Clinical Study On The Treatment Of Chronic Atrophic Gastritis With Low-grade Intraepithelial Neoplasia By The Method Of Strengthening The Spleen,Activating Blood Circulation And Detoxification And The Effect On P53 Protein Expression

Objective: To observe and evaluate the clinical efficacy and the effect on the expression of P53 in the gastric mucosa of chronic atrophic gastritis with low-grade intraepithelial neoplasia by the formula of Jianpixiaodu Decoction II,and to explore the mechanism of action of the method of invigorating blood and detoxifying blood to prevent and treat chronic atrophic gastritis with low-grade intraepithelial neoplasia,so as to provide support for the clinical treatment of this disease.Methods:Thirty-six patients with chronic atrophic gastritis with low-grade intraepithelial neoplasia(with or without mild-to-moderate intestinal epithelial metaplasia)were selected according to the case selection criteria,and all of them were treated with the Chinese herbal soup formula Jianpixiaodu Decoction II,which was taken 6 days a week for 4 weeks for 6 courses.During the treatment period,all drugs other than this herbal treatment regimen that have therapeutic effects on chronic atrophic gastritis with low-grade intraepithelial neoplasia were discontinued as far as possible.The changes in symptom(gastric fullness,stomach pain,noisy,acid reflux)scores,gastroscopic images and pathological(atrophy,intestinalization,heterogeneous hyperplasia)scores of the 36 patients were observed and compared before and after treatment,and the changes in the overall clinical efficacy,TCM symptom scores,gastroscopic images,pathological scores and P53 protein expression of gastric mucosa were compared at the end of the treatment course.Results:(1)Comprehensive efficacy: the total efficacy rate of the treatment group reached 91.67%;(2)Efficacy of the TCM symptom scores and total scores: the efficacy of each symptom such as gastric fullness,stomach pain,noisy and acid reflux was better than that before the treatment(P<0.05);the total scores of gastric fullness,stomach pain,noisy and acid reflux were better than that before the treatment(P<0.05);(3)Time point scores(4)Gastroscopic and pathological histological efficacy: after treatment,the pathological histological score and total score of gastric mucosa were better than before(P<0.05),and the degree of gastric mucosal lesion was significantly reduced compared with before treatment;(5)P53 expression:after treatment with Jianpixiaodu Decoction II,the P53 protein expression score was reduced compared with before(P<0.05).(P < 0.05),which was statistically significant.Conclusion: The treatment of chronic atrophic gastritis with low-grade intraepithelial neoplasia in patients with spleen deficiency and stasis toxicity with the Chinese medicine formula Jianpixiaodu Decoction II can effectively alleviate the clinical symptoms and Chinese medicine symptoms of patients,significantly improve the pathological condition of gastric mucosa,and regulate the expression of P53 gene,and the method of strengthening the spleen and detoxifying the toxin,together with invigorating blood,has a preventive effect on precancerous lesions in chronic atrophic gastritis.