基于湿热理论的蒿芩清胆汤治疗慢性萎缩性胃炎癌前病变临床研究

Treatment of Gastric Precancerous Lesions in Chronic Atrophic Gastritis Patients with Haoqin Qingdan Decoction(蒿芩清胆汤)Based on Damp-heat Theory

目的探究基于湿热理论的蒿芩清胆汤治疗慢性萎缩性胃炎癌前病变的临床研究。方法回顾性研究医院2021年1月—2021年12月中医科收治的116例萎缩性胃炎患者,根据治疗方法不同将患者分为观察组与对照组,观察组60例,对照组56例,对照组使用常规的治疗方法,观察组则在对照组基础上联合使用蒿芩清胆汤治疗。观察两组患者治疗前后中医证候积分、周期蛋白E(cyclin E)、E-钙黏着蛋白(E-cadherin)、基质金属蛋白酶9(matrix metalloproteinase 9,MMP-9)蛋白表达及血清肿瘤标志物干扰素-γ(interferon γ,IFN-γ)、白介素-2(HUMAN IL-2)、肿瘤坏死因子-α(tumor necrosis factor,TNF-α)、白介素-10(HUMAN,IL-10)。观察两组患者病理结果改善情况、临床疗效、不良反应。结果治疗后观察组中医证候积分显著低于对照组(P<0.05)。治疗后观察组MMP-9、CyclinE水平显著低于对照组,且E-cadherin水平显著高于对照组(P<0.05)。治疗后观察组IFN-γ、TNF-α较对照组显著降低,且IL-2、IL-10较对照组显著升高(P<0.05)。治疗后观察组胃黏膜萎缩病理结果改善有效率均高于对照组(P<0.05);且观察组总有效率91.66%显著高于对照组76.77%(χ^(2)=4.892,P=0.027)。观察组不良反应发生率为4.98%,显著低于对照组不良反应发生率8.92%,但两组患者不良反应发生率比较差异无统计学意义(χ^(2)=0.696,P=0.404)。结论蒿芩清胆汤能降低癌前病变中肿瘤标志物水平,提高患者疗效,降低患者不良反应,提升患者生活质量。

Objective To investigate the clinical efficacy of gastric precancerous lesions in chronic atrophic gastritis patients with Haoqin Qingdan Decoction(蒿芩清胆汤)based on damp-heat theory.Methods A total of 116 patients with atrophic gastritis admitted to TCM Department of the hospital from January 2021 to December 2021 were selected and classified into two groups via different therapeutic regimes.The control group(56 cases)received routine treatment.Based on this,the observation group(60 cases)received Haoqin Qingdan Decoction.Then the comparison was conducted on TCM syndrome scores,cyclin E,E-cadherin,matrix metalloproteinase 9(MMP-9),interleukin-γ(IFN-γ),interleukin-2(IL-2),tumor necrosis factor-α(TNF-α)and interleukin-10(IL-10).Meanwhile,the improvement of pathological outcomes,clinical efficacy and incidence of adverse effects.Results Compared with the control group,the observation group presented a reduction in TCM syndrome scores with statistical difference(P<0.05).The observation group had down-regulated levels of MMP-9 and cyclin E and elevated E-cadherin level by comparison to control group(P<0.05).A remarkable decrease in the levels of serum IFN-γ and TNF-α along with an obvious increase in the levels of IL-2 and IL-10 were found in the observation group compared with those of control group after interventions(all P<0.05).The observation group had better effective rates for the improvement of pathological findings of gastric mucosal atrophy than those in the control group(P<0.05).The observation group achieved higher overall efficacy rate than the control group with statistical difference(91.66%vs 76.77%,χ^(2)=4.892,P=0.027).The observation group yielded lower adverse reaction rate than the control group with no statistical difference(4.98%vs 8.92%,χ^(2)=0.696,P=0.404).The score of the observation group was higher on quality of life scale than that of the control group(P<0.05).Conclusion The application of Haoqin Qingdan Decoction based on damp-heat theory in the treatment of gastric precancerous lesions in chronic atrophic gastritis patients can effectively decrease the serum levels of tumor markers,reduce the adverse reaction rate and improve the quality of life.