活血散结法防治增生性胃息肉胃镜下电切术后复发与癌变的临床研究  

Clinical study on prevention and treatment of recurrence and canceration of hyperplastic gastric polyps by activating blood circulation and resolving masses after endoscopic electroresection

作　　者：王威[1] 方小美 Wang Wei;Fang Xiaomei(The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China;Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China)

机构地区：[1]天津中医药大学第一附属医院,天津300381 [2]天津中医药大学,天津300193

出　　处：《现代中西医结合杂志》2021年第3期269-272,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：天津市卫生和计划生育委员会中西医结合科研课题(2017112)。

摘　　要：目的观察活血散结法代表方健胃合剂防治增生性胃息肉胃镜下电切术后复发与癌变的临床疗效。方法将2017年10月—2018年12月天津中医药大学第一附属医院收治的92例增生性胃息肉患者随机分为治疗组和对照组,每组46例,2组患者均行胃镜下电凝切除术,术后治疗组给予健胃合剂口服3个月,对照组不进行任何药物干预。观察2组治疗2周后胃黏膜创面愈合情况,治疗3个月组织学病理评分及胃息肉病变部位Bcl-2表达情况,随访术后12个月胃息肉复发率。结果治疗组术后2周创面愈合评分明显低于对照组(P<0.05);术后3个月,治疗组慢性炎症、萎缩、肠化、异型增生病理评分及胃息肉病变部位Bcl-2阳性表达率均明显低于对照组(P均<0.05);术后12个月,治疗组复发率明显低于对照组(P<0.05)。结论活血散结法代表方健胃合剂可以促进增生性胃息肉胃镜下电切术后创面愈合,并可能通过减少Bcl-2的表达降低其癌前病变程度,且可降低复发率,对增生性息肉及其癌前病变防治具有积极意义。Objective It is to observe the clinical efficacy of therapy for activating blood circulation and resolving masses represented by Jianwei mixture in the prevention and treatment of recurrence and canceration of hyperplastic gastric polyps after endoscopic electroresection.Methods 92 patients with hyperplastic gastric polyps admitted to the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from October 2017 to December 2018 were randomly divided into treatment group and control group,with 46 cases in each gorup,both groups were treated with endoscopic electroresection,the treatment group was treated with Jianwei mixture by oral administration after operation for 3 months,the control group was treated with no drug intervention.The gastric mucosal wound healing after 2 weeks of treatment,the histopathological score and the expression of Bcl-2 in the gastric polyps after 3 months of treatment and recurrence rate of gastric polyps after 12 months of postoperative follon-up were observed in the two groups.Results The scores of wound healing in 2 weeks after operation in the treatment group was lower than that in the control group(P<0.05).The pathological scores of chronic inflammation,atrophy,intestinal metaplasia,dysplasia and the expression of Bcl-2 in the gastric polypectomy site in 3 months after operation in the treatment group were significantly lower than those in the control group(P<0.05).The recurrence rate of gastric polyps in 12 months after operation in the treatment group was lower than that in the control group(P<0.05).Conclusion Jianwei mixture can promote wound healing and reduce recurrence of hypertrophic gastric polyps after electrosurgical resection under gastroscope,and may reduce the degree of precancerous lesions by reducing the expression of Bcl-2,which has positive significance for the prevention and treatment of hypertrophic gastric polyps and precancerous lesions.

关 键 词：增生性息肉 活血散结法 健胃合剂 

分 类 号：R573[医药卫生—消化系统]