健脾通络解毒方加减辨治慢性萎缩性胃炎癌前病变40例临床观察  

A Clinical Observation on Spleen-Supplementing Network Vessels-Freeing Toxin-Resolving Formula for 40 Patients with Precancerous Lesions of Chronic Atrophic Gastritis

作　　者：白宇宁[1] 王少丽[1] 姚乃礼[1] 柳平[2] 朱昱翎[1] 马继征[1] 彭艳[1] 

机构地区：[1]中国中医科学院广安门医院 [2]北京大学第一医院

出　　处：《中医杂志》2014年第4期301-304,共4页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目资助(81072804)

摘　　要：目的观察健脾通络解毒方加减治慢性萎缩性胃炎(CAG)胃癌前病变(PLGC)的临床疗效。方法收集40例PLGC患者,给予健脾通络解毒方加减辨证治疗,每日1剂,治疗6个月后评定临床疗效。观察患者治疗前后主要临床症状(胃脘疼痛、胃脘胀满、胃脘痞塞、烧心、反酸、嗳气、胃寒、纳差、嘈杂),胃镜下征象(黏膜苍白、血管透见、黏膜皱襞变薄、黏膜粗糙颗粒改变、肠化结节)及病理组织学(肠上皮化生、异型增生、腺体萎缩、慢性炎症、活动性)半定量积分情况。结果患者主要临床症状积分及总积分治疗前后比较,差异均有统计学意义(P<0.01);胃镜下胃窦小弯各病变征象积分及总积分治疗前后比较,差异均有统计学意义(P<0.05或P<0.01),胃角的黏膜苍白、血管透见、肠化结节积分及总积分治疗前后比较,差异均有统计学意义(P<0.05或P<0.01);病理组织学胃窦小弯各病变积分及总积分治疗前后比较,差异均有统计学意义(P<0.05或P<0.01),胃角的异型增生、慢性炎症、活动性积分及总积分治疗前后比较,差异均有统计学意义(P<0.05或P<0.01);40例患者中显效1例(2.5%),有效30例(75.0%),无效9例(22.5%),临床总有效31例(77.50%)。结论健脾通络解毒方加减辨证PLGC可明显改善临床症状、胃黏膜病变,临床疗效肯定。Objective To observe the therapeutic effect of Spleen-Supplementing Network Vessels-Freeing Toxin- Resolving Formula for precancerous lesions of chronic atrophic gastritis （CAG）. Methods Forty patients with precancerous lesions of CAG were selected and given modified Spleen-Supplementing Network Vessels-Freeing Toxin-Resolving Formula one dose daily. The therapeutic effect was evaluated after 6-month treatment. The common symptoms, endoscopic signs and histopathologic changes were observed before and after treatment. Results There were signifi- cant differences between before and after treatment in the scores of main clinical symptoms and total score （P 〈 0. 01 ）. There were significant differences between before and after treatment in the scores of signs in the lesser curvature and total score under gastroscope （P = 0. 035, P = 0. 003, P = 0. 046, P 〈 0. 001, P 〈 0. 001, P 〈 0. 001 ） There were significant differences between before and after treatment in the scores of pale mucous membranes, trans- parent vascular and intestinal metaplasia nodules in the gastric angle and total score （ P = 0. 010, P 〈 0. 001, P = 0. 002, P 〈 0. 001 ）. There were significant differences between before and after treatment in the scores of histopatho- logic lesions in the lesser curvature and total score （P =0. 001, P =0. 002, P =0. 030, P =0. 001, P =0. 001, P 〈 0. 001 ）. There were significant differences between before and after treatment in the scores of dysplasia, chronic in- flammation and activity in the gastric angle and total score （ P = 0. 014, P -- 0. 008, P 〈 0. 001, P = 0. 047 ）. There were 1 case （2.5%） markedly effective, 30 cases （75.0%） effective and 9 cases （22.5%） ineffective, with a total effective rate of 77.50% （31 cases）. Conclusion Spleen-Supplementing Network Vessels-Freeing Toxin-Resolving Formula has a certain effect in blocking the development of precancerous lesions of CAG.

关 键 词：健脾通络解毒方 慢性萎缩性胃炎 胃癌前病变 病理组织 

分 类 号：R259[医药卫生—中西医结合]