Clinical Efficacy Observation On Treating Chronic Gastritis And Precancerous Lesions With Syndrome Of Dampness Stagnation In Spleen And Stomach By Anwei Decoction-2 Combined With Argon Plasma Coagulation

Objective: The purpose of this study is to explore the clinical efficacy of Anwei Decoction-2 combined with argon plasma coagulation in the treatment of chronic gastritis and precancerous lesions with syndrome of dampness stagnation in spleen and stomach,so as to provide a new basis for clinical application of Anwei Decoction-2.Methods: A total of 70 patients whom were diagnosed chronic gastritis and precancerous lesion with dampness stagnation in spleen and stomach syndrome were selected from outpatients and inpatients by Department of Gastroenterology of Ruikang Hospital affiliated to guangxi university of chinese medicine during December 2017 to June 2019.Divided the 70 patients into the treatment group and the control group according to random number table method,with 35 cases in each group.After argonplasma coagulation treatment,the treatment group was treated with Anwei Decoction-2,and the control group was treated with Pantoprazole Sodium Enteric-Coated Capsules and L-Glutamine Granules for 12 weeks.Patients with Hp infection were treated with quadruple therapy for 2 weeks before APC.The curative effect of symptoms,gastroscopy,pathology,the overall clinical efficacy,the serum pepsinogen level,clearance rate of Hp,and safety were compared between two groups after treatment.The longterm effect of symptoms,gastroscopy,pathology were compared between two groups whom were cured,markedly effective and effective after 3 months.Results: 1.Basic data: A total of 63 patients were finally included in the statistical analysis.There was no significant difference in gender,age and course of disease between the two groups(P>0.05),which were comparable.And the scores and distribution of symptoms,gastroscopy and pathology,the serum pepsinogen level and Hp infectionin two groups were no significantly different before treatment(P>0.05),which were comparable.2.Curative effects of symptoms: after treatment,each symptom and total symptom scores of two groups were decreased before treatment(p<0.01),the decrease range in treatment group was better than control group(p<0.05).The total effective rate of symptoms in treatment group and control group was 90.6% and 61.3%,the curative effect of symptoms in treatment group was significantly better than that in the control group(p<0.01).3.Curative effects of gastroscope: the gastroscope scores of two groups were both significantly lower than before(p<0.01),the reduction range of treatment group was better than control group(p<0.05).The total effective rate of gastroscopy in treatment group and control group was 90.6% and 74.2%,the curative effect of gastroscopy in treatment group was better than control group(P<0.05).4.Curative effects of pathological: the pathological and total pathological scores in treatment group were significantly lower than before(p<0.01).In control group,the activity score was lower than before(p<0.05),the score of chronic inflammation,activity,atrophy,intestinal metaplasia and total pathological scores were decreased significantly than before(p<0.01).There was no significant difference in the reduction range of dysplasia between two groups(P<0.05).And the reduction range of chronic inflammation,activity,atrophy,intestinal metaplasia and total score in treatment group is greater than control group(P<0.05).There was no significant difference in curative effect of dysplasia between two groups(p>0.05),while the cure rate in treatment group was higher.The total pathological curative effect in treatment group was 87.5% which was better than 64.5% in control group(p<0.05).5.Overall clinical efficacy: in the treatment group,5 were cured,3 weremarkedly effective,20 were effective and 4 were ineffective,the total effective rate was 87.5%.In the control group,2 were cured,1 was markedly effective,16 were effective and 12 were ineffective,the total effective rate was 61.3%.The overall clinical effect of treatment group was better than control group(p<0.05).6.Serum pepsin levels: the levels of PGI,PGI/PGII in two groups were significantly higher than before(p<0.01),and the increase range of PGI,PGI/PGII levels in treatment group was better than control group(p<0.05).7.Hp clearance rate: after treatment,17 of 18 Hp positive patients were turned negative in treatment group,13 of 16 Hp positive patients were turned negativein in control group.The clearance rate in the treatment group was94.4% which is higher than 81.3% in control group.8.Safety comparison: the safety indexes of two groups before and after treatment were not abnormal,there were no obvious adverse reactions during treatment.9.Long-term effect:3 of 28 patients in the treatment group recurred,7 of 19 patients in the control group recurred,the recurrence rate of in the control group was 36.8% which is higher than 10.7% in the treatment group(p<0.05).Conclusion: Anwei Decoction-2 combined with argon plasma coagulation is effective in chronic gastritis and precancerous lesions with damp stagnation of spleen and stomach syndrome.It's obviously improve the clinical symptoms of patients,restore gastroscopy signs and pathological changes,affect the expression of pepsinogen level,improve the clearance rate of Hp,with high safety and long-term effect.Therefore,It's worthy of clinical application.