| Objective:1.To investigate the clinical efficacy of Meiqing Decoction in the treatment of chronic atrophic gastritis(CAG).To observe the effect of Meiqing Decoction on clinical symptoms and gastroscopic pathology of CAG patients.2.The rat model of CAG was established by using the solution of N-methyl-N’-nitro-N-nitrosoguanidine(MNNG),and the reasonable dosage of MNNG was investigated.3.To explore the effect of Meiqing Decoction on CAG rats,to study the effect of Meiqing Decoction on gastric mucosal pathology of CAG rats,and to observe the changes of serum pepsinogen(PG)and gastrin-17(G-17)levels in CAG rats treated with Meiqing Decoction.Methods:1.Clinical study:according to the inclusion and exclusion criteria,60 patients with CAG(Qi-deficiency and Blood-stasis syndrome)in Jiangsu Province Hospital of Traditional Chinese Medicine were randomly divided into treatment group(Meiqing Decoction group)and control group(folic acid group),30 cases in each group.The treatment group was treated with Meiqing Decoction for 12 weeks,and the control group was treated with folic acid tablets for 12 weeks.The changes of clinical symptom scores of the two groups before and after treatment were recorded.The gastroscopic pathological changes of patients treated with different drugs were observed and compared.2.Experimental research 1(establishment of CAG rat model):20 healthy SD rats,male,which were randomly divided into 5 groups:group A(120 μg/ml),B(160μg/ml),C(170μg/ml),D(180 μg/ml)and E(200 μg/ml),with 4 rats in each group,were given corresponding concentrations of MNNG solution to drink freely,and the MNNG solution was changed once a day.During the model period,rats were fed normally.And pathological changes of gastric mucosa in different dose groups were observed 8 weeks later.3.Experimental research 2(effect of Meiqing Decoction on CAG rats):40 healthy SD rats,male,randomly divided into 5 groups:group A(blank control group),group B(pathological model group),group C(low dose of Meiqing Decoction),group D(medium dose of Meiqing Decoction)and group E(high dose of Meiqing Decoction),with 8 rats in each group.The rats in group A drank water and ate food normally,and the rats in groups B,C,D and E drank MNNG solution freely.The rats in groups B,C,D and E continued to model for 8 weeks,and ate food normally during model building.After modeling,from the 9th week,groups A and B were gavaged with distilled water daily,while groups C,D and E were respectively gavaged with low,medium and high doses of Meiqing Decoction daily,for 12 weeks.Before and after oral administration of Meiqing Decoction,the levels of PG Ⅰ,PG Ⅱ,PG Ⅰ/PG Ⅱ and G-17 in serum of rats in each group were detected by ELISA,analyze and compare its changes.The pathological changes of gastric mucosa were observed after 4 weeks and 12 weeks of administration.Results:1.Clinical study:1)Symptom score:compared with that before treatment,the symptom score of both groups decreased after treatment,and the improvement of total symptom score of Meiqing Decoction group was significantly better than that of folic acid group(P<0.01).In terms of individual symptom scores,there was no significant difference in belching and acid regurgitation symptoms between Meiqing Decoction group and folic acid group after treatment,but the improvement of other symptom scores in Meiqing Decoction group was better than that in folic acid group(P<0.05).2)Gastroscopic pathology:compared with before treatment,gastric mucosal atrophy was improved in Meiqing Decoction group and folic acid group,and Meiqing Decoction group was better than folic acid group(P<0.05).Intestinal metaplasia and intraepithelial neoplasia were significantly improved(P<0.01),and intraepithelial neoplasia was improved(P<0.05)in Meiqing Decoction group.There was no significant improvement in intestinal metaplasia and intraepithelial neoplasia in folic acid group.2.Establishment of CAG rat model:eight weeks after the establishment of the model,the pathological sections of gastric mucosa showed that the pathological changes of CAG induced by each dose group were mainly in the gastric antrum.Among them,glandular atrophy was found in 1 case in 120 μg/ml group,inflammatory lesion in 1 case and no obvious lesion in 2 cases,glandular atrophy was found in 3 cases in 160 μg/ml group,only inflammatory lesion was found in 1 case in 160 μg/ml group,and glandular atrophy was found in 170,180,200 μg/ml group.The results of pathological score showed that the higher the concentration of MNNG was,the more serious the gastric mucosal lesion was,but there was no significant difference among the groups.3.Study on the effect of Meiqing Decoction on CAG rats:1)Changes of body weight in rats:There was no significant difference in initial body weight among the five groups.After 8 weeks,the body weight of rats in each model group(group B,C,D,E)was significantly lower than that in group A(P<0.05),and 12 weeks after administration of Meiqing Decoction,the body weight of rats in each treatment group(group C,D,E)was not significantly different from that in group A,but the body weight in group B was still significantly lower than that in group A(P<0.05).The results showed that Meiqing Decoction could significantly improve the growth rate of body weight of rats.2)Pathology:Four weeks after administration,according to the results of pathological sections,compared with group B,the gastric mucosal lesions of each treatment group(group C,D,E)showed improvement,among which the pathological improvement was the most obvious in the high-dose Meiqing Decoction group.After 12 weeks of administration,compared with the pathological scores of group A,the scores of gastric antrum and gastric body of rats in group B were significantly higher than those of group A,and the increase of gastric antrum was more obvious.Compared with group B,the pathological score of each Meiqing Decoction treatment group decreased.The gastric antrum of group C,D and E and the gastric body of group E were significantly lower than those of group B(P<0.05),in which the decrease was more obvious and the difference was more significant.There was no significant difference in the gastric body of groups C and D(P>0.05).3)Comparison of serum G-17,PG Ⅰ,PGⅡ and PG Ⅰ/PG Ⅱ levels:There was no significant difference in the level of serum PG Ⅱ among all groups before and after treatment.Before administration(after MNNG modeling),the serum levels of G-17,PG Ⅰ and PG Ⅰ/PG Ⅱ in each group were significantly lower than those in group A(P<0.05).After 12 weeks of treatment with Meiqing Decoction,the serum levels of G-17,PG Ⅰ and PG Ⅰ/PG Ⅱ in each treatment group were significantly higher than those in group B(P<0.05).However,all the serum indexes(except PG Ⅱ)in group B were significantly different from those in group A(P<0.05).Conclusion:1.Meiqing Decoction is better than folic acid tablets in alleviating clinical symptoms and improving gastric mucosal pathology.Meiqing Decoction is a clinically effective prescription for the treatment of CAG patients(type of Qi-deficiency and Blood-stasis)with good clinical efficacy.2.MNNG free drinking method is an effective method to establish CAG rat model,and with the increase of MNNG concentration,the pathological changes of gastric mucosa in rats were aggravated gradually.There were glandular atrophy in 170,180,200 μg/ml groups,but some rats in 120,160 μg/ml group failed to form glandular atrophy.3.Meiqing Decoction can significantly improve gastric mucosal glandular atrophy,restore mucosal thickness and reduce inflammatory cell infiltration in CAG rats.It can increase the levels of serum PG Ⅰ,PG Ⅰ/PG Ⅱ and G-17 in CAG rats,which has a positive effect,suggesting that Meiqing Decoction has obvious therapeutic effect on CAG rats. |
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