文献类型：期刊文献

中文题名：平胃胶囊治疗慢性萎缩性胃炎癌前病变45例临床研究

英文题名：Clinical Study on Pingwei Capsules for 45 Cases of Chronic Atrophic Gastritis with Precancerous Lesions of Gastric Cancer

作者：杨少军[1];汪龙德[1];张晶[2];王琦[2]

第一作者：杨少军

机构：[1]甘肃中医学院附属医院;[2]甘肃中医学院

第一机构：甘肃中医药大学第二附属医院

年份：2014

卷号：55

期号：20

起止页码：1745

中文期刊名：中医杂志

外文期刊名：Journal of Traditional Chinese Medicine

收录：CSTPCD;;北大核心:【北大核心2011】；CSCD:【CSCD2013_2014】；

基金：甘肃省自然科学基金资助项目(2011-1107RJZA161)

语种：中文

中文关键词：平胃胶囊;慢性萎缩性胃炎;癌前病变;肠上皮化生;异型增生;表皮生长因子

外文关键词：Pingwei Capsules; chronic atrophic gastritis; precancerous lesions; intestinal metaplasia; dysplasia; vascular endothelial growth factor; gut-specific transcription factor

摘要：目的观察平胃胶囊治疗慢性萎缩性胃炎癌前病变(PLGC)临床疗效及可能作用机理。方法将80例PLGC患者分为治疗组45例和对照组35例。治疗组给予平胃胶囊口服,每次4粒,每日3次。对照组给予维酶素片,每次4片,每日3次。两组均治疗6个月。观察治疗前后两组患者临床症状、临床疗效、胃镜及胃黏膜组织中表皮生长因子(EGF)、肠道特异性转录因子(CDX2)表达的变化。结果治疗组临床疗效总有效率为91.1%,对照组为77.1%,治疗组明显优于对照组(P<0.05)。两组患者治疗后症状积分均明显下降(P<0.05);治疗组治疗后症状积分明显低于对照组(P<0.05)。治疗组病理改善率为51.1%,对照组为31.4%,治疗组病理改善率明显优于对照组(P<0.05)。治疗后治疗组糜烂、黏膜白相、颗粒增生、血管透见、胆汁反流改善率明显优于对照组(P<0.05)。两组患者治疗后胃黏膜上皮细胞EGF阳性表达率较治疗前均明显降低(P<0.05);两组患者治疗后EGF阳性表达率比较,差异无统计学意义(P>0.05)。治疗组治疗后Ⅰ型肠化、Ⅱ型肠化、异型增生CDX2阳性表达率明显下降(P<0.01)。对照组治疗后Ⅰ型肠化、Ⅱ型肠化CDX2阳性表达率均明显下降(P<0.01)。治疗后治疗组Ⅰ型肠化、Ⅱ型肠化PLGC胃黏膜组织中CDX2阳性表达率明显低于对照组(P<0.05)。结论平胃胶囊能有效改善PLGC患者的临床症状和病理改变,改善胃黏膜血液循环,使黏膜再生加强并得到修复,同时抑制EGF和CDX2的表达,使癌前病变PLGC得以有效逆转。
Objective To observe the efficacy and mechanism of Pingwei Capsules for chronic atrophic gastritis with precancerous lesions of gastric cancer（ PLGC）. Methods Totally 100 cases of PLGC were randomized into the treatment group and control group,with 50 in each. There were 5 cases excluded and 45 cases remained in the treatment group. There were 15 cases excluded and 35 cases remained in the control group. The treatment group was given Pingwei Capsules（ 4 caps once and three times daily）. The control group was given Vitacoenzyme Tablets（ 4tablets once and three times daily）. The treatment lasted for 6 months. The symptoms,gastroscope results and the expressions of vascular endothelial growth factor（ VEGF） and CDX2 were observed before and after treatment in both groups. Results The total effective rate of the treatment group and control group was 91. 1% and 77. 1% respectively,with a significant difference between groups（ P〈0. 05）. After treatment,the symptom scores were significantly decreased in both groups（ P〈0. 05）,especially in the treatment group（ P〈0. 05）. The pathological improvement rate in the treatment group and control group was 51. 1% and 31. 4% respectively,with a significant difference between groups（ P〈0. 05）. After treatment,the improvement rates of erosion,mucosal Shiraai,particle hyperplasia,vascular permeability and bile reflux in the treatment group were superior to those in the control group（ P〈0. 05）.The expression of VEGF was significantly decreased after treatment in both groups（ P〈0. 05）. There was no significant difference between groups in the expression rate of VEGF（ P〈0. 05）. After treatment,the positive expression rate of CDX2 in type I intestinal metaplasia（ IM）,type Ⅱ IM and dysplasia was significantly decreased in the treatment group（ P〈0. 01）. After treatment,the positive expression rate of CDX2 in type I IM and type Ⅱ IM was significantly decreased in the control group（ P〈0. 01）. After treatment,the positive expression rate of CDX2 in type I IM and type Ⅱ IM in the treatment group was significantly lower than that in the control group（ P〈0. 05）.Conclusion Pingwei Capsules can effectively relieve the symptoms and pathological changes of PLGC patients,promote the expression of VEGF,improve gastric blood circulation,strengthen and repair the mucosal regeneration,inhibit the expression of CDX2 and reverse precancerous lesions.