探析邵荣世教授理气化湿和络法治疗胃癌前病变的疗效

Professor SHAO Rongshi’s Theory of Regulating Qi, Resolving Dampness and Harmonizing Collaterals Method in Treatment of Gastric Precancerous Lesions

目的 研究邵荣世教授理气化湿和络法治疗胃癌前病变的疗效。方法 临床纳入2020年4月—2021年4月期间南京中医药大学附属南通市中医院脾胃科门诊收治的90例胃癌前病变患者作为研究对象,按随机数字表法将患者分为两组各45例。其中45例患者采用常规西药治疗作为对照组;另45例患者采用理气化湿和络法治疗作为中药组。观察两组患者治疗效果、血清学指标、临床症状积分、病理症状积分以及不良反应情况。结果 中药组治疗总有效率高达84.44%(38/45),明显高于对照组的66.67%(30/45),差异有统计学意义(P<0.05)。治疗前两组患者环氧化酶-2(Cyclooxygenase, COX-2)、p53、胃泌素(gastrin, GAS)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平对比差异均无统计学意义(P>0.05);治疗后中药组COX-2、p53、GAS以及TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。治疗前两组患者胃脘痞满、刺痛、痛有定处、胃痛拒按、黑便以及面色黯滞积分对比差异无统计学意义(P>0.05);治疗后中药组上述临床症状积分均低于对照组,差异有统计学意义(P<0.05)。治疗前两组患者慢性炎症、肠化、腺体萎缩以及低级别上皮内瘤变病理症状积分对比差异无统计学意义(P>0.05);治疗后中药组上述病理症状积分均低于对照组,差异有统计学意义(P<0.05)。中药组、对照组发生率分别为15.56%(7/45)、11.11%(5/45),两组不良反应发生率对比差异无统计学意义(P>0.05)。结论 理气化湿和络法治疗胃癌前病变效果显著,能显著改善中医和病理临床症状,降低血清因子水平,不良反应少,值得临床应用。

Objective To study the clinical effects of Professor SHAO Rongshi’s theory of regulating Qi, resolving dampness and harmonizing collaterals method on treating gastric precancerous lesions.Methods Ninety gastric precancerous lesions patients treated from April 2020 to December 2020 in Spleen and Stomach Department, Nantong Hospital of TCM Affiliated to Nanjing University of Chinese Medicine were selected as research subjects.According to random number table, patients were divided into two groups, 45 cases in each group.The patients who took western medicine were set as the control group.Those who took regulating Qi, resolving dampness and harmonizing collaterals herbal medicine were set as the TCM group.The therapeutic effects, serological indicators, clinical symptom scores, pathological symptom scores and adverse drug reactions were compared.Results The total effective rate in the TCM group(84.44%,38/45) was higher than that(66.67%,30/45) of the control group with statistically significant difference(P<0.05).Before treatment, there were no significant differences between two groups about levels of cyclooxygenase(COX-2),p53,gastrin(GAS) or tumor necrosis factor-α(TNF-α)(P>0.05).After treatment, the levels of COX-2,p53,GAS and TNF-α in the TCM group were lower than those of the control group with statistically significant difference(P<0.05).Before treatment, there were no significant differences between two groups about stomach fullness, stabbing pain, fixed pain, stomachache, tarry stool or dark complexion symptom scores(P>0.05).After treatment, the clinical symptom scores in the TCM group were lower than those of the control group with statistically significant difference(P<0.05).Before treatment, there were no significant differences between two groups about the scores of pathological symptoms like chronic inflammation, intestinal metaplasia, gland atrophy or low-grade intraepithelial neoplasia(P>0.05).After treatment, the pathological symptom scores in the TCM group were lower than those of the control group with statistically significant difference(P<0.05).The adverse drug rate in the TCM group(15.56%,7/45) and control group(11.11%,5/45) was not significantly different(P>0.05).Conclusion The regulating Qi, resolving dampness and harmonizing collaterals method can greatly improve TCM and pathological symptoms, reduce the serological factors and adverse drug reactions.It is worthy of clinical application.