Experimental Study On Clinical Research Of Qilian Shupi Prescription In The Treatment Of Precancerous Lesions Of Chronic Atrophic Gastritis And Effect Of C-myc, Caspase-3and Survivin MRNA Expression

Objective：To observe the clinical curative effect of Qilian Shupi prescription in thetreatment of precancerous lesions of Chronic Atrophic Gastritis. And through theexperimental study, to observe its effect on gastric mucosa pathological morphology of ratCAG precancerous lesion, the effect on the expression of the c-myc, caspase-3andsurvivin mRNA in gastric mucosa. To probe into the mechanism of Qilian Shupiprescription in the treatment of precancerous lesions of CAG.Methods:76patients met the inclusion criteria were precancerous lesions of CAG,randomly divided into Qilian Shupi group40cases and Weifuchun group36cases, doubleblind, randomized control observation. To observe the compositive clinical effect, clinicalsymptoms, HP eradication rate, gastroscopic and pathological effects.In the experimentalstudy,we use the comprehensive method of “MNNG+ranitidine+ethanol+hunger andsatiety dysregulation” to copy the Wistar rat model of CAG precancerous lesion.The ratswere randomly divided into normal group, model group, Weifuchun group and QilianShupi large, middle, small dose group. They were given drug intervention respectively.And then to observe the weight of rats and the pathologic changes of gastric mucosa.Immunohistochemical S-P method was used to detect c-myc, caspase-3expression,RT-PCR method was used to detect the expression of survivin mRNA.Results: Clinical studies showed that the total efficiency of QLSP group is82.5%,andWeifuchun group is66.7%, there were significant differences between the two groups（P＜0.05）; the individual clinical symptom scores of QLSP group were significantly decreased, which differed significantly form Weifuchun group（P＜0.01）; the gastroscopic images andpathological results of QLSP group were significantly improved, and also differedsignificantly form Weifuchun group（P＜0.05）; The HP eradication rate was72%in QLSPgroup, Weifuchun group HP eradication rate was42.1%, which had statistical differences.Animal experimental researches showed that QLSP and Weifuchun could increase the bodyweight of rats, and the former is better, there was statistical significance（P＜0.05）;Pathologic changes of gastric mucosa: after statistical analysis,in model rats group, themembers of the gastric mucosa inflammation, atrophy, intestinal metaplasia, dysplasiawere significantly increased to compared with the normal group（P＜0.01or P＜0.05）;Compared with the model group, the members of gastric mucosal inflammation rats ofQLSP large and middle dose group were significantly reduced（P＜0.01or P＜0.05）; thenumber of cases of atrophy, intestinal metaplasia of QLSP large dose group weresignificantly reduced（P＜0.05）; There was no significant difference in the number ofcases of dysplasia in drug intervention groups. Compared with the normal group, thepositive rate of c-myc expression of model group was increased significantly（P＜0.01）;Compared with model group, the positive expression rates of c-myc of QLSP large, middledose group and Weifuchun group were significantly lower（P＜0.01or P＜0.05）.Compared with the normal group, except QLSP high dose group, the positive expressionrates of caspase-3of the other groups were significantly lower（P＜0.01）; Compared withthe model group, the positive expression rates of caspase-3of QLSP large, middle dosegroup and Weifuchun group were significantly elevated（P＜0.01or P＜0.05）; Comparedwith the normal group, the expression rates of survivin mRNA of the rest groups weresignificantly increased（P＜0.01）; Compared with the model group, the expression rates ofsurvivin mRNA of QLSP and Weifuchun group were significantly decreased（P＜0.01or P＜0.05）.Conclusions: There was obvious clinical efficacy of Qilian Shupi prescription intreating precancerous lesions of CAG. Splenogastric asthenia, blood stasis and toxinaccumulation, and involvement of the kidney functions at the advanced stage are themain causes of the disease. Therefore,invigorating spleen and tonifying kidney, regulatingqi to disperse stagnation,and dispersing accumulation of pathogenic factors are theprinciples in the management of the conditon. The animal experiment showed that, Qilian Shupi can obviously increase the body weight of rats, improve the pathologicalmorphology of gastric mucosal of rats of precancerous lesions of CAG,inhibit theexpression of c-myc, activate caspase-3,and inhibit the expression of survivin mRNA,which may be the mechanism of the therapeutic effect of precancerous lesions of CAG.Clinical and experimental studies both proved that Qilian Shupi prescription was effectivein treating the disease.