调气温中方对慢性萎缩性胃炎胃癌前病变患者中医症状积分及转归的影响

Effect of Tiaoqi Wenzhong Decoction on Traditional Chinese Medicine Symptom Score and Prognosis for Patients with Chronic Atrophic Gastritis and Gastric Precancerous Lesions

目的:观察调气温中方对慢性萎缩性胃炎(CAG)胃癌前病变患者中医症状积分及转归的影响。方法:选取2014年2月~2016年2月在我院诊治的124例CAG胃癌前病变患者,依据治疗方式不同,随机分为对照组(n=62)和治疗组(n=62),对照组给予胃富春片治疗,治疗组给予调气温中方治疗,比较两组治疗效果。结果:治疗后两组胃脘冷痛、喜热喜按、胃脘痞胀、口淡、饮食减少、气短懒言、呕吐清水、大便稀溏积分以及症候总积分均显著降低,且治疗组降低幅度显著高于对照组,差异具有统计学意义(P<0.05);治疗组治疗总有效率90.32%,对照组74.19%,两组差异显著(P<0.05);治疗后两组胃萎缩程度、胃炎伴肠上皮化生(IM)和伴异性增生(Dys)评分均显著降低(P<0.05),且治疗组降低幅度显著高于对照组(P<0.05);治疗组幽门螺旋杆菌(HP)阴转率61.29%,对照组61.36%,两组差异显著(P<0.05)。结论:调气温中方可显著改善慢性萎缩性胃炎胃癌前病变患者症状,改善胃萎缩、肠上皮化生和异性增生程度,促进HP转阴,可有效阻断或逆转CAG向胃癌转化,值得临床推广应用。

Objective： To study the effect of Tiaoqi Wenzhong Decoction on TCM symptom score and prognosis of patients with chronic atrophic gastritis （CAG） and gastric precancerous lesions. Methods： From February 2014 to February 2016, 124 patients with CAG and gastric precancerous lesions in our hospital were randomly divided into controlled group （ n = 62） and treat- ment group （n = 62）. The controlled group was treated with stomach restoring pills while the treatment group was treated with Tiaoqi Wenzhong Decoction, and the effects were compared between the two groups. Results： After treatment, the scores of TCM symptoms and total symptom score were significantly decreased, and the decreasing range in the treatment group was greater than that in the controlled group （ P 〈 0. 05 ） ; The total effective rate of the treatment group was 90. 32% while the controlled group was 74. 19% （P 〈 0. 05） ; After treatment, the degree of gastric atrophy, gastritis with intestinal metaplasia （IM） and dysplasia （Dys） scores were significantly decreased （ P 〈 0. 05）, and the decreasing range in the treatment group was greater than that in the controlled group （P 〈 0.05） ; The negative conversion rate of Helicobacter pylori （HP） in the treatment group was 61. 29% while in the controlled group was 61. 36% （P 〈 0. 05 ）. Conclusion： Tiaoqi Wenzhong Decoction can significantly relieve the symptoms in patients with CAG and gastric precancerous lesions, alleviate gastric atrophy, IM and Dys, promote negative conver- sion of HP and effectively block and reverse CAG to gastric cancer.