| Objective:.This project aims to use the traditional Chinese medicine Buzhong Yiqi Jiaweidecoction to treat patients with chronic atrophic gastritis diagnosed by gastroscopy and histopathology based on syndrome differentiation.Through the collection and analysis of data which include the symptoms and TCM syndromes as well as its elements of patients with atrophic gastritis and the randomized controlled trials,proving whether this Chinese medicine intervention can reverse gastric mucosal atrophy,intestinal metaplasia,dysplasia and whether it can dsignificantly improve the clinical symptoms of these patients,objectively assessing the intervention and treatment of Buzhong Yiqi Jiawei decoction on gastric mucosal atrophy,intestinal metaplasia,and dysplasia of atrophic gastritis with deficiency of spleen and stomach,and its effect on improving the clinical efficacy of patients.It provides clinical basis and objective evaluation for medium and long term drug regimens that are effective,safe,and convenient to take for gastric precancerous lesions.Method: Collecting patients with chronic atrophic gastritis from the department of gastroenterology at the first affiliated hospital of Guangxi university of traditional Chinese medicine from October 2016 to December 2017.48 patients who met the diagnostic criteria and did not meet the exclusion criteria were included in the study.A practical randomized controlled trial design was used to divide the patients into the Chinese medicine intervention group and the control group,with 24 patients in each group.Since there were 2 cases that fall off naturally during the experiment in the control group,and there were 1 case that fall off naturally in the Chinese medicine group,so there were 23 cases in the Chinese medicine intervention group and 22 cases in the control group actually.The Chinese medicine intervention group was given to Buzhong Yiqi Jiawei decoction;and the control group was given to folic acid(if necessary,symptomatic western medicine was added according to the symptoms),and the course of treatment was 24 weeks.In the course of treatment,making follow-up of patients’ curative effect which mainly includes the histopathological scoring of gastric mucosa(atypical hyperplasia,intestinal metaplasia,atrophy)and total pathological score(before treatment and taking drugs for 24 weeks);symptom score(before treatment and taking drugs for 24 weeks);endoscopic mucosal lesion evaluation(before treatment and taking drugs for 24 weeks).If special circumstances occurred,adopting follow-up,observation,record or instructing the patients to see the doctor in time.After the treatment,the gastric mucosal histopathologic score as well as total pathological score,gastroscopy performance grade and symptom score were evaluated by statistical analysis of patients in two groups.Result: The results of clinical studies showed that:(1)The curative effect of individual symptom: In the improvement of symptoms such as stomach pain,bloating,poor appetite,and loose stools,the traditional Chinese medicine intervention group was significantly better than the control group(P<0.05).There was no significant difference between the traditional Chinese medicine intervention group and the control group in the improvement of symptoms such as being fond of massage as well as warm and fatigue(P>0.05);(2)The total curative efficacy of traditional Chinese medicine syndromes: The total effective rate of the Chinese medicine intervention group was 87.05%;the total effective rate of the control group was 68.18 %,the Chinese medicineintervention group was significantly better than the control group(P <0.05);(3)Endoscopic curative effect: the improvement of endoscopic gastric mucosa in the Chinese medicine intervention group was significantly better than the control group(P <0.05);(4)Pathological curative effect: in the improvement of gastric mucosal atrophy and intestinal metaplasia,the Chinese medicine intervention group was better than the control group(P<0.05);There was no significant difference between the two groups in the improvement of dysplasia(P>0.05).Conclusion: Buzhong Yiqi Jiawei decoction has obviously improving in clinical symptoms in patients of chronic atrophic gastritis with deficiency of spleen and stomach.It can effectively improve symptoms such as stomach pain,bloating,poor appetite,and loose stools,and can effectively improve gastric mucosal atrophy and intestinal metaplasia,achieving the reversal of pathological state.The drug is safe and basically no side effects,which can be recommended as medium and long term medication plan. |
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