Clinical Observation On Treating Chornic Atrophic Gastritis(Spleen Deficiency And Blood Stasis)with Jianpi Huoyu Prescripition And The Effect Of COX-2 In Serum Of Patients

Objective:To summary and authenticate the clinical effects of Jianpi Huoyu Prescription and to discuss the mechanism of the treatment of chronic atrophic gastritis,we used Jianpi Huoyu Prescription to treat patients with chronic atrophic gastritis of spleen deficiency and blood stasis by observing the clinical symptoms,mucosal phase under gastroscope,the histopathological changes such as atrophy of gastric mucosal glands,intestinal metaplasia,dysplasia,and the changes of serum cyclooxygenase-2(COX-2)levels before and after treatment.This study is to provide a scientific basis for the treatment of CAG with traditional Chinese medicine.Methods:A total of 66 patients with chronic atrophic gastritis of spleen deficiency and blood stasis were collected from The First Affiliated Hospital of Henan University of TCM.According to the order,33 cases in each group were divided into treatment group and control group by the method of random digital table distribution.The treatment group was given Jianpi Huoxu decoction and the control group was given Weifuchun tablet for 6 months,and other drugs were stopped during the study period.Then the changes of clinical symptoms and the curative effect of TCM syndromes and the histopathology(gastric mucosal atrophy,intestinal metaplasia,dysplasia)before and after treatment were observed.The serum of two groups was taken before and after the treatment,and the COX-2 was detected by the method of ELISA to make statistical analysis and compare the difference of curative effects.Results:(1)Comparison of the baseline data:There was no obvious difference and it was comparable between the two groups in gender,age,course of disease,family history,symptom distribution,the degree of gastric mucosal atrophy and intestinal metaplasia byχ~2or rank sum test(P>0.05).(2)Comparison of the total symptom scores:There was no obvious difference and it was comparable between the two groups in comparison of the total scores before treatment by t test(P>0.05).There was statistical significance in each group in comparison of the total scores before and after treatment by t test(P<0.05).There was statistical significance between the two groups in comparison of the D-value of the total scores before and after treatment by rank sum test(P<0.05).(3)Comparison of TCM syndromes efficacy:The cure rate of the treatment group and the control group was 68.8%and 35.5%,and the total effective rate was 96.9%and 67.7%respectively.There was statistical significance between the two groups in comparison of the two rates byχ~2 test(P<0.05).(4)Comparison of the curative effect of histopathology:In the effect of gastric mucosal gland atrophy,the cure rate of the treatment group and the control group was 65.6%and 32.3%,and the total effective rate was 81.3%and 48.4%respectively.There was statistical significance between the two groups in comparison of the two rates byχ~2 test(P<0.05).In the effect of intestinal metaplasia of gastric mucosa,the cure rate of the treatment group and the control group was 53.8%and 16.7%,and the total effective rate was69.2%and 37.5%respectively.There was statistical significance between the two groups in comparison of the two rates byχ~2 test(P<0.05).In the effect of dysplasia of gastric mucosa,analysis of data was not done because the sample size was too small.(5)Comparison of the COX-2 in serum:There was no obvious difference and it was comparable between the two groups in comparison of the COX-2 before treatment by t test(P>0.05).There was statistical significance in each group in comparison of the COX-2 before and after treatment by t test(P<0.05).There was statistical significance between the two groups in comparison of the D-value of the COX-2 before and after treatment by rank sum test(P<0.05).Conclusion:1.Jianpi Huayu recipe could significantly improve the clinical symptoms of CAG patients with spleen deficiency and blood stasis,reverse the gastric mucosal atrophy and intestinal metaplasia and reduce the COX-2 in serum.The curative effect of the recipe was better than that of Weifuchun group.2.The mechanism of Jianpi Huayu recipe may be to reduce the COX-2 in serum of CAG patients,inhibit the inflammation of gastric mucosa,reduce the injury of microvascular endothelial cells,increase the effective circulating blood flow of localtissues,and promote mucosal gland repair and cell function recovery,thereby reversing atrophy.