摩罗丹治疗104例胃黏膜肠化生患者的疗效分析  

Efficacy of Moluodan in Patients With Gastric Intestinal Metaplasia:Analysis of 104 Cases

作　　者：朱晓静 李嵩博 刘洁 朱疆依 刘俊 时永全 ZHU Xiaojing;LI Songbo;LIU Jie;ZHU Jiangyi;LIU Jun;SHI Yongquan(Department of Gastroenterology,Xijing Hospital of Air Force Medical University,Xi’an 710032;Department of Air Service,Xijing Hospital of Air Force Medical University,Xi’an 710032)

机构地区：[1]空军军医大学西京医院消化内科,710032 [2]空军军医大学西京医院空勤科,710032

出　　处：《胃肠病学》2022年第12期717-722,共6页Chinese Journal of Gastroenterology

基　　金：国家自然科学基金面上项目(82170560)。

摘　　要：背景:胃黏膜萎缩和肠化生(IM)是胃癌的癌前状态。摩罗丹可用于慢性萎缩性胃炎(CAG)的治疗,但尚无基于病理分期评估摩罗丹疗效的研究。目的:基于慢性胃炎OLGA和OLGIM分期系统评估摩罗丹逆转胃黏膜萎缩和IM的疗效并分析其影响因素。方法:回顾性纳入2019年10月—2022年1月在空军军医大学西京医院就诊并接受摩罗丹治疗的104例CAG伴IM患者,摩罗丹浓缩丸用法为1袋/次、3次/d,疗程6个月。比较治疗前后OLGA和OLGIM分期变化,分析摩罗丹疗效相关影响因素。结果:经摩罗丹治疗6个月,胃黏膜萎缩和IM逆转率分别为47.1%(49/104)和51.0%(53/104),总有效率为65.4%(68/104);分别有49.3%(34/69)和52.4%(22/42)的患者OLGA、OLGIM分期从高分期(Ⅲ~Ⅳ期)逆转为低分期(0~Ⅱ期);OLGA、OLGIMⅢ~Ⅳ期患者的逆转率显著高于Ⅰ~Ⅱ期患者(P均<0.01)。相关性分析未发现患者的人口统计学资料、生活和饮食习惯、胃癌家族史、手术和疾病史、胃黏膜炎症程度与摩罗丹疗效之间存在相关性(P均>0.05)。结论:摩罗丹能有效逆转CAG患者的胃黏膜萎缩和IM,在胃癌预防方面有较好的临床应用前景。Background:Gastric mucosal atrophy and intestinal metaplasia(IM) are precancerous conditions of gastric cancer.Although Moluodan has been used in the treatment of chronic atrophic gastritis(CAG),there is little study on efficacy evaluation of Moluodan based on pathological stages.Aims:To assess the efficacy of Moluodan on reversal of gastric mucosal atrophy and IM based on OLGA and OLGIM staging systems,and to analyze the related factors.Methods:A total of 104 patients with CAG and IM from October 2019 to January 2022 at Xijing Hospital of Air Force Medical University were enrolled retrospectively in this study.All the patients received Moluodan treatment(one bag each time,three times daily) for 6 months.Changes of OLGA and OLGIM stages before and after treatment,and the related factors affecting the efficacy were analyzed.Results:After treatment with Moluodan for 6 months,the reversal rates for gastric mucosal atrophy and IM were 47.1%(49/104) and 51.0%(53/104),respectively,and the overall efficacy was 65.4%(68/104).There were 49.3%(34/69) and 52.4%(22/42) of patients with higher OLGA and OLGIM stages(Ⅲ-Ⅳ) reversed to lower stages(0-Ⅱ),respectively.In addition,patients with OLGA and OLGIM stage Ⅲ-Ⅳ showed a higher reversal rate than those with stage Ⅰ-Ⅱ(all P<0.01).No correlations were found between the demographic data,life and dietary styles,family history of gastric cancer,operation history,comorbidities,severity of mucosal inflammation and the efficacy of Moluodan(all P>0.05).Conclusions:Moluodan could reverse gastric mucosal atrophy and IM effectively in patients with CAG,which suggests that Moluodan has good potential in prevention of gastric cancer.

关 键 词：摩罗丹 慢性萎缩性胃炎 肠化生 胃肿瘤 

分 类 号：R573[医药卫生—消化系统]