<0.01);治疗后两组血清TFF3水平均显著下降,观察组下降更为明显(P<0.01);两组血清胃泌素-17水平明显升高,观察组升高更为显著(P<0.01)。结论:参枳消萎汤能阻断或逆转胃癌前病变(PLGC),延缓CAG向胃癌的发展,临床疗效显著。

Objective： To discuss the effect of on outcomes of precancerous lesions of gastric cancer （PLGC） in patients with chronic atrophic gastritis （CAG） （qi-stagnation syndrome of liver and stomach） , as well as on serum trilobites factor 3 （TFF3） and gastric secrete element-17. Method： Eighty-nine PLGC patients were randomly divided into control group （44 cases） and observation group （45 cases） based on the principles of digital meter method to 1： 1. Patients in control group orally took Weisu granules, 15 g/time, 3 times/clay. Patients in observation group orally took Shenzhi Xiaowei decoction, 1 dose/day. Treatment course was 16 weeks for both groups. Histopathological examination was done for gastric mucosa before and after treatment. Gastric cavity pain, fullness, distension, belching and anorexia were scored before and after treatment. TFF3 and gastric secrete element-17 levels were detected before and after treatment. Result： Total effective rate for gastroscope and gastric mucosa clinical pathological effect was 100% in both group, superior to 84. 1% in control group （P 〈 0.05）. The pathology scores of atrophy degree, intestinal metaplasia （IM） and dysplasia （Dys） in observation group were lower than those in control group （P 〈0.01 ）. The scores of gastric cavity pain, fullness, distension, belching and anorexia in observation group were lower than those in control group （P 〈 0.01 ）. Serum TFF3 in both group went down obviously after treatment, while the declined degree in observation group was more significant （P 〈 0.01 ）.Serum gastric secrete element-17 level in both group went up obviously after treatment,, while the increase degree in observation group was more significant （P 〈 0.01 ）. Conclusion： Shenzhi Xiaowei decoction can block or reverse the precancerous lesions of gastric cancer （PLGC） , and delay the development of CAG to gastric cancer, with significant clinical effect.