| Objective: To observe the therapeutic effect of Hua zhuo jie du fang decoction on Precancerous Lesion of gastric cancer(PLGC) patients with retention of turbid toxins syndrome, and to observe Huazhuojiedufang gastric precancerous lesions in experimental rats with intestinal metaplasia,dysplasia and cancer gene expression,of the trement of Huazhuojiedufang mechanism of gastric precancerous lesions, to provide experimental basis for clinical research.Method: 1.Clinical method: The case-control study was adopted. The selected cases according to"Randomized Number Scale"were randomly divided into two groups: 60 patients in treatment group were treated with Hua zhuo jie du fang decoction; 60 patients in control group were treated with Weifuchun. Both groups were treated for twelve weeks. Observe the change of Clinical symptoms, gastroscopy, pathology and Helicobacter pylori(Hp) before and after treatment. 2.Experimental method: Clean grade healthy male Wistar rats 5 weeks of age 60, were randomly divided into 2 groups: control group, 10 rats in the model 50. Daily free drinking 200μg/ml in the model of MNNG (plastic bottles tightly wrapped in black plastic bags away from light) solution, and fed by 0.03g/ml the ranitidine solution, each fed 1ml; After the modeling, the remaining modules will be made in accordance with 40 rats were randomly assigned into 5 groups, namely: the model group 8, the high dose group Hua zhuo Jie du fang 8, Hua zhuo jie du fang prescription dose group 8, Hua zhuo Jie du fang 8 low dose group, control group Weifuchun 8. Started treatment: model control group: saline 10ml/kg.d once a day 1; normal group: normal saline by 10ml/kg.d once a day 1; Weifuchun control group: gastric complex Spring suspension 0.06g/ml.d once a day 1. Hua zhuo jie du fang of high dose group: the liquid volume by 21.6g/kg orally, once daily; middle dose group: 10.8g/kg volume by gavage once daily; low dose group: volume irrigation by 5.4g/kg stomach once a day. Treatment for 6 weeks. Fasting after the last administration, the water 24 hours, weighed, and sacrificed after anesthesia. Specimens from gastric specimens were measured the following indicators: general view of gastric mucosa, gastric mucosa observed under light microscope immunohistochemical determination of the blank group, the rest of the group rate of positive expression of oncogenes. Measurement data ( X±s), said statistical analysis using statistical software SPSS 13.0 to P <0.05 indicated significant difference.Result: 1.Clinical result:(1)Comparison of clinical symptom therapeutic effect: In treatment group the total efficiency is 73.3%, In control group the total efficiency is 46.7%, which is significantly higher than that of control group(P<0.05). (2) Comparison of main symptom scores before and after treatment: After 12 weeks of treatment, improvement in symptoms, the treatment group than that before treatment the symptoms improved (P <0.05), the control group in the epigastric pain, belching Tunsuan symptom improvement than the treatment, (P<0.05 ), and the remaining symptom improvement was not obvious (P>0.05). Tip Hua zhuo jie du fang side epigastric pain, food intake, meal blocking nausea, belching Tunsuan, dry mouth, mouth pain, improvement of constipation symptoms were significantly better than the control group compared symptom score, with significant difference (P<0.05). (3) Comparative efficacy of endoscopy: endoscopic treatment group after treatment, 73% total efficiency, the efficiency of the control group 56.7% of the total endoscopy. The two groups, the treatment group than the control group, were significantly different (P <0.05). (4) Comparative efficacy of two endoscopic pathology, treatment group, 70% total efficiency, the healing rate of precancerous lesions of 61.7% in the control group was 53.3%, the healing rate of precancerous lesions by 48.3%. Two groups were significantly different (P<0.05), the treatment group than the control group. (5) Comparison of the effects of Hp: Hp-positive before treatment, 42 cases of Hp-positive after treatment in 15 cases, 64.3% clearance rate; Hp-positive control group, 38 patients before treatment, after treatment, 18 cases of Hp-positive, 52.6% clearance rate . The two groups, the treatment group than the control group, were significantly different(P<0.05).(6) Comparison of long-term effect: treatment group, the recurrence rate was 14.2%, 56.7% in control group, two groups was significant difference (P <0.05). (7) Security Assessment: two groups of patients before and after treatment of blood, urine, then routine, ECG, no significant changes in liver and kidney function, suggesting that two drugs had no obvious side effects. 2.Experiment result: (1) General conditions: the treatment groups of rats can be improved PLGC coat, mental status, appetite, activity and stool, but the high dose group Hua zhuo Jie du fang improved significantly. (2) eye view of gastric mucosa: normal gastric mucosa the naked eye see the regular, smooth, pink mucous membranes, mucosal folds structured; model group, rough mucosa, mucous membrane disorder folds, color gray, shallow part of the regional fold or disappear, but also visible point sheet bleeding, erosion and other changes; Chinese medicine treatment group and the group Weifuchun gastric mucosal lesions can be improved, but the high dose group Hua zhuo Jie du fang improved significantly, most of the gastric mucosa close to normal. (3) gastric mucosal light microscopy: normal rats, the thickness of normal gastric mucosa, epithelial integrity, epithelial cells and glands lined, rules, clear boundaries and duct epithelium, and no further proliferation of the phenomenon to the muscularis mucosa; Gastric mucosal atrophy model group was significantly thinner and less glandular disorder, sparse, showing epithelium - severe dysplasia and intestinal metaplasia, mucosal muscular layer thickening and inflammatory cell infiltration; Middle and high dose group showed moderate mucosal thickness, gland arranged in the rules, no obvious epithelial cells degeneration and necrosis, there is still a small amount of interstitial inflammatory cell infiltration. The treatment group compared with the model group, gastric intestinal metaplasia, dysplasia improved in varying degrees, in which traditional Chinese medicine, the high dose group improved the most obvious. (4) The treatment group and model group, Bcl-2, c-erbB-2, c-myc oncogene expression of three rates of comparison: positive expression of the three rates of cancer after treatment in each group had different degree of reduction. Huazhuo Jiedu high dose group, middle dose group compared with model group, the positive example of three oncogenes were significantly decreased compared, and there was significant difference (P <0.01). With the low dose group Huazhuo Jiedu Weifuchun group compared with the three lower cancer gene positive example, and there are differences (P <0.05). Huazhuo Jiedu low dose group compared with Weifuchun no significant difference (P>0.05). High dose group compared with no significant difference in the dose group (P>0.05).Conclusion: Clinical studies have shown that to effectively improve the Hua zhuo jie du fang Cloud precancerous lesions Syndrome drug intrinsic efficacy, suppression kill Hp, improve the healing rate of gastric precancerous lesions and can reduce the recurrence rate, and its effective than stomach re- Spring Group, in which can improve gastric mucosa of intestinal metaplasia, dysplasia and other state, Hua zhuo Jie du fang can also reduce the cancer gene protein expression, cell proliferation and apoptosis to restore the balance between the state of play in rats the treatment of gastric precancerous lesions.
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