仙芪消痞汤治疗慢性萎缩性胃炎64例

目的 :观察仙芪消痞汤治疗慢性萎缩性胃炎的疗效。方法 :对 64例慢性萎缩性胃炎患者给以仙芪消痞汤 (仙灵脾、砂仁、黄芪、白术、茯苓、柴胡等 )加减治疗 3个疗程 ,并进行胃镜检查 ,观察胃粘膜病变和幽门螺旋杆菌 ( Hp)根除情况。结果 :64例患者临床症状、体征、胃粘膜病变、Hp根除情况均有显著改变。提示 :仙芪消痞汤对慢性萎缩性胃炎有较好的疗效 ,既能大大改善胃粘膜病变 ,又能对 Hp有一定治疗作用。

芪莲舒痞膏穴位贴敷治疗慢性萎缩性胃炎癌前病变的临床疗效观察

目的观察芪莲舒痞膏穴位贴敷治疗CAG癌前病变的临床疗效。方法将160例患者随机分为试验组(芪莲舒痞膏)与对照组(胃复春片)各80例,均治疗6个月。比较两组治疗后症状积分、证候总积分、证候疗效、胃镜及病理疗效、HP转阴率、综合疗效、成本-效果分析等。结果治疗后两组症状积分、证候总积分较前均显著降低(P <0. 05或0. 01)。除嗳气、乏力改善差异不显著外,试验组均明显优于对照组(P <0. 05),尤其在食少纳呆、嘈杂泛酸方面(P <0. 01)。试验组证候显效率(68. 83%)、HP转阴率(65. 63%)明显优于对照组(43. 59%、45. 71%)(P <0. 05)。虽两组证候总有效率、胃镜及病理疗效、综合疗效比较均无显著性差异(P> 0. 05),但成本-效果分析(C/E)表明,试验组治疗方案优于对照组。结论芪莲舒痞膏穴位贴敷治疗CAG癌前病变临床疗效确切,值得进一步临床推广应用。

Gastric carcinoids:Between underestimation and overtreatment

Gastric carcinoids(GCs),which originate from gastric enterochromaffin-like(ECL) mucosal cells and account for 2.4% of all carcinoids,are found increasingly in the course of upper gastrointestinal tract endoscopy.Current nosography includes those occurring in chronic conditions with hypergastrinemia,as the type 1 associated with chronic atrophic gastritis,and the type 2 associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1,and type 3,which is unrelated to hypergastrinemia and is frequently malignant,with distant metastases.The optimal clinical approach to GCs remains to be elucidated,depending upon type,size and number of carcinoids.While there is agreement concerning the treatment of type 3 carcinoids,for types 1 and 2,current possibilities include simple surveillance,endoscopic polypectomy,surgical excision,associated or not with surgical antrectomy,or total gastrectomy.Moreover,the recent introduction of somatostatin analogues represents a therapeutic option of possibly outstanding relevance.