Clinical Study Of Chronic Atrophic Gastritis With Intestinal Epithelial Hyperplasia And Its Effect On P53 Protein Expression Based On The Hypothesis Of Spleen Deficiency And Toxicity Damage To The Stomach Complex

Objective:Based on the hypothesis that "spleen deficiency and toxicity damage the gastric ligament",to investigate the clinical study of "Jian spleen disinfectant decoction" in the treatment of chronic atrophic gastritis with intestinal epithelial hyperplasia and its effect on P53 protein expression,so as to provide support for the clinical treatment of this disease.Methods:Based on the case selection criteria,50 patients with chronic atrophic gastritis with intestinal epithelial hyperplasia(with or without mild heterotypic hyperplasia)and identified by Chinese medicine as having spleen deficiency and dampness toxicity were selected and treated with the Chinese medicine formula Jian Spleen Disinfectant Decoction for 24 weeks,with every 4 weeks being a course of treatment,taking the medicine 6 days a week.All other treatments other than this treatment regimen were stopped during the course of treatment.Changes in symptom(stomach pain,gastric fullness,noisy,acid reflux)scores,gastroscopic images and pathological(atrophy,enterosis)scores were observed and compared before and after treatment in50 patients,and changes in overall efficacy scores,TCM clinical symptom scores,gastroscopic mucosal images,pathological scores and P53 protein expression in gastric mucosa were compared at the end of treatment.Results:(1)Comprehensive efficacy: 12% cure rate,42% significant rate,38% effective rate,8% ineffective rate,total effective rate was 92%;(2)Efficacy of each symptom score and total score in TCM: after treatment,the efficacy of each symptom such as gastric pain,gastric fullness,noisy and acid reflux were significantly improved than before treatment(<0.05);(3)Change of time point score: from one day before treatment to 24 weeks after treatment,each The total points at each time point showed a significant decrease from the day before treatment to 24 weeks after treatment;(4)Gastroscopic and pathological histological efficacy: the comparison of mucosal images and pathological histological points under gastroscopy after treatment showed an improvement compared with those before treatment(<0.05),and the degree of gastric mucosal lesions(atrophy and intestinalization)was significantly reduced compared with that before treatment;(5)P53 expression:the expression of P53 decreased after treatment compared with that before treatment(<0.05).Conclusion:Jian spleen disinfection Decoction has a more obvious effect in improving the clinical symptoms,gastric mucosal condition and pathological histology of patients with chronic atrophic gastritis with intestinal epithelial hyperplasia in the spleen deficiency and dampness toxicity type,and also has a relationship with the expression of P53 gene.Using the three methods of strengthening the spleen,resolving dampness and detoxifying toxicity can effectively prevent and treat precancerous lesions in chronic atrophic gastritis.