加味四君子汤三联疗法对萎缩性胃炎及癌前病变PCNA表达的影响  

Effect of Jiawei Sijunzi decoction based triple therapy on atrophic gastritis and expression of PCNA

作　　者：宋福林[1] 林一帆[2] 李昊燃[2] 陆宇平[2] 杨卓[2] 高文艳[2] 巩阳[2] 刘阳[2] 陈山泉[2] 王长洪[2] 

机构地区：[1]沈阳军区总医院病理科,沈阳110015 [2]沈阳军区总医院中医科,沈阳110015

出　　处：《中华中医药杂志》2009年第3期367-369,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：辽宁省自然科学基金资助项目(No.20052070)

摘　　要：目的:观察加味四君子汤联合甲硝唑、叶酸三联疗法对萎缩性胃炎及癌前病变,中医辨证属脾虚血瘀证患者增殖细胞核抗原(PCNA)表达的影响及胃黏膜病理改变与临床疗效。方法:68例脾虚血瘀型胃脘痛,经胃镜检查,病理证实为萎缩性胃炎和(或)肠上皮化生及异型增生患者,随机分为三联治疗组(n=34),给予加味四君子汤100ml 2次/日,联合甲硝唑200 mg 2次/日、叶酸10 mg 3次/日,对照组(n=34)仅给予甲硝唑200mg 2次/日、叶酸10 mg3次/日。以上药物除甲硝唑服用1周外,其他服用至第24周。治疗前后观察临床症状、黏膜病理、PCNA表达。结果:三联治疗组治疗后PCNA表达较对照组减弱(P<0.01),三联治疗组临床症状缓解、病理改变逆转总有效率(79.4%)均优于对照组(39.4%)(P<0.05或P<0.01)。结论:加味四君子汤三联疗法能有效改善症状,一定程度逆转胃黏膜萎缩、肠化和异型增生,并对胃黏膜异常活跃的增殖状态有明显抑制作用,脾虚血瘀与萎缩性胃炎及癌前病变关系密切。Objective： To observe the effects of triple therapy （Jiawei Sijunzi decoction＋ Metronidazole ＋ folic acid） on symptom, mucosal changes, and PCNA expression in chronic atrophic gastritis（CAG） and gastric precancerous lesion（GPL） differentiated as syndrome of spleen deficiency and blood stasis. Method： Sixty-eight patients with stomach pain of spleen deficiency and blood stasis syndrome ,diagnosed as CAG and GPL by gastroscopy and pathological examination, were randomly divided into two groups. Treatment group （n=34） received Jiawei Sijunzi decoction 100ml,b.i.d, ＋ Metronidazole 200mg b.i.d. ＋ folic acid 10 mg t.i.d, and control group （n=34） received Metronidazole 200mg b.i.d. ＋ folic acid 10 mg t.i.d.. Metronidazole was given for one week, the others for 24 weeks. The symptoms of the patients, mucosal pathological changes and the expression of PCNA protein were observed before and after treatment. Result： The curative effects of symptom, mucosal pathological changes in treatment group were significantly improved compared with that in control group （ P〈 0.05,P〈0.01 ） . The expression of PCNA in treatment group was significantly lower compared with that in control group after the therapy （ P〈 0.01 ） . Conclusion： Spleen deficiency and blood stasis played an important role in pathogenesis of CAG and GPL, Jiawei Sijunzi decoction based triple therapy can decrease the expression of PCNA, improve the clinical symptom, and reverse the pathological changes to some extent.

关 键 词：萎缩性胃炎 癌前病变 加味四君子汤 PCNA 

分 类 号：R259[医药卫生—中西医结合]