| Objective: To observe the effect of Yun Qi Fang on pepsinogen(PG I,PG II),serum gastrin G-17,HP negative conversion rate and symptom score in patients with chronic atrophic gastritis(CAG)at different altitudes in Qinghai Based on the five-yun-six-qi theory,so as to explore the possible mechanism of Yun Qi Fang on CAG,make up for the lack of modern medicine in the treatment of this disease,and provide a more powerful scientific basis for the prevention and treatment of this disease with traditional Chinese medicine,To provide a prevention and treatment program more in line with the local luck pattern for patients with chronic atrophic gastritis.Methods: with the consent of the medical ethics committee of Qinghai Provincial Hospital of traditional Chinese medicine,60 patients with HP positive chronic atrophic gastritis were selected from the outpatient and inpatient department of the spleen and stomach department of Qinghai Provincial Hospital of traditional Chinese medicine from November 2020 to February 2022,Longsha characteristic outpatient clinic(2200m above sea level),Delingha traditional Chinese medicine hospital(3080 m above sea level)and Maqin County People’s Hospital(4100 m above sea level),a total of 180 patients.They were randomly divided into control group A(a2000=30,a3000=30,a4000=30)and treatment group(bb2000=30,b3000=30,b4000=30).Control group A was treated with western medicine standard quadruple therapy,and treatment group B was treated with western medicine standard quadruple therapy + Yun Qi Fang.Both groups were treated for 4 weeks.Gastric function and HP were reexamined one month after the drug was stopped,and gastric function and HP were revisited three months after the drug was stopped.The changes of HP negative conversion rate,pepsinogen(PG I,PG II),serum gastrin G-17,TCM symptom score and safety index before and after treatment were compared between the two groups at the same altitude and at different altitudes,And statistical analysis.Results:1.a total of 180 CAG patients at an altitude of 2000 m,3000 m and 4000 m were included in this trial.175 patients were finally completed and 5 patients fell off(unwilling to have a follow-up gastric function examination),4 patients in control group a fell off(1 case in A3000 and 3 cases in a4000),and 1 patient in treatment group B fell off(1 case in b4000).2.before treatment,the gender,age and course of disease of the patients in the three altitude areas were not statistically significant(p>0.05)within the group,between the groups and between different altitudes,which was comparable.3.before treatment,the three items of gastric function(PG I,PG II,G-17),HP and symptom scores of patients at the same altitude(altitude 2000 m,altitude 3000 m,altitude 4000 m)were compared.The difference was not statistically significant(p>0.05),which was comparable.4.comparison of PG I,PG II,G-17,HP and symptom scores of patients at different altitudes(2000m,3000 m and 4000m)before treatment.There were significant differences in PG I and PG II between 2000 m and 3000 m above sea level(p<0.05);There was significant difference in G-17 between 2000 m and 4000 m above sea level(p<0.05);All cases included before treatment were HP positive and comparable.Compared with the score of TCM symptoms,there was a significant difference between the altitude of 2000 meters and the altitude of 4000 meters(p<0.05).5.comparison of HP,PG I,PG II,G-17 and symptom scores at the same altitude after treatment5.1 comparison of HP,PG I,PG II and G-17 in an altitude of 2000 meters after treatmentThe negative rate of HP was 66.66% in a2000 group and 93.33% in b2000 group.The negative rate of HP was 63.33% in a2000 group and 86.67% in b2000 group.There was significant difference in the negative rate of HP and the negative rate of HP after treatment between the two groups(p<0.05);After treatment,the comparison of gastric function in the two groups showed that the drugs in the two groups had a certain lowering effect on the three levels of gastric function.After treatment,the comparison of three indexes of gastric function among groups showed that PG I,PG II and G-17 were statistically significant.The comparison of three indexes of gastric function between the two groups during the follow-up visit showed that PG I,PG II and G-17 were statistically different.The results of the follow-up visit showed that Yun Qi Fang combined with quadruple therapy was better than the single quadruple therapy of Western medicine in regulating the levels of PG I,PG II and G-17.5.2 comparison of HP,PG I,PG II and G-17 in areas with an altitude of 3000 meters after treatmentThe negative rate of HP in A3000 group was 72.41%,that in B3000 group was 93%,and the negative rate of HP in return visit was 68.97% in A3000 group and 90% in B3000 group.There was significant difference in the negative rate of HP and the negative rate of HP in return visit between the two groups after treatment(p<0.05);After treatment,the comparison of gastric function in the two groups showed that the drugs in the two groups had a certain lowering effect on the three levels of gastric function.After treatment,the three comparisons of gastric function between groups showed that PG II and G-17 were statistically significant,but PG I was not statistically significant,indicating that Qi Qi Fang combined with quadruple therapy was superior to western medicine group in regulating PG II and G-17,and the decrease in regulating PG I level was the same as that in western medicine group.The comparison of the three indexes of gastric function between the two groups in the follow-up visit showed that G-17 was not statistically significant,but PG I and PG II were statistically different.The follow-up results showed that Yun Qi Fang combined with quadruple therapy was better than the single quadruple therapy of Western medicine in regulating the levels of PG I and PG II.5.3 comparison of HP,PG I,PG II and G-17 in areas with an altitude of 4000 meters after treatmentThe negative rate of HP was 66.66% in a4000 group and 89.65% in b4000 group.The negative rate of HP was 40.74% in a4000 group and 51.72% in b4000 group.There was significant difference in the negative rate of HP after treatment between the two groups(p<0.05),but there was no significant difference in the negative rate of HP during follow-up(p>0.05);After treatment,the comparison of gastric function in the two groups showed that the drugs in the two groups had a certain lowering effect on the three levels of gastric function.After treatment,the three comparisons of gastric function between groups showed that PG I was not statistically significant,but PG II and G-17 were statistically significant,indicating that Yun Qi Fang combined with quadruple therapy was superior to the single quadruple therapy of Western medicine in regulating the levels of PG II and G-17.The comparison of the three indexes of gastric function between the two groups in the follow-up visit showed that G-17 was not statistically significant,but PG I and PG II were statistically different.The follow-up results showed that Yun Qi Fang combined with quadruple therapy was better than the single quadruple therapy of Western medicine in regulating the levels of PG I and PG5.4 comparison of HP,PG I,PG II and G-17 at three altitudes after treatmentThe negative rate of HP in control group A was 69.77%,that in treatment group B was 92.13%,that in follow-up group A was 58.14%,and that in treatment group B was 76.40%.There was a statistical difference between the two groups in terms of the return visit HP negative rate(p<0.05).The return visit HP negative rate in the treatment group was lower than that in the control group.The comparison within the gastric function groups at three altitudes showed that the drugs in the two groups had a certain reduction effect on the three levels of gastric function.The comparison between the groups after treatment showed that PGI,PGII and G-17 had statistical significance;There were significant differences in PGI PGII and G-17 among the three indexes of gastric function during follow-up(p<0.05).5.5 comparison of symptom scores at the same altitude after treatmentThe scores of TCM symptoms of the two groups in the same altitude area after treatment were compared,and the scores within the group were lower than those before treatment;Among the groups,the treatment group was better than the control group in the improvement of TCM symptoms and the decrease of scores,with statistical significance(p<0.05)6.comparison of HP,PG I,PG II,G-17 and symptom scores at different altitudes after treatment6.1 comparison of HP,PG I,PG II and G-17 at different altitudes after treatmentThere was no significant difference in the negative conversion rate between the two groups: control group A χ2=0.220,p=0.89>0.05,treatment group B χ2=0.365,p=0.83>0.05.The return visit HP negative conversion rate in the control group was 2=8.516,p<0.01,which was statistically significant,while that in the treatment group was 2=14.627,p<0.01,which was statistically significant.There was no significant difference between the control group and the treatment group in the regulation of G-17 levels in three different altitude regions(p>0.05),but there was significant difference between a2000 group and A3000 group in the regulation of PG I and PG II levels(p<0.05).6.2 comparison of symptom scores at different altitudes after treatmentThere was no significant difference in TCM symptom scores between the control groups at different altitudes after treatment;There was no significant difference in TCM symptom scores between treatment groups at different altitudes(p<0.05).7.the heart rate,blood pressure,liver and kidney function,blood glucose and other safety indicators of 175 CAG patients in three different altitude areas were basically the same before treatment,and there was no significant abnormality after treatment.No adverse reactions and allergic reactions occurred during the treatment period of taking Yun Qi Fang and Western medicine quadruple therapy,and no obvious abnormality was found in the safety indicators,which was statistically significant.Conclusion:1.the curative effect of Yun Qi Fang combined with western medicine in the treatment of chronic atrophic gastritis patients at different altitudes in Qinghai is remarkable.It can alleviate clinical symptoms,reduce TCM symptom score,regulate and reduce the levels of serum PG I,PG II,G-17,and have a high negative rate of HP;2.it was observed that there were differences in gastric function between different altitudes.The symptom score increased with the increase of altitude,and the eradication rate of HP decreased in the higher altitude areas;3.Qi Qi Fang has stable clinical safety in the treatment of CAG,and has further research value. |
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