胃转安颗粒治疗胃癌前病变气虚血瘀型患者的临床观察  

Clinical observation of Weizhuan′an granules in treating gastric precancerous lesions of Qi deficiency and blood stasis type

作　　者：孟令凯 杨峻炜 杨阔[2] 刘华一[2] MENG Ling-kai;YANG Jun-wei;YANG Kuo;LIU Hua-yi(Tianjin University of Traditional Chinese Medicine,Tianjin 301617;Affiliated Hospital of Tianjin Institute of TCM,Tianjin 300120)

机构地区：[1]天津中医药大学,天津301617 [2]天津市中医药研究院附属医院,天津300120

出　　处：《世界中西医结合杂志》2020年第6期1122-1125,1129,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：天津市科委支撑计划项目(16YFZCSY01070)。

摘　　要：目的观察胃转安颗粒对胃癌(GC)癌前病变患者的治疗效果及对血清胃蛋白酶原(PG)及人胃癌MG7抗原(MG7-Ag)的影响。方法选取2018年10月—2019年10月确诊为GC癌前病变的患者105例,所有患者入组前进行14C呼气试验检测幽门螺杆菌(Hp)的感染情况,Hp阴性者直接入组,阳性者进行Hp根除治疗后入组,均给予胃转安颗粒连续治疗3个月。观察所有患者中医症状评分、胃镜下黏膜改变评分、病理组织学改变评分,检测血清胃蛋白酶原(PG)Ⅰ、Ⅱ及MG7-Ag水平,计算PGⅠ/PGⅡ比值(PGR)。结果所有患者治疗后中医症状改善总有效率为70.48%,胃镜情况改善总有效率为55.24%,病理组织学改善总有效率为64.76%。所有患者治疗6、12周后胃脘疼痛、胃脘痞满、嗳气反酸、嘈杂不舒、纳呆少食、证候总分均较治疗前降低(P<0.05),且治疗12周后各症状评分均较治疗6周后降低(P<0.05)。所有患者治疗3个月后胃镜总评分、病理萎缩程度评分、肠上皮化生评分、异型增生评分及病理总评分均较治疗前有明显改善,差异有统计学意义(P<0.05)。与治疗前相比,患者血清PGⅠ水平、PGR均升高(P<0.05),PGⅡ水平无明显改变(P>0.05),MG7-Ag水平显著降低(P<0.05)。结论胃转安颗粒治疗气虚血瘀型GC癌前病变疗效显著,值得进一步研究及临床推广。Objective To observe the therapeutic effect of Weizhuan′an granules on patients with precancerous lesions of gastric cancer(GC)and the effects on serum pepsinogen(PG)and human gastric cancer MG7 antigen(MG7-Ag).Methods A total of 105 patients diagnosed with GC precancerous lesions from October 2018 to October 2019 were selected.All patients underwent 14C breath test to detect Helicobacter pylori(Hp)infection,and those who were negative were directly enrolled.Those who were positive were enrolled after Hp eradication treatment,and all were given Weizhuan′an granules for 3 months.Observe the TCM symptom scores,gastroscopy mucosal change scores,and histopathological change scores of all patients,detect serum pepsinogen(PG)Ⅰ,Ⅱ,and human gastric cancer MG7 antigen(MG7-Ag)levels,calculate PGⅠ/PGⅡratio(PGR).Results The total effective rate of symptom improvement of traditional Chinese medicine after treatment was 70.48%,the total effective rate of gastroscopy improvement was 55.24%,and the total effective rate of pathological histology improvement was 64.76%.After 6 and 12 weeks of treatment,all patients suffered from epigastric pain,epigastric fullness,belching,acid reflux,noisy and uncomfortable,lack of food,and the total score of syndromes was lower than before treatment(P<0.05),and after 12 weeks of treatment.The symptom scores were lower than those after 6 weeks of treatment(P<0.05).All patients had a significant improvement in gastroscope total score,pathological atrophy degree score,intestinal metaplasia score,dysplasia score and total pathology score after treatment for 3 months.The difference was statistically significant(P<0.05).Compared with before treatment,the serum PGⅠlevel and PGR increased(P<0.05),PGⅡlevel did not change significantly(P>0.05),and MG7-Ag level decreased significantly(P<0.05).Conclusion Weizhuan′an granules are effective in treating GC precancerous lesions of qi deficiency and blood stasis type,which is worthy of further research and clinical promotion.

关 键 词：胃癌前病变 胃蛋白酶原 人胃癌MG7抗原 胃转安颗粒 

分 类 号：R735[医药卫生—肿瘤]