| Objective: To observing the efficacy and safety of YunQi Fang in the treatment of chronic atrophic gastritis(CAG)in different high-altitude areas in Qing Hai,the correlation between CAG and altitude was clarified,so as to establish a Qing Hai region based on the guidance of the five-yun and six-qi theory.CAG’s traditional Chinese medicine diagnosis and treatment system,and then achieve social and economic benefits.Methods: With the consent of the medical ethics committee of Qinghai Provincial Hospital of traditional Chinese medicine,180 patients with HP positive CAG diagnosed by gastroscopy,gastric tissue biopsy and carbon 14 breath test in the outpatient and inpatient department of spleen and stomach department of Qinghai Provincial Hospital of traditional Chinese medicine,Longsha characteristic outpatient department,Delingha Hospital of traditional Chinese medicine and Maqin County People’s Hospital at an altitude of 3080 meters from November 2020 to February2022 were collected,They were randomly divided into control group A(a2000 = 30,A3000 = 30,a4000 = 30)and treatment group B(b2000 = 30,B3000 = 30,b4000 =30).The control group A was treated with western medicine standard quadruple therapy,and the treatment group B was treated with western medicine standard quadruple therapy + YunQi Fang.Both groups were treated for 4 weeks.The TCM symptom scores,gastric mucosal grading under gastroscope and pathological histological scores of the two groups and patients at different altitudes were compared before and after treatment,and the curative effect and safety were evaluated.result:1.A total of 180 patients with HP positive CAG at an altitude of 2000 meters,3000 meters and 4000 meters were included in this test.Finally,175 patients completed the test and 5 patients fell off(refusing to return to gastroscopy and disease 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 disease duration of patients at altitudes of 2000 meters,3000 meters,and 4000 meters above sea level had no statistical significance within the group,between groups,and between altitudes at different altitudes(p>0.05),which were comparable.3.Before treatment,there was no significant difference in the scores of TCM symptoms,mucosal grading under gastroscopy,and gastric histopathological signs in patients at the same altitude(2000 meters above sea level,3000 meters above sea level,and 4000 meters above sea level)between groups(p>0.05).),which are comparable.4.There were differences in the scores of TCM symptoms,pathological signs,and mucosal grades under gastroscope between the three altitude areas before treatment,with statistical significance(p<0.05).In the comparison of the single TCM symptom scores among the three altitude areas,there were differences in the single TCM symptom scores of sleep,fullness,stomach pain,and constipation,with statistical significance(p<0.05);the single pathological symptom scores among the three altitude areas In comparison,there were differences in the scores of individual pathological signs of chronic inflammation,abnormal hyperplasia and intestinal metaplasia,with statistical significance(p<0.05).5.Comparison of TCM efficacy and TCM symptom scores in the same altitude area after treatment.The effective rate of a2000 group is 70.00%,the effective rate of b2000 group is93.33%;the effective rate of a3000 group is 72.41%,the effective rate of b3000 group is 90.00%;the effective rate of a4000 is 74.07%,the effective rate of b4000 is 93.10%;the effective rate of control group A is 72.09%,and the effective rate of treatment group B has an effective rate of 92.13%.Compared with the control group and the treatment group at the same altitude,the TCM symptom scores in the two groups decreased.Comparison between the control group and the treatment group at the same altitude after treatment,the b2000 group was better than the a2000 group in the reduction of TCM symptom scores and the improvement of individual TCM symptoms of stomachache,fullness,fullness,and anorexia,and the b3000 group was in the reduction of TCM symptom scores and The improvement of single TCM symptoms of stomach pain and acid regurgitation was better than that of the a3000 group,and the b4000 group was better than the a4000 group in the reduction of TCM symptom scores and the improvement of the single TCM symptoms of stomach pain,fullness,fullness,and acid regurgitation,and the treatment group B was better in TCM symptoms The score reduction and the improvement of single TCM symptoms of stomach pain,fullness,belching,fullness,acid reflux,anorexia,and noise were better than those of the control group A,with statistical significance(p<0.05).6.Comparison of mucosal grading under gastroscope and gastroscope curative effect in the same altitude area after treatment.The effective rate of a2000 group is 73.33%,the effective rate of b2000 group is90.00%,the effective rate of a3000 group is 82.76%,the effective rate of b3000 group is 86.67%,the effective rate of a4000 group is 77.78%,the effective rate of b4000 group is 89.65%,and the effective rate of control group A is 77.90%.The effective rate of treatment group B was 88.76%,and the curative effect of gastroscope in the treatment group was better than that in the control group at the same altitude,with statistical significance(p<0.05).Compared between groups after treatment,gastric mucosa repair in the treatment group was better than that in the control group at the same altitude,with statistical significance(p<0.05).7.Comparison of curative effect of pathological signs and pathological signs scores in the same altitude area after treatment.The effective rate of a2000 group was 66.67%,the effective rate of b2000 group was 93.33%;the effective rate of a3000 group was 65.51%,and the effective rate of b3000 group was 90.00%;the effective rate of a4000 group was 70.37%,and the effective rate of b4000 group was 89.65%;the effective rate of control group A was67.44%,The effective rate of treatment group B was 91.01%.Compared with the control group and the treatment group at the same altitude,the scores of pathological signs in the two groups decreased.Compared with the control group and the treatment group at the same altitude after treatment,the b2000 group was better than the a2000 group in the decrease of the pathological sign score and the improvement of a single pathological sign of chronic inflammation and intestinal metaplasia.The improvement is better than the a3000 group,the b4000 group is better than the a4000 group in the decrease of the pathological sign score and the improvement of a single pathological sign of chronic inflammation,and the treatment group B is better in the decrease of the pathological sign score and the improvement of the single pathological sign of chronic inflammation,atrophy and intestinal metaplasia.Compared with control group A,it was statistically significant(p<0.05).8.Comparison of TCM efficacy and TCM symptom scores at different altitudes after treatment.The effective rate of a2000 group is 70%,the effective rate of a3000 group is72.41%,the effective rate of a4000 group is 74.07%,the effective rate of b2000 is93.33%,the effective rate of b3000 is 90.00%,and the effective rate of b4000 is93.10%;There was no difference in the improvement of clinical symptoms between the groups after treatment,and there was no statistical significance(p>0.05).The a2000 and a3000 groups were significantly different in sleep,a2000 and a4000 groups in belching,acid reflux,b2000 and b4000 groups in anorexia,and b3000 and b4000 groups in the score of a single TCM symptom of fatigue(p <0.05).9.Comparison of gastroscopic mucosal grading and gastroscopic efficacy in different altitude areas after treatment.The effective rate of a2000 group is 73.33%,the effective rate of a3000 group is82.75%,the effective rate of a4000 group is 89.65%,the effective rate of b2000 is90.00%,the effective rate of b3000 is 90.00%,and the effective rate of b4000 is93.10%.There was no difference in gastric mucosa repair between the control group and the treatment group after treatment in three different altitude areas,and there was no statistical significance(p>0.05);10.Comparison of curative effect of pathological signs and pathological signs scores at different altitudes after treatment.The effective rate of a2000 group was 66.66%,the effective rate of a3000 group was 65.51%,the effective rate of a4000 group was 70.37%,the effective rate of b2000 was 93.33%,the effective rate of b3000 was 90.00%,and the effective rate of b4000 was 89.65%.There was no difference in the improvement of pathological signs between the control group and the treatment group in the three different altitude areas after treatment,and there was no statistical significance(p>0.05).The difference was statistically significant(p<0.05).11.There were no adverse reactions or allergic reactions in 175 CAG patients in3 different altitude areas during the treatment period of luck prescription and western medicine quadruple therapy,and there were no abnormalities in safety indicators such as white blood cells,liver and kidney function,blood sugar,blood pressure,and heart rate.in conclusion:1.There are differences in clinical symptoms,gastroscopic mucosal grading and gastric histopathological signs among CAG patients at different altitudes,and the severity increases with the increase of altitude.2.The combination of YunQi Fang and Western medicine standard has a good clinical effect in the treatment of CAG in different high-altitude areas of Qinghai.It can improve clinical symptoms,promote the repair of gastric mucosa in patients with CAG and improve the pathological signs of gastric tissue.3.The curative effect of YunQi Fang combined with western medicine standard quadruple is better than that of simple western medicine standard quadruple.4.YunQi Fang is safe and reliable in CAG clinical application. |
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