| Objective To observe the clinical efficacy and safety of Chaihu Danshen Decoction in the treatment of chronic atrophic gastritis with stagnation of liver and stomach Qi,and to explore the basis of its prescription and possible mechanism of action,so as to provide ideas and methods for clinical diagnosis and treatment of chronic atrophic gastritis with stagnation of liver and stomach Qi.Method Seventy patients with chronic atrophic gastritis diagnosed by gastroscopy and pathology and syndrome differentiation of liver and stomach Qi stagnation were selected from The outpatient department of Wuhan Hospital of Integrated Traditional Chinese and Western Medicine from October 2020 to September 2021.They were randomly divided into treatment group and control group with 35 cases in each group by random number table method.The treatment group was given a 150 ml bupleurum salvia decoction decocted by the Pharmacy of Wuhan Hospital of Integrated Traditional Chinese and Western Medicine,one bag of 150 ml,one dose a day,three times a day,one bag each time,30 minutes after meals.The control group was given Qizhiweitong granule,1 bag 5g,1 bag once,3 times a day,30 minutes after meals with boiled water.Both groups were treated for 3 months as a course of treatment,during which drugs that might affect the results of this study were prohibited.At the end of a course of treatment,the improvement of TCM symptoms and the efficacy of TCM syndromes in the two groups were evaluated,and the gastroscopy and pathological changes were evaluated.Meanwhile,the safety analysis was conducted to compare the efficacy and safety differences between the two groups.Results 1.During the treatment process,there were 4 cases of shedding in two groups.After removing the shedding cases,33patients were included in the final treatment group and control group respectively.2.General data: There were no statistically significant differences in gender,age and disease course between the two groups（P>0.05）,indicating comparability.3.TCM symptom score:Respectively to compare the two groups before treatment every single TCM symptom score（gastric distension or distension pain,hypochondriac distension pain,symptoms induced or aggravated by emotional factors,belching frequency,chest distress and discomfort）and total score of TCM symptoms,comparison between groups had no statistical difference（P> 0.05）,comparable.Self-comparison between the two groups before and after treatment showed that both groups could improve single TCM symptom score and total TCM symptom score（P<0.01）.After treatment,compared with the control group,the treatment group had better efficacy in relieving gastric distension or distension pain,hypochondriac distension pain,symptoms induced or aggravated by emotional factors,and belching frequency as symptoms（P<0.05）,but there was no significant difference between the two groups in relieving chest distress and discomfort（P>0.05）.After treatment the curative effect of the treatment group in the total TCM score was better than that of the control group（P<0.01）.4.TCM syndrome efficacy: After treatment,the total effective rate of TCM syndromes in the two groups was 87.88% and 75.76%,respectively,the difference was statistically significant（P<0.05）,indicating that the TCM syndromes in the treatment group were better than those in the control group.5.Gastroscopic efficacy:Before treatment,there was no significant difference between the two groups in endoscopic grading（P>0.05）,indicating comparability.After treatment,the endoscopic efficacy of the two groups were 84.85% and 72.73%,respectively,with statistical significance（P<0.05）,indicating that the endoscopic efficacy of the treatment group was better than that of the control group.6.Pathological score and efficacy:Before treatment,there was no significant difference in pathological scores of atrophy,intestinal metaplasia and dysplasia between the two groups（P>0.05）,indicating comparability.There were statistically significant differences in atrophy pathology scores between the two groups before and after treatment（P<0.01）.After treatment,there was statistically significant difference in atrophy pathology score between the two groups（P<0.05）,indicating that both groups had significant effect on the improvement of atrophy pathology score,and the improvement of atrophy pathology score in the treatment group was better than that in the control group.There was no significant difference in the pathological score of intestinal metaplasia between the two groups before and after treatment（P>0.05）,indicating that the two groups had no significant effect on the improvement of the score of intestinal metaplasia.There was no significant difference in the pathological score of dysplasia between the two groups before and after treatment（P>0.05）,indicating that the two groups had no significant effect on the improvement of pathological score of dysplasia.The total effective rate of the treatment group and the control group was78.79% and 60.61%,respectively.The effect of improving atrophy in the treatment group was better than that in the control group（P<0.05）.The total effective rate of the treatment group and the control group was 22.22% and 15.00%,respectively,and there was no statistical difference in the efficacy of intestinal metaplasia between the two groups（P>0.05）.The sample size of the two groups was small,and the difference in efficacy was not compared.7.There were no obvious adverse reactions in both groups during and after treatment,and the safety test indexes before and after treatment were normal.Conclusion Chaihu Danshen Decoction can effectively improve the clinical symptoms,gastric mucosal lesions and atrophic pathological conditions of patients with chronic atrophic gastritis with stagnation of liver and stomach qi under gastroscopy,and its efficacy is superior to Qizhiweitong granule with good safety,but there is still no definite evidence of its efficacy on intestinal metaplasia and dysplasia. |
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