| Objective: To explore the long-term effect of Piwei Peiyuan prescription on chronic atrophic gastritis(CAG)with spleen and stomach weakness,and to provide a new guidance for the prevention and treatment of chronic atrophic gastritis with traditional Chinese medicine.Methods: Included patients with CAG of spleen and stomach weakness who were treated in the Second Affiliated Hospital of Anhui University of Chinese Medicine from June 2014 to December 2020 and participated in the clinical efficacy observation of Piwei Peiyuan Decoction,and were cured of pathological changes after treatment and stopped taking medicine for more than 1 year.By retrospective analysis,the enrolled patients were followed up by telephone and outpatient,and the general and clinical data of the patients as well as the changes of clinical symptoms and pathological degree at the end of treatment and follow-up were recorded,so as to evaluate the long-term efficacy of piwei Peiyuan Decoction in the treatment of CAG with spleen and stomach weakness,and explore the related factors affecting the prognosis of patients.Results:(1)A total of 96 patients were included in this study,including 51 males and45 females,with an average age of 59.74±7.54 years.Among them,the age distribution of 61-70 years old is the most,accounting for 46.88% of the total number.There were33 patients with a family history of gastrointestinal tumors,accounting for 34.38% of the total number.A total of 41 patients had a history of HP infection before treatment,accounting for 42.71% of the total number.Three patients were reinfected with HP after treatment,and the re-infection rate was 7.32%.According to the investigation of patients’ lifestyle,40 patients had irregular diet before treatment,36 patients had a history of smoking,and 37 patients had a history of drinking.(2)Compared to the post-treatment period,the TCM symptom score(main symptom scores and secondary symptom scores,etc.)of the enrolled patients were slightly increased at the follow-up,and the difference was not statistically significant(P >0.05).The score of gastroscopy(mucosal color,vascular permeability,mucosal eminence,mucosal texture,etc.)did not change significantly,and the difference was not statistically significant(P>0.05).The pathological score(degree of atrophy,degree of intestinal metaplasia,chronic inflammatory reaction,activity,etc.)was slightly increased,and the difference was not statistically significant(P>0.05).There were no significant changes in serological indicators(PGI,PGII,G-17),and TFF2 and NF-κB levels in gastric mucosa(P>0.05).(3)Among the 96 patients in this study,45 patients showed varying degrees of aggravation of symptoms,and with the increase of drug withdrawal time,the overall symptom recurrence rate showed an increasing trend.Further statistical analysis showed that among the 45 patients with symptoms of different degrees of aggravation,32 patients had obvious predisposing factors for symptom aggravation.The main predisposing factors were diet irregularity in male patients and mood disturbance in female patients.In addition,the 28 patients showed different degrees of aggravation of microscopic and pathological manifestations respectively,and the pathological recurrence rate showed an increasing trend with the increase of drug withdrawal time.Further statistical analysis showed that poor diet,drinking and smoking were the main influencing factors of pathological recurrence or aggravation in 28 patients.Conclusion: Piwei Peiyuan Decoction has good long-term efficacy in the treatment of CAG with spleen and stomach weakness,which can effectively improve the clinical symptoms and pathological degree of gastric mucosa,thus improve the quality of life.Improper diet and poor mood are the main factors to promote disease recurrence,and the guidance of post-disease adjustment should be strengthened. |
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