| Objective:To investigate the clinical effect and the indication of P16,Fas,Survivin on gastric mucosa treated by YiqiHuoxueQingre treatment, and explore the mechanism of this treatment which can reverse precancerous lesions of gastric cancer and prevent gastric cancer from the perspective of molecular biology by the technology of cell cultivation.Review:This thesis has reviewed the concept of chronic atrophic gastritis (CAG) precancerous lesion in traditional Chinese medicine in aetiology, pathology, clinical treatment and experimental research. Besides of these, the modern research in etiology and pathology of CAG precancerous lesion, the modern research results of the experimental models and certain relative genes on the CAG precancerous lesion have also been reviewed.Clinical research:76 cases of CAG precancerous lesions were divided into two groups randomly. One group has been treated by YiqiHuoxueQingre prescription as the treatment group(46 cases), and the other one has been treated by WeiFuChun Tablet(WFCT) as the control group(30 cases). The whole duration of treatment was 6 months. The improvement in clinical symptoms, the gastroscopic signs and histapathological changes was compared between the two groups, and the expression of P16,Fas and Survivin on gastric mucosa of the treatment group before and after treatment were compared at the same time. Results showed that the clinical effective rate and the effective rate for gastroscope of the treatment group were 91.3% and 82.6% respectively, which were significantly higher than the control group(83.3%,70%) (P<0.05).The clinical symptoms in both groups have improved. Compared with the control group,the treatment group had symptomatic improvement in abdominal distention and fullness, poor appetite, belching, gastric upset and fatigue significantly(P<0.01,0.05). Endoscopic signs improved in both groups. The mucosal edema and erosions of the treatment group improved better than that of the control group(P<0.01,0.05). Pathologic results in both groups have improved. The treatment group improved significantly on atrophy, chronic inflammation, activity and intestinal metaplasia than the control group(P<0.05). After the Chinese medicine intervention, the expression of P16 and Fas is increased, and Survivin protein is declined, the expression of P16,Fas,Survivin protein has a significant change after treatment(P<0.01,0.05).Experimental research:The experiments adopted MC cells gained from GES-1 cells transformed by N-methyl-N'-nitro-N-nitroso-guanidine (MNNG) as the model of precancerous lesions for study in vitro. Observe the inhibition effect of the proliferation and promotion effect of the apoptosis, and the influence of P16,Fas and Survivin on MC cell of rabbit serum containing Renzhu Jianwei Granule(RZJWG). Results indicated that rabbit serum containing RZJWG could restrain MC cell's proliferation significantly and promote apoptosis of MC cells. While RZJWG could raise the expression of P16 and Fas, and reduce the expression of Survivin (P<0.05)Conclusion:YiqiHuoxueQingre treatment can not only obviously relieve the clinical symptoms of CAG patients and ameliorate the pathological changes of gastric mucosa, but also reduce the inflammation, atrophy and intestinal metaplasia. Its mechanism to treat precancerous lesions of gastric cancer may be possibly related with inhibiting the proliferation and promoting apoptosis of precancerous cells. |
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