善胃系列方治疗胃癌前期病变的临床及基础研究  

Clinical and molecular mechanism of Shanwei formula series in treating gastric precancerous lesions

作　　者：袁红霞[1] 唐丽明[1] 赵强[2] 袁红梅 王洪俊[1] 王学 

机构地区：[1]天津中医学院保康医院消化内科,天津300193 [2]天津中医学院第一附属医院肝胆科,天津300192 [3]山东省邹平县中医院,山东邹平256200

出　　处：《中国中西医结合消化杂志》2006年第4期222-226,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：国家自然基金资助项目(30371708)

摘　　要：[目的]观察善胃系列方对胃癌前期病变的临床效果,探讨其逆转胃癌前期病变的分子机制。[方法]154例胃癌前期病变患者随机分为2组,治疗组106例,口服善胃系列方中药,根据辨证分型又分为3组:血瘀热毒型(善胃Ⅰ号方)组34例,阴虚有热型(善胃Ⅱ号方)组43例,气阴两虚型(善胃Ⅲ号方)组29例;对照组48例,口服猴头菌片。连续治疗6个月,观察2组患者临床症状改善、胃镜所见及胃黏膜病理组织学改善情况;采用免疫组化法检测治疗前后胃黏膜组织表皮生长因子(EGF)、表皮生长因子受体(EGFR)、转化生长因子α(TGF-α)的表达。[结果]治疗组总有效率为83.96%,显效率为45.28%;对照组分别为29.17%及6.25%,治疗组显著优于对照组(P<0.01)。胃癌前病变患者胃黏膜的EGF、EGFR、TGF-α的表达水平较高,善胃系列方均可降低其表达水平。[结论]善胃系列方对胃癌前期病变的临床效果明显优于猴头菌片,其作用可能与抑制胃癌前期病变时胃黏膜EGF、EGFR、TGF-α的过度表达有关。[Objective] To study the clinical effect of Shanwei formula series （SFS） and explore its underlying molecular mechanisms in the treatment of gastric precancerous lesions. [Methods] One hundred and fifty-four patients of gastric precancerous lesions were randomly divided into two groups：48 cases of control group （Houtougujun tablet was orally taken for 6 months） and 106 cases of SFS treatment group that was subdivided into 3 groups according to clinical characters：34 cases differentiated as blood-stagnation and heat-virulence syndrome（treated by Shanwei formula Ⅰ ）, 43 cases of yin asthenia generating intrinsic heat syndrome（treated by Shanwei formula Ⅱ ） and 29 cases of deficiency of both vital qi and yin syndrome（treated by Shanwei formula Ⅲ ）. All the patients were treated for 6 months. The improvements of clinical symptoms, examinations of gastroscope and pathological examination of gastric mucosa were observed. Moreover, immunohistochemical method was employed to detect the expression of epidermal growth factor （EGF）, epidermal growth factor receptor（EGFR） and transforming growth factor-alpha（TGFa）in gastric mucosa biopsy sample before and after the therapy course. [Results] （1）The total effective rate and the total improvement rate of SFS treatment group was 83.96% and 45. 28% respectively which were significantly higher than those of control group（29. 17% and 6. 25% respectively） （P〈0. 01）. （2）The expression of EGF, EGFR and TGFa in gastric mucosa biopsy sample of patients treated by SFS decreased significantly. [Conelusion]The clinical efficacy of SFS is obviously superior to that of control drug, and the effects may be due to inhibiting the expression of EGF, EGFR and TGFa in gastric mucosa and blocking the invasion of gastric precancerous lesions.

关 键 词：胃癌前期病变 善胃系列方 表皮生长因子 表皮生长因子受体 转化生长因子Α 

分 类 号：R735.2[医药卫生—肿瘤]