| Objective:To study the clinical effect of Qizhu Jianwei Prescription on chronic atrophic gastritis and precancerous lesions of spleen deficiency,dampness and blood stasis,and to explore the mechanism of action.Methods:Own before-and-after study methods,included in 31 patients with conforms to the diagnostic criteria of traditional Chinese and western medicine as a treatment group,treated with traditional Chinese medicine medicinal broth to stilbene bamboo jianwei party,daily 1 agent,2 times daily oral treatment,after 12 weeks of treatment,compared before and after treatment of TCM symptoms curative effect,gastroscope signs,mucosal pathology,cancer risk,the change of the serum levels of gastric function three.In addition,serum gastric function of the treatment group after treatment was compared with that of 31 patients with chronic non-atrophic gastritis.The expressions of Lgr5,Wntl and C-MYC proteins in gastric mucosa of 4 patients in the treatment group before and after treatment and 4 patients with chronic non-atrophic gastritis were detected by western blotting,and comparative analysis was conducted to explore the mechanism of action of this prescription.SPSS25.0 software was used to process and analyze the collected data.Results:(1)Comparison of TCM syndrome and curative effect before and after treatment:among the 31 cases in the treatment group,0 cases were clinically cured,8 cases were significantly effective,20 cases were effective and 3 cases were ineffective.The significant efficiency was 25.8%and the effective rate was 64.5%,the total effective rate was 90.3%.Symptom score comparison:Compared with before treatment,the score of each syndrome was only P=0.061(P<0.05)in loose stool,which was not statistically significant,while the score of other syndromes was significantly improved compared with before treatment,which was statistically significant(P<0.01).(2)Improvement of gastroscopic signs before and after treatment:comparison of changes of gastroscopic signs before and after treatment P<0.01,with significant statistical significance.Gastroscopic signs and curative effect:recovery rate 16.13%,significant efficiency 12.90%,effective rate 67.74%.(3)Pathological improvement of gastric mucosa before and after treatment:Compared with before treatment,Qizhu Jianwei Prescription had significant effect on gastric mucosa atrophy and intestinal metaplasia,P<0.01,all have statistical significance;It has a certain therapeutic effect on improving dysplasia,and further study is needed to expand the sample size.To improve the treatment of pathological injury:gastric mucosa atrophy:cure rate 16.13%,significant efficiency 25.81%,effective rate 54.84%;Intestinal metaplasia:cure rate 16.67%,effective rate 30.00%,effective rate 50.00%;Dysplasia:cure rate 77.78%,effective rate 22.22%.(4)Improvement of cancer risk before and after treatment:simplified OLGA staging:the proportion of stage Ⅰ to Ⅳ before treatment in the treatment group was 0%,6.45%,58.06%,32.26%,3.23%,and 16.43%,80.65%,3.23%,0%,and 0%after 12 weeks of treatment.Simplified OLGIM staging:the proportions of stage Ⅰ to Ⅳ in the treatment group before treatment were 3.23%,6.45%,54.84%,32.26%3.23%,and 19.35%77.42%3.23%,0%,0%,respectively,after 12 weeks of treatment.(5)Three improvements of serum gastric function before and after treatment:compared with before treatment,serum G17 and PG Ⅰ values were significantly increased after treatment,with significant statistical differences(P<0.01);PGR showed an increasing trend with statistical difference(P<0.05);there was no statistical difference in PG Ⅱ(P>0.05).Compared with the patients with mild chronic non-atrophic gastritis,the serum G17 and PGⅠ values in the treatment group were still significantly lower than those in the former 12 weeks later,P<0.01,showing statistical differences.PGR was lower than that of patients with chronic non-atrophic gastritis P<0.05,statistically significant;no statistical significance was found in PGⅡ(P>0.05).(6)Protein expression of Lgr5,Wntl and C-myc in gastric mucosa of 4 patients in the treatment group before and after treatment and 4 patients with chronic non-atrophic gastritis:The protein expressions of Lgr5,Wntl and C-myc in gastric mucosa showed a trend of gradual decline in the three groups,compared with before and after treatment and compared with chronic non-atrophic gastritis after treatment,they were all P>0.05,Lgr5,C-myc protein expression before treatment compared with chronic non-atrophic gastritis had statistical difference(P<0.05),Wntl protein expression before treatment was significantly different from that of chronic non-atrophic gastritis(P<0.01).Conclusion:1.Stilbene bamboo jianwei fong treating wet blood stasis type the CAG pixu(spleen deficient)and precancerous lesions has better clinical curative effect,can significantly ease the discomfort of patients with clinical symptoms and improve patients’ serum gastric function three indicators,gastroscope signs,reduce or even reverse gastric mucosa pathological damage,reduce the OLGA,OLGIM staging,to a certain extent,reduce to the risk of stomach cancer.2.After 12 weeks of treatment with Qizhujiangwei prescription,the clinical symptoms,gastroscopic signs and mucosal pathology of PATIENTS with CAG and precancerous lesions were significantly improved,but the improvement of serum gastric function and protein expression of Lgr5,Wntl and C-MYC in gastric mucosa was not as good as that in chronic non-atrophic gastritis.3.Qizhu Jianwei Prescription for the treatment of CAG and gastric precancerous lesions may inhibit the abnormal proliferation and differentiation of LGR5-labeled gastric stem cells through regulating the dysregulated Wnt pathway,so as to repair or even reverse gastric mucosal injury,which needs further study. |
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