| Objective:RENZHUJIANWEI Granula(RZJWG) which can reinforcing qi, activating blood, and clearing heat has been used to treat chronic atrophic gastritis (CAG) precancerous lesions. This investigation is to further prove its clinical effect and explore the mechanism of RZJWG in interfering the process of GES-1 cell's canceration caused by MNNG.Review:This thesis has reviewed the concept of CAG precancerous lesions in traditional Chinese medicine in aetiology, pathology, treatment principal and treatment method. The modern research in molecular biology of CAG precancerous lesions, its relationship with H.pylori(Helicobacter Pylori) infection and treatment methods have also been reviewed.Clinical research:72 cases of CAG precancerous lesions were divided into two groups randomly. One group has been treated by RZJWG as the treatment group, and the other one has been treated by WEIFUCHUN Tablet(WFCT) as the control group. After 2 treatment courses, the clinical effect has been valued. Results showed that the total effective rate and curative rate of the treatment group were 90.5% and 52.4% respectively, which were significantly higher than that of the control group(63.3%,26.7%)(P<0.05). Endoscopic signs improved in both groups. The mucosal edema and erosions of the treatment group improved better than that of the control group (P<0.05). Pathologic performance in both groups have improved. The treatment group improved significantly on atrophy than the control group (P<0.05). The treatment group showed some advantage on the eradication of Hp infection (P<0.05).Experimental research:The experiments adopted MC cells gained from GES-1 cells transformed by N-methyl-N'-nitro-N-nitroso-guanidine (MNNG) as the model of precancerous lesions for study in vitro. Observe the inhibition effect and the influence of Fas, Bcl-2, CDK4 and P16 on MC cell of rabbit serum containing RZJWG. Results indicated that rabbit serum containing RZJWG could restrain MC cell's multiplication significantly. The apoptosis in the GES-1 cells transformed by MNNG has decreased, and the expression of Bcl-2 and CDK4 of its model group has increased. The expression of P16 has increased, and there was no significant decrease of the Fas expression in the model group. While RZJWG could promote apoptosis of MC cells and reduce the expression of Bcl-2 and CDK4, and raise the expression of Fas and P16.Conclusion:RZJWG could greatly relieve the clinical symptom of CAG patients, ameliorate the pathological changes of gastric mucosa, reduce the atrophy and inflammation, and restrain H.pylori infection. Its mechanism curing precancerous lesions of gastric cancer may lie in promoting apoptosis of precancerous cells, and control the cell cycle.
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