芪麦调中汤对慢性萎缩性胃炎伴低级别上皮内瘤变患者的效果及病理组织学研究

Study on the Therapeutic Effect and Histopathology of Qimai Tiaozhong Decoction on Patients with Chronic Atrophic Gastritis Accompanied by Low-Grade Intraepithelial Neoplasia

目的探讨芪麦调中汤治疗慢性萎缩性胃炎(chronic atrophic gastritis,CAG)伴低级别上皮内瘤变(low grade intraepithelial neoplasia,LGIN)患者的效果及病理组织学改变。方法选取2023年1月至2023年9月就诊于山西省中西医结合医院消化科的脾胃虚弱型CAG伴LGIN患者,运用随机数字表法将86例患者分为研究组和对照组,每组43例。对照组给予常规治疗,研究组给予芪麦调中汤治疗。对比两组患者服药前后中医证候改善情况、胃病理组织学评分及前列腺素E2(PGE2)、降钙素基因相关肽(CGRP)、胃蛋白酶原Ⅰ(PGⅠ)等血清学指标的改善情况。结果研究组服药后胃脘疼痛、胃脘胀满、饮食减少、大便稀溏中医证候评分低于对照组(P<0.05);研究组服药后胃黏膜萎缩、肠上皮化生、异型增生、慢性炎症病理组织学积分低于对照组(P<0.05);研究组治疗后PGE2、CGRP、PGⅠ水平高于对照组(P<0.05)。结论芪麦调中汤治疗CAG伴LGIN的效果确切,可改善患者临床症状,有效降低病理组织学评分,促进黏膜修复。

Objective To explore the therapeutic effect and histopathological study of Qimai Tiaozhong decoction on patients with chronic atrophic gastritis(CAG)and low-grade intraepithelial neoplasia(LGIN)before and after treatment.Methods Patients with spleen stomach weakness type CAG and LGIN diagnosed and treated from January 2023 to September 2023 were randomly divided into a study group and a control group,with 40 cases in each group.The control group received routine treatment,while the study group received Qimai Tiaozhong decoction treatment.Compare the improvement of traditional Chinese medicine syndromes,gastric pathology and histology scores,as well as the improvement of serum indicators such as prostaglandin E2(PGE2),calcitonin gene related peptide(CGRP),and pepsinogenⅠ(PGⅠ)between the two groups of patients before and after treatment.Results After treatment,the score of traditional Chinese medicine symptoms in the study group was significantly lower than that in the control group(P<0.05);The histopathological score of the study group after treatment was significantly lower than that of the control group(P<0.05);After treatment,the levels of PGE2,CGRP,and PGⅠin the study group were higher than those in the control group(P<0.05).Conclusions Qimai Tiaozhong decoction has a definite therapeutic effect on CAG with LGIN,can significantly improve clinical symptoms,effectively reduce histopathological scores,promote mucosal repair,and is worth promoting and applying.