Effect Of Jiawei Wuqi Powder On Clinical Efficacy Of Postoperative EMR Of Gastric Polyps And Its Experimental Study

Clinical part:Objective:To observe the clinical efficacy of Jiawei Wuqi Powder in the treatment of artificial ulcer after EMR of gastric polyp.Methods:Sixty patients with artificial ulcer after EMR of gastric polyp divided into treatment group and control group in randomly,earch group have 30 cases.In the treatment group,40 mg of Esomeprazole was intravenously infused twice a day for 3 days,and the treatment of Jiawei Wuqi Powder was for 4 weeks.Control group:Esomeprazole 40mg intravenous infusion,2 times a day,3 days of treatment,compound allantoin treatment for 4 weeks.Gastroscopic examination was performed before and after treatment;before and after treatment,and the scores of syndromes were recorded.Observed the symptom score and efficacy score before and after the patient’s medication;the size of the ulcer area before and after treatment,the reduction of ulcer area and the number of ulcers in the flattened scar period,to evaluate the healing quality of artificial ulcer;observe the drug-related occurrence of the patient during treatment Adverse reactions and complications.Results:The observations of TCM syndrome scores before treatment and 4 weeks later in the treatment group and the control group showed:(1)The symptoms of stomach cramps,sputum,suffocation,sputum acid reflux,and sputum stagnation after treatment were significantly improved compared with before treatment.(P<0.01).(2)The total effective rate of TCM syndromes in the treatment group was 86.7%,and the control group was 83.3%.The two groups of patients had significant improvement in TCM symptom after treatment.There was no significant difference between the treatment group and the control group(P>0.05).Gastroscopic examination was performed 4 weeks after EMR,and the area reduction rate of ulcer in the treatment group was 0.94±0.05,the healing rate was 40%,and the improvement rate was 86.7%.The reduction rate of ulcer area in the control group was 0.92±0.05,and the healing rate was 26.7%,the improvement rate was 83.3%.There was no significant difference in the area of artificial ulcer reduction,healing rate and improvement rate between the two groups(P>0.05).In the treatment group,10 cases of flat scar ulcers accounted for 83.3%;in the control group,3 cases of flat scar ulcers accounted for 37.5%.The quality of ulcer healing in the treatment group was better than that in the control group(P<0.05).Four weeks after EMR follow-up,no serious complications such as delayed perforation or delayed bleeding occurred in either treatment group or control group.Conclusion:The efficacy of Jiawei Wuqisan combined with Esomeprazole in the treatment of artificial ulcer after EMR of gastric polyp can improve the clinical symptoms of patients and significantly reduce the area of artificial ulcer after EMR and improve the quality of healing.Animal experimentObj ection:To evaluate the protection and mechanism of panax notoginseng saponins to gastric mucosal injury induced by acetic acid.Methods:54 SD rats were divided into 6 groups(Con,Mod,Low,Middle,High and Positive Drug).After treatment in difference groups,observation the gastric mucosal,pathology by H&E staining and cell apoptosis by TUNEL assay,measuring the TNF-a,IL-1β and IL-10concentrations of difference groups in gastric tissues by Elisa assay and evaluating the TLR4,IKK and NF-κB proteins expressions by WB assay.Results:The observation found the panax notoginseng saponin improved gastric mucosal inj ury and pathology induced by acetic acid with dose-dependent;by TUNEL assay,the cell apoptosis rates were significantly suppressed in panax notoginseng saponin treated groups with dose-dependent(P<0.05 or P<0.001,respectively).Meanwhile,the TNF-a,IL-1βand IL-10 concentrations of panax notoginseng saponin treated groups were significantly improved compared with those of Model group with dose-dependent(P<0.05,respectively);By WB assay,the results found that TLR4,IKK and NF-κB proteins expressions of panax notoginseng saponin treated groups were significantly depressed compared with those of Model group with dose-dependent(P<0.05,respectively).Conclusion:Panax notoginseng saponin protected gastric mucosal injury induced by acetic acid via TLR4/NF-κB pathway by in vivo study.