Systematic evaluation and Meta-analysis of the efficacy of Xiaochaihu Decoction in the treatment of chronic superficial gastritis

Objective:To compare the effectiveness of Xiaochaihu Decoction(XCHD)or the modified XCHD combined with western medicine in the treatment of superficial gastritis.Methods:We collected the studies about XCHD or the modified XCHD combined with western medicine for superficial gastritis in China Biology Medicine(CBM)Database(2010-2018),China National Knowledge Infrastructure(CNKI)Database(2010-2018),VIP Database(2010-2018),Wanfang Database(2010-2018)and the Back Issues Database of Hebei University.The randomized controlled trials(RCTs)were included in this study.The literatures were independently extracted by two researchers and the Cochrane Review Handbook(version 5.1.0)was applied to assess the quality of included trials.Statistical analysis was performed with RevMan(version 5.3).Results:A total of 8 RCTs,including 732 cases,were included finally.Meta-analysis results showed that compared with the western medicine treatment group,XCHD or the modified XCHD combined with western medicine could improve the total effective rate[OR=4.67,95%CI(2.90,7.55),P<0.00001],physiological function[MD=10,95%CI(8.78,11.23),P<0.00001],role physical[MD=13.85,95%CI(11.19,16.51),P<0.00001],physical pain[MD=11.64,95%CI(9.05,14.23),P<0.00001],general health[MD=11.20,95%CI(9.52,12.88),P<0.00001],vitality[MD=13.46,95%CI(12.30,14.62),P<0.00001],social function[MD=19.20,95%CI(17.32,21.09),P<0.00001],affection function[MD=30.3,95%CI(28.99,31.62),P<0.00001],mental health[MD=9.80,95%CI(8.44,11.16),P<0.00001].Conclusion:XCHD or the modified XCHD combined with western medicine in the treatment of superficial gastritis has good performance in clinical efficacy and the improvement of quality of life.However,with several methodology problems existing in the included RCTs,the effectiveness of XCHD or the modified XCHD is still need more high-quality randomized,double-blind,placebo-controlled trials to further confirmed.

Clinical manifestation,lifestyle,and treatment patterns of chronic erosive gastritis:A multicenter real-world study in China

BACKGROUND Although chronic erosive gastritis(CEG)is common,its clinical characteristics have not been fully elucidated.The lack of consensus regarding its treatment has resulted in varied treatment regimens.AIM To explore the clinical characteristics,treatment patterns,and short-term outcomes in CEG patients in China.METHODS We recruited patients with chronic non-atrophic or mild-to-moderate atrophic gastritis with erosion based on endoscopy and pathology.Patients and treating physicians completed a questionnaire regarding history,endoscopic findings,and treatment plans as well as a follow-up questionnaire to investigate changes in symptoms after 4 wk of treatment.RESULTS Three thousand five hundred sixty-three patients from 42 centers across 24 cities in China were included.Epigastric pain(68.0%),abdominal distension(62.6%),and postprandial fullness(47.5%)were the most common presenting symptoms.Gastritis was classified as chronic non-atrophic in 69.9%of patients.Among those with erosive lesions,72.1%of patients had lesions in the antrum,51.0%had multiple lesions,and 67.3%had superficial flat lesions.In patients with epigastric pain,the combination of a mucosal protective agent(MPA)and proton pump inhibitor was more effective.For those with postprandial fullness,acid regurgitation,early satiety,or nausea,a MPA appeared more promising.CONCLUSION CEG is a multifactorial disease which is common in Asian patients and has non-specific symptoms.Gastroscopy may play a major role in its detection and diagnosis.Treatment should be individualized based on symptom profile.

Identifying the molecular basis of Jinhong tablets against chronic superficial gastritis via chemical profile identification and symptom-guided network pharmacology analysis

Chronic superficial gastritis(CSG)is a common disease of the digestive system that possesses a serious pathogenesis.Jinhong tablet(JHT),a traditional Chinese medicine(TCM)prescription,exerts therapeutic effects against CSG.However,the molecular basis of its therapeutic effect has not been clarified.Herein,we employed ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry(UPLC-Q/TOF-MS)based chemical profile identification to determine the chemical components in JHT.Further,we applied network pharmacology to illustrate its molecular mechanisms.A total of 96 chemical constituents were identified in JHT,31 of which were confirmed using reference standards.Based on the bioinformatics analysis using the symptom-guided pharmacological networks of“chi,”“blood,”“pain,”and“inflammation,”and target screening through the interaction probabilities between compounds and targets,matrix metalloproteinase 2(MMP2),dopamine d2 receptor(DRD2),and Aldo-keto reductase family 1 member B1(AKR1B1)were identified as key targets in the therapeutic effect exhibited by JHT against CSG.Moreover,according to the inhibitory activities presented in the literature and binding mode analysis,the structural types of alkaloids,flavonoids,organic acids,including chlorogenic acid(10),caffeic acid(13),(-)-corydalmine(33),(-)-isocorypalmine(36),isochlorogenic acid C(38),isochlorogenic acid A(41),quercetin-3-O-a-L-rhamnoside(42),isochlorogenic acid B(47),quercetin(63),and kaempferol(70)tended to show remarkable activities against CSG.Owing to the above findings,we systematically identified the chemical components of JHT and revealed its molecular mechanisms based on the symptoms associated with CSG.

Evaluation of the Gastric Microbiome in Patients with Chronic Superficial Gastritis and Intestinal Metaplasia

Objective To evaluate the gastric microbiome in patients with chronic superficial gastritis(CSG)and intestinal metaplasia(IM)and investigate the influence of Helicobacter pylori(H.pylori)on the gastric microbiome.Methods Gastric mucosa tissue samples were collected from 54 patients with CSG and IM,and the patients were classified into the following four groups based on the state of H.pylori infection and histology:H.pylori-negative CSG(n=24),H.pylori-positive CSG(n=14),H.pylori-negative IM(n=11),and H.pylori-positive IM(n=5).The gastric microbiome was analyzed by 16S rRNA gene sequencing.Results H.pylori strongly influenced the bacterial abundance and diversity regardless of CSG and IM.In H.pylori-positive subjects,the bacterial abundance and diversity were significantly lower than in H.pylori-negative subjects.The H.pylori-negative groups had similar bacterial composition and bacterial abundance.The H.pylori-positive groups also had similar bacterial composition but different bacterial relative abundance.The relative abundance of Neisseria,Streptococcus,Rothia,and Veillonella were richer in the I-HP group than in G-HP group,especially Neisseria(t=175.1,P<0.001).Conclusions The gastric microbial abundance and diversity are lower in H.pylori-infected patients regardless of CSG and IM.Compared to H.pylori-positive CSG group and H.pylori-positive IM,the relative abundance of Neisseria,Streptococcus,Rothia,and Veillonella is higher in H.pylori-positive patients with IM than in H.pylori-positive patients with CSG,especially Neisseria.

The Exploration of the Clinical Treatment of Chronic Atrophic Gastritis

Purpose:To explore the effect of the clinical treatment of chronic atrophic gastritis Methods:70 patients with chronic atrophic gastritis treated in our hospital from October 2017 to November 2018 were selected and randomly divided into an observation group and a control group with 35 patients in each group.The control group received standard triad treatment with gastroprokinetic drug orally.On the basis of the control group,patients in the observation group received Xianlu Pazhu Wan.The treatment efficiency,eradication rate of helicobacter pylori(H.pylori),incidence of adverse effects and length of stay were compared between the two groups.Results:Compared with the control group,patients in the observation group had higher treatment efficiency,higher H.pylori eradication rate,lower incidence of adverse effects,and shorter length of stay with statistical significance(P<0.05).Conclusion:In the clinical treatment of patients with chronic atrophic gastritis,adding Xianlu Pazhu Wan into the basic medication plan can have better treatment efficiency,reduce the incidence of adverse effects,and shorten the length of stay.Therefore,Xianlu Pazhu Wan should be promoted in the practice.

Serum protein profiles suggest a possible link between qi deficiency constitution and Pi-qi-deficiency syndrome of chronic superficial gastritis

Objective:To identify potential serum protein candidates involved in linking the traditional Chinese medicine(TCM)-defined qi deficiency constitution(QDC)to Pi-qi-deficiency syndrome(PQDS)of chronic superficial gastritis(CSG).Methods:Using participants with the TCM-defined balanced constitution as a control population,labelfree quantitative proteomics was adopted to identify differentially expressed proteins(DEPs)in serum samples from two case populations:case population 1(participants with QDC)and case population 2(patients with PQDS of CSG).The DEPs discovered in both case populations were analyzed to identify common DEPs as potential candidates for proteins involved in the link between QDC and PQDS.Based on Kyoto Encyclopedia of Genes and Genomes pathway(KEGG)and Gene Ontology(GO)enrichment analysis and analysis of proteineprotein interaction networks,we evaluated the possible functions of these potential serum candidates.Results:We discovered 24 and 28 proteins that were differentially expressed in case populations 1 and 2,respectively,compared with the control population.Hierarchical clustering analysis showed that the expression profile of DEPs of individuals from the same population clustered well,while those from different populations were segregated.Furthermore,GO analysis revealed the 10 DEPs that were common to both case populations to be mainly associated with negative regulation of cellular metabolic and immune system processes while KEGG analysis indicated these proteins to be associated with complement and coagulation cascades and peroxisome proliferator-activated receptor signaling.Notably,serum levels of C4b-binding protein beta chain,glycosylphosphatidylinositol-specific phospholipase D1 and MS-F1 light chain variable region proteins were notably higher in the two case populations compared with the control,particularly in the case of CSG with PQDS.Conclusion:The results presented here provide new insights into the molecular mechanisms underlying development of PQDS of CSG from QDC,and suggest candidate serum biomarkers for future application in integrative medicine.

Screening for blood leukocyte microRNA biomarkers responsible for association between qi deficiency constitution and Pi-qi-deficiency syndrome of chronic superficial gastritis

Objective:To screen for blood leukocyte microRNA(miRNA)biomarkers responsible for the association between the traditional Chinese medicine(TCM)qi deficiency constitution(QDC)and the Pi-qi-deficiency syndrome(PQDS)of chronic superficial gastritis(CSG).Methods:Peripheral blood leukocytes were separated from people of two TCM constitutions(balance and qi deficiency)and from CSG patients with PQDS.Total RNA was isolated from the leukocytes and subjected to subsequent high-throughput miRNA sequencing to identify the miRNAs that are specifically and highly expressed in persons of QDC and CSG patients with PQDS.In addition,the target genes of the associated miRNAs were predicted.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway-based enrichment analyses of these target genes were performed to further evaluate the associated miRNA candidates as potential biomarkers responsible for the association between QDC and PQDS of CSG.Results:Compared with the control group with a balance constitution(P<.05,fold change>1.5 or<0.5),31 and 38 differentially expressed miRNAs were found in persons of QDC and CSG patients with PQDS,respectively.In particular,hsa-miR-145-5p and hsa-miR-146a-3p were highly expressed in both the persons of QDC and CSG patients with PQDS.GO analysis of the target genes of the two common miRNAs showed that they were mainly associated with functions related to synthesis and metabolism,such as cellular nitrogen compound metabolic processes,biosynthetic processes,cellular protein modification processes,and cellular component assembly.KEGG analysis identified the common pathways enriched among the target genes,including the Hippo signaling pathway and the transcriptional misregulation pathway.The common target genes of the two miRNAs seemed to be associated with the spliceosome pathway and the RNA degradation pathway.Conclusion:Hsa-miR-145-5p and hsa-miR-146a-3p may serve as candidate biomarkers responsible for the association between QDC and PQDS of CSG.

Paradoxical association between dyspepsia and autoimmune chronic atrophic gastritis:Insights into mechanisms,pathophysiology,and treatment options

BACKGROUND Autoimmune gastritis(AIG)is a progressive,chronic,immune-mediated inflammatory disease characterized by the destruction of gastric parietal cells leading to hypo/anacidity and loss of intrinsic factor.Gastrointestinal symptoms such as dyspepsia and early satiety are very common,being second in terms of frequency only to anemia,which is the most typical feature of AIG.AIM To address both well-established and more innovative information and knowledge about this challenging disorder.METHODS An extensive bibliographical search was performed in PubMed to identify guidelines and primary literature(retrospective and prospective studies,systematic reviews,case series)published in the last 10 years.RESULTS A total of 125 records were reviewed and 80 were defined as fulfilling the criteria.CONCLUSION AIG can cause a range of clinical manifestations,including dyspepsia.The pathophysiology of dyspepsia in AIG is complex and involves changes in acid secretion,gastric motility,hormone signaling,and gut microbiota,among other factors.Managing dyspeptic symptoms of AIG is challenging and there are no specific therapies targeting dyspepsia in AIG.While proton pump inhibitors are commonly used to treat dyspepsia and gastroesophageal reflux disease,they may not be appropriate for AIG.Prokinetic agents,antidepressant drugs,and non-pharmacological treatments may be of help,even if not adequately evidence-based supported.A multidisciplinary approach for the management of dyspepsia in AIG is recommended,and further research is needed to develop and validate more effective therapies for dyspepsia.

A Long-Term Follow-up Study of Chronic Gastritis with Fibergastroscope

A more than 5 year follow up study about 48 cases of chronic atrophic gastritis(CAG) and 100 cases of chronic superficial gastritis (CSG) is reported in CAG, it is found that 35.5% of the patients were improved, 41.6% stabilized, 12.5% deteriorated, 6.2% recovered, and 4.2% cancerated. In CSG, it is found that 40% of the patients were improved, 48% stabilized, 6% deteriorated, 5% recovered and 1% cancerated. It is concluded that CAG group has a higher rate of cancerization than that of CSG group.

Clinical Efficacy of Chaihu Shugan Powder Classical Formula in Treating Chronic Superficial Gastritis with Liver-Stomach Disharmony

[Objectives] To investigate the clinical efficacy of Chaihu Shugan Powder on chronic superficial gastritis with liver-stomach disharmony syndrome.[Methods] A total of 72 patients diagnosed with chronic superficial gastritis characterized by liver-stomach disharmony syndrome between September 2023 and August 2024 were randomly assigned into two groups. The control group received treatment with western medicine, and the treatment group was administered both western medicine and Chaihu Shugan Powder. The therapeutic effects, TCM syndrome scores, adverse reactions, and recurrence rate were compared between the two groups.[Results] The total effective rate was 88.89% in the treatment group and 80.56% in the control group. The differences between the two groups were statistically significant ( P <0.05), indicating that the improvement observed in the treatment group was significantly greater than that in the control group ( P <0.05). In comparison to pre-treatment levels, the TCM syndrome scores for both patient groups exhibited a reduction following treatment. Notably, the extent of this reduction in the treatment group was significantly greater than that observed in the control group ( P <0.05). Neither group of patients experienced serious adverse reactions during treatment. Furthermore, the recurrence rate among patients in the control group was found to be higher than that in the treatment group.[Conclusions] The clinical efficacy of Chaihu Shugan Powder in the treatment of chronic superficial gastritis with liver-stomach disharmony syndrome is significant, demonstrating a notable reduction in the recurrence rate of the condition.

Gastric autoimmune disorders in patients with chronic hepatitis C before,during and after interferon-alpha therapy

AIM:To explore the prevalence of autoimmune gastritis in chronic hepatitis C virus (HCV) patients and the influence of α-interferon (IFN) treatment on autoimmune gastritis. METHODS:We performed a prospective study on 189 patients with positive anti-HCV and viral RNA enrolled in a 12-month IFN protocol.We evaluated:a) the baseline prevalence of autoimmune gastritis,b) the impact of IFN treatment on development of biochemical signs of autoimmune gastritis (at 3,6 and 12 months),c) the evolution after IFN withdrawal (12 months) in terms of anti-gastric-parietal-cell antibodies (APCA),gastrin,anti-thyroid,and anti-non-organ- specific antibodies. RESULTS:APCA positivity and 3-fold gastrin levels were detected in 3 (1.6%) and 9 (5%) patients,respectively,at baseline,in 25 (13%) and 31 (16%) patients at the end of treatment (both P<0.001,vs baseline),and in 7 (4%) and 14 (7%) patients 12 months after withdrawal (P=0.002 and P=0.01 respectively,vs baseline;P=not significant vs end of treatment).The development of autoimmune gastritis was strictly associated with the presence of autoimmune thyroiditis (P=0.0001),no relationship was found with other markers of autoimmunity. CONCLUSION:In HCV patients,IFN frequently precipitates latent autoimmune gastritis,particularly in females.Following our 12-month protocol,the phenomenon generally regressed.Since APCA positivity and high gastrin levels are associated with the presence of antithyroid antibodies, development of autoimmune thyroiditis during IFN treatment may provide a surrogate preliminary indicator of possible autoimmune gastritis to limit the need for invasive examinations.

Xinli Wen's Experience in Treating Chronic Gastritis with Insomnia

Through reviews of chronic gastritis treatment literatures in the past 10 years,it has been found that most patients with chronic gastritis also have insomnia and other symptoms in addition to the manifestations of gastritis,in which modem medicine has found clear correlations between the two.In Professor Xinli Wen's practice,the professor believes that the pathogenesis of this disease is a mixture of cold and heat.In regard to treating the disease,the characteristic of"the desire to solve Jueyin disease"is well-grasped.Professor Wen emphasizes on the harmonization of the liver and spleen as well as the restrain from following the original prescription and application of its medicine.Therefore,she used Mume pill to increase and decrease the upper temperature and lower temperature in regulating cold and heat.

ClinicalApplicationsManuscriptNotesofXuanfudaizheDecoction

目的：探讨旋覆代赭汤治疗以噫气不除为主病症的临床疗效。方法：回顾性分析旋覆代赭汤治疗胆汁反流性胃炎、梅尼埃病、慢性浅表性胃炎等症。结果与结论：旋覆代赭汤治疗以噫气不除为主的病症疗效较好。

Helicobacter pylori eradication combined with folic acid in the treatment of chronic atrophic gastritis: a long-term follow-up study

Objective To investigate the clinical and pathological outcome of gastric mucosa lesions in chronic atrophic gastritis treated with Helicobacter pylori(H.pylori)eradication combined with folic acid(three months treatments).Methods From December 2009 to December2010,outpatients with chronic atrophic gastritis were selected and divided into H.pylori positive group and H.

Bioinformatics Research on Chronic Superficial Gastritis of Pi-deficiency Syndrome by Gene Arrays

Objective： To determine the bioinformatical characteristics of differential gene expression in patients with chronic superficial gastritis （CSG） with the Pi-deficiency syndrome （PDS） and those of the non- Pi-deficiency syndrome （non-PDS）, i.e. patients of CSG with Pi （脾）-Wei （胃） dampnese-heat syndrome and healthy persons. Methods： With the BRB-Array Tools software package, original data collection and bioinformatic analysis of gene arrays were conducted in 6 CSG patients of PDS （CSG-PDS）, 6 CSG patients of non-PDS （CSG-nPDS）, and 6 healthy volunteers （Normal）. Results： Compared with non-PDS, the gene expressions in PDS with regards to protein synthesis, energy metabolism, immune reaction and ionic transport tended to be down-regulated, while those concerning secretion, cytoskeleton and ubiquitinization were up-regulated dominantly. Conclusions： The two kinds of samples, CSG-PDS/Normal and CSG-PDS/CSG-nPDS, have their respective gene expression profiles with different characteristics. Gene expression profile has certain referential significance in syndrome classification.

慢性萎缩性胃炎的中医辨治思路与对策

慢性萎缩性胃炎(CAG)是临床上公认的胃癌前疾病,中医药治疗CAG具有明显的优势及鲜明的特色。从CAG病因病机等方面的研究入手,对中医药治疗CAG提出治本独取阳明,补虚泻实,顾护脾胃,升降气机,调气和血,祛瘀通络,祛邪解毒,甘平凉润,和胃护络的辨治思路与对策,以期进一步提高中医药治疗CAG的临床疗效。

消痞汤对脾胃虚弱证慢性萎缩性胃炎患者的临床疗效

目的考察消痞汤对脾胃虚弱证慢性萎缩性胃炎患者的临床疗效。方法97例患者随机分为对照组(48例)和观察组(49例),2组均采用常规治疗,同时对照组给予枸橼酸莫沙必利片和胰酶肠溶片,观察组给予消痞汤,疗程4周。检测临床疗效、脑肠肽指标(CGRP、5-HT、SP、NPY)、Hp转阴率、胃液成分(游离酸、胃蛋白酶、亚硝酸盐、总酸)、胃肠激素(GAS、MLT、SS)、胃黏膜病理评分、不良反应发生率变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,2组脑肠肽指标、NPY、SS、游离酸、胃蛋白酶、总酸升高(P<0.05),MLT、亚硝酸盐、黏膜炎症和黏膜萎缩评分降低(P<0.05),以观察组更明显(P<0.05)。2组Hp转阴率、不良反应发生率比较,差异无统计学意义(P>0.05)。结论消痞汤可安全有效地缓解胃黏膜炎症和萎缩,改善胃液成分和胃肠激素,其机制可能与调节脑-肠轴有关。

从“气虚宜掣引之”探讨慢性萎缩性胃炎的辨治思路及方法应用

姜德友教授基于“气虚宜掣引之”理论,从“气虚”探讨慢性萎缩性胃炎的病因病机及证候特点,以“掣引”立论治之法,提出了脾胃同调、体用兼顾、疏肝理肺、温行肾气等辨治思路,以指导慢性萎缩性胃炎治疗方法的具体应用。

HP阳性慢性浅表性胃炎患者采用益生菌联合铋剂四联治疗价值探讨

目的探究幽门螺旋杆菌阳性慢性浅表性胃炎患者应用益生菌联合铋剂四联治疗的效果。方法将福建省福清市医院自2021年2月至2023年10月收治的120例HP阳性慢性浅表性胃炎患者纳入研究。采用完全随机分组法均分为试验组及对照组,每组均为60例。对照组采用铋剂四联治疗,试验组加用益生菌治疗。比较两组的治疗效果、HP转阴率、临床症状改善情况、胃肠功能水平、炎性因子水平及安全性。结果试验组治疗效果高于对照组(P<0.05);试验组HP转阴率高于对照组(P<0.05);试验组临床症状改善情况中腹胀、恶心呕吐、反酸嗳气及上腹痛症状消失时间均少于对照组(P<0.05);试验组胃肠功能中PGⅠ、PGⅡ水平均低于对照组(P<0.05);试验组胃肠功能中GAS水平高于对照组(P<0.05);试验组不良反应率低于对照组(P<0.05)。结论对比单独应用铋剂四联治疗,益生菌联合治疗能够提高HP阳性慢性浅表性胃炎患者的疗效,改善临床症状及胃肠功能,降低炎性因子水平,且不良反应较少,安全性较好。

基于数据挖掘的慢性萎缩性胃炎中医证治规律分析

目的采用数据挖掘方法分析慢性萎缩性胃炎中医证治规律,为临床治疗提供参考。方法借助涵盖消化领域多个优势病种的中医药循证文献大数据平台,检索2000年1月1日-2022年7月31日发表的中医药治疗慢性萎缩性胃炎的名医经验、理论探讨及个案报道类文献,依据纳入、排除标准筛选医案,对医案的中医病名、临床症状、舌象、脉象、中医证候、中医治法等术语进行数据规范及统计分析。结果共纳入文献169篇,收录医案228则,涉及患者228例,累计诊次361次,平均年龄(53.17±11.11)岁,以50~60岁患者最多。慢性萎缩性胃炎多属中医学“胃痛”“痞满”等范畴,主要症状为胃痛、脘痞、嗳气,舌象常见舌黯红、苔白、苔薄或腻,脉象常见弦滑、弦细和弦,高频证型有肝胃气滞证、脾胃湿热证、肝郁脾虚证。病位主要在胃、脾、肝,病性证素多为气虚、气滞、血瘀、热、湿等,复合病性多于单一病性,其中二病性证素以“气虚+气滞”最常见,治法以补益法、理气法、理血法最为常用。结论中医治疗慢性萎缩性胃炎多从胃、脾、肝论治,核心证素为气虚、气滞、血瘀,治疗多用益气健脾、疏肝和胃、调气和血之法。