胃康宁治疗幽门螺杆菌相关性胃癌前病变临床疗效及对胃黏膜Ki-67蛋白表达的影响  

Effect the treatment of Weikangning decoction to HP with gastric precancerous lesions and its influence on Ki-67 protein expression

作　　者：刘涛[1] 张霞[2] 刘登科[1] 张旖晴[1] 苏晓兰[1] 杨洋[1] 魏玮[1] 

机构地区：[1]中国中医科学院望京医院脾胃病科,北京100102 [2]大同大学医学院中医系,山西大同037000

出　　处：《中国临床医生杂志》2017年第6期21-24,共4页Chinese Journal For Clinicians

基　　金：国家中医药管理局行业专项(201507001);北京市科委G20工程支撑保障项目(Z161100001816016)

摘　　要：目的观察胃康宁治疗幽门螺杆菌(HP)相关性脾虚寒热瘀毒型胃癌前病变(PLGC)患者的临床疗效和调节胃黏膜Ki-67蛋白的机制。方法将118例PLGC患者随机分为治疗组和对照组各56例。治疗组口服胃康宁组方,对照组口服胃复春片,疗程均为12周,观察临床疗效,HP根除率,胃黏膜病理组织学改变,比较中医证候积分和胃黏膜Ki-67蛋白变化情况。结果治疗组、对照组临床总有效率分别为89.83%和59.32%,两组比较差异有显著性;两组治疗前后肠化积分差异均有显著性(P<0.05),治疗组治疗前后异型增生积分差异有显著性(P<0.05),两组治疗后比较,肠化和异型增生积分差异均有显著性(P<0.05);两组内治疗前后比较,胃痛、痞满、嘈杂、乏力、纳呆和总积分差异均有显著性(P<0.05),两组治疗后比较,胃痛、痞满、乏力、纳呆和总积分差异均有显著性(P<0.05);治疗组HP根除率为88.2%,对照组根除率为74.6%,两组比较差异有显著性(P<0.05);治疗组治疗前后胃黏膜Ki-67蛋白比较差异有显著性(P<0.05),两组治疗后比较差异亦有显著性(P<0.05)。结论胃康宁可显著改善患者临床症状,抑杀幽门螺杆菌,逆转胃黏膜不完全肠上皮化生和异型增生,临床疗效确切;降低胃黏膜Ki-67蛋白表达可能为机制之一。Objective To Observe the clinical efficacy of wei-kang-ning to treat helicobacter pylori （HP） correlation with Precancerous lesions of gastriccancer（ PLGC ）which pattern is spleen deficiency and cold-heat stagnation, and explore the regulation mechanism of gastric mucosa of Ki-67 protein. Method 118 cases with（ CAG）of spleen defi- ciency and cold-heat stagnation pattern accompanied with PLGC were randomized into treatment group and control group, each group of 56 cases. Therapeutic group was treated using wei-kang-ning,and the control group oral Wei- Fu-Chun tablets ,with the course of 12 weeks. The clinical curative effect, HP eradicate rate, pathological and histo- logical changes of gastric mucosa ,and TCM syndrome integral changes and gastric mucosa Ki - 67 protein changes were evaluated. Result The treatment group and control group in clinical total effective rate was 89. 83% and 59.32% respectively ,Clinical curative effect comparison between groups was statistically significant difference; In the two groups before and after treatment of intestinal metaplasia integral difference had statistical significance （P〈 0.05 ） , The treatment group before and after treatment of hyperplasia of integral difference was statistically signifi- cant（ P 〈 0.05 ） , Comparing the two groups after treatment, intestinal metaplasia and hyperplasia of integral differ- ence had statistical significance（ P〈0.05 ） ;In the two groups before and after treatment, stomach pain, stomach full bilge feeling, noisy, fatigue,loss of appetite and total integral difference had statistical significance（ P〈0.05 ） , Com- pared the two groups after treatment, stomach pain, stomach full bilge feeling, noisy, fatigue ,loss of appetite and total integral difference had statistical significance（ P〈0.05 ） ;Treatment group HP eradicate rate was 88.2% ,the control group in the eradication rate was 74.6% ,two groups compare the difference was statistically significant（P〈0.05 ） ; Treatment group before and a

关 键 词：胃康宁 辛开苦降法 胃癌前病变 临床疗效 机制研究 

分 类 号：R256[医药卫生—中医内科学]