| OBJECTIVE In the study ,the TCM theories of treatment according to syndrome differentiation were used clinically and experimentally to probe into the possible causes, pathogenesis, management method and prescription of precancerous lesions of chronic atrophic gastritis,and to find out the pharmacodynamic mechanism of the prescription.METHODS On the basis of clinical syndrom differentiation,we come to the conclusion that the precancerous lesions of chronic atrophic gastritis are resulted from splenogastric asthenia,accumulation of stagnant pathogenic factors in the body,and involvement of the kidney functions at the advanced stage.Accordingly,we adopted the treatment principles of invigorating spleen and tonifying kidney,regulating qi to disperse stagnation,and dispersing accumulation of pathogenic factors to resolve masses.Guided by these principles we made up a prescription of medicinal herbs,which are processed and prepared with modern technique into granules named Qilian Shupi Granule(QLSP).61 patients of precancerous lesions of chronic atrophic gastritis were treated with QLSP Granule,and the clinical and pathological effects were compared with those of the 40 patients treated with Wei Fuchun Tablet and 36 patients treated with Weimeisu.At the same time, the Hp-eradicating rates, and the change of cAMP, SOD,LPO,TXB2,6-K-PGF0 inblood of the experinmental group were observed.In experiments,models of precancerous lesions of gastric cancer were induced by cancerogenic agent in Wistar rats,and in situ hybridizational and immunohistochemical methods were used to monitor angiogenesis factors (VEGF,VEGFR,bFGF, PDGF and so on)and MVD's expression and pathological changes, the changes of SOD and LPO in plasma,and the weight changes of immune organs(thymus and spleen)in the QLSP group and the two control groups before and after treatment.RESULTS DATA of clinical research showed that in QLSP group the notable effective rate was 32.8%,and the total effective rate was 80.3%,while the notable effective rate was 27.5% and the total effective rate was 70.0% in Wei Fuchun group,and those of Weimeisu group was 2.8% and 47.2% respectively.The effective rate of QLSP being significantly higher than the other two drugs. It has been found that QLSP granule can inhibit Hp,rais cAMP and SOD in blood, lower MDA and improve TXB2/6-K-PGF|0, and the difference with the other two drugs is remarkable.Animal experimental research showed that precancerous lesions of gastric mucosa also has angiogenesis factors' expression and the significant difference is compared with the control groups(p<0.05).QLSP Granule can notably inhibit the expression and secretion of angiogenesis factors (VEGF,VEGFR, bFGF,PDGF and so on),raise SOD in plasma,lower MDA,stop or reverse the pathological process of precancerous lesions of gastric mucosa,and considerably increase the weight of thyinus and spleen,and there was significant difference between the QLSP group and the two control groups(p<0.05).CONCLUSIONS Splenogastric asthenia,accumulation of stagnant pathogenic factors in the body, and involvement of the kidney functions at the advanced stage are the main causes leading to the pathogenesis of precancerous lesions of chronic atrophic gastritis.Therefore,invigorating spleen and tonifying kidney, regulating qi to disperse stagnation,and dispersing accumulation of pathogenic factors to resolve masses are the principles in the management of the conditon.The excellent clinical effect of QLSP together with the data from experimental research reveal itsmechanism at the systemic,cellular and molecular levels in treating precancerous lesions of chronic atrophic gastritis.The QLSP prescription acts on many chains and targets of the disease to produce a comprehensive therapeutic effect,the therapeutic mechanism may have much to do with an overall effect o inhibition of angiogenesis factors and lipid peroxidation,antioxidation, regulation of immunity,improvement of the balance between PG\2 and TXAi in blood,inhibition of Hp and anti-inflammatio...
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