胃粘膜肠化生患者脾胃平治疗的临床研究

经胃镜活检组织病理检查，明确诊断胃窦部慢性浅表性胃炎与慢性浅表萎缩性胃炎的肠化生患者１４３例，分为脾胃虚寒、肝胃不和、脾胃阴虚与脾虚气滞四型。治疗组７５例，按型给予脾胃平胶囊Ⅰ、Ⅱ、Ⅲ、Ⅳ号治疗；对照组６８例，四型均给三九胃泰治疗。经３～６个月治疗后，胃粘膜ｃＡＭＰ、ＤＮＡ与氚胸腺嘧啶核苷掺入淋巴细胞转化率的改善，治疗组显著优于对照组（Ｐ＜０．０５～０．００１）；症状疗效的治愈率、总有效率，病理疗效的肠化生治愈率、总有效率，治疗组为４９．３％、９２．０％、４５．３％和６２．７％；对照组为２９．４％、６７．６％，１０．３％和２９．４％，组间比较有显著性差异（Ｐ＜０．００１）。结果提示：脾胄平是通过改善胃粘膜ｃＡＭＰ、ＤＮＡ和细胞免疫功能的机制来逆转肠化生的，辨证施治疗效尤佳。

英文摘要:

One hundred and forty-three patients were diagnosed as chronic superficial atrophic gastritis of gastric antrum or with metaplasia by means of gastroscopic observation with pathological biopsy examination. They were divided into 4 types (the Spleen-Stomach Cold-Deficiency type, Disharmonious of Liver and Stomach type, Spleen-Stomach Yin Deficiency type and Spleen Deficiency with Qi-Stagnation type) and subdivided according to treatment into two groups, 75 patients of treatment group of above-mentioned 4 types were treated with Piweiping capsule(PWPC)Ⅰ,Ⅱ,Ⅲ, Ⅳ respectively, 68 patients of control group were all treated with Sanjiu Weitai(SJWT). After 3～6 months of treatment, the improvement of gastric mucosa cyclic adenosine monophosphate,deoxyribonucleic acid, 3H-thymopyrimidine nucleoside and lymphocyte transformation of treatment group were all superior to that of control group, P<0.05～0.001. The curative rate and total effective rate of symptomatic effect of treatment group were 49.3% and 92.0%, while at intestinal metaplasia of treatment group were 45.3% and 62.7%. As in control group, they were 29.4%,67.6%, 10. 3% and 29. 4% respectively. The difference between two groups was significant, P<0.001. These results suggested that the PWPC could reverse the intestinal metaplasia through improving the gastric cAMP, DNA and strengthening the cellular immunity and the effect would be enhanced when the treatment was based on syndrome differentiation.

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