羔羊胃提取物维B_(12)胶囊治疗490例胃黏膜肠化生患者的疗效分析  

Therapeutic effects of lamb's tripe extract and vitamin B_(12)capsule on 490 cases of gastric intestinal metaplasia

作　　者：朱晓静 聂燕 刘俊 张丽峰 时永全 ZHU Xiaojing;NIE Yan;LIU Jun;ZHANG Lifeng;SHI Yongquan(State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases,Department of Gastroenterology,the First Affiliated Hospital,Air Force Medical University,Xi'an,710032,China)

机构地区：[1]空军军医大学第一附属医院消化内科,国家消化系统疾病临床医学研究中心消化系肿瘤整合防治全国重点实验室,西安710032

出　　处：《中国中西医结合消化杂志》2024年第6期473-480,共8页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：国家自然科学基金项目(No:82170560)。

摘　　要：目的:评估羔羊胃提取物维B_(12)胶囊对胃黏膜肠化生患者的疗效并分析其影响因素。方法:回顾性纳入2016年8月—2023年3月在空军军医大学第一附属医院就诊并接受羔羊胃提取物维B_(12)胶囊治疗的490例慢性萎缩性胃炎伴肠化生患者。所有患者口服羔羊胃提取物维B_(12)胶囊,2粒/次,3次/d,疗程为6个月。比较治疗前后OLGA和OLGIM分期变化以评估疗效,采用多因素回归法分析影响疗效的因素。结果:治疗6个月后,胃黏膜萎缩和肠化生逆转率分别为35.1%(172/490)和39.2%(192/490),总逆转率为55.3%(271/490)。分别有54.0%(107/198)和59.1%(75/127)的患者OLGA和OLGIM分期从高分期(Ⅲ~Ⅳ期)逆转为低分期(0~Ⅱ期)。此外,OLGA、OLGIMⅢ~Ⅳ期患者的有效率高于0~Ⅱ期的患者(均P<0.05)。多因素分析结果显示,性别(男)与羔羊胃提取物维B_(12)胶囊治疗失败有关(OR=1.705,95%CI:1.112~2.616,P<0.05);OLGA高分期、OLGIM高分期和摄入水果(≥100 g/d)与治疗成功有关(OR=0.124,95%CI:0.080~0.193;OR=0.216,95%CI:0.140~0.334;OR=0.600,95%CI:0.367~0.981;均P<0.05)。结论:羔羊胃提取物维B_(12)胶囊可有效逆转胃黏膜萎缩和肠化生,在胃癌预防方面有较好的临床应用前景。Objective To assess the efficacy of lamb's tripe extract and vitamin B_(12)capsule(LTEVB_(12))on reversal of gastric intestinal metaplasia(IM)and to analyze the related factors.Methods A total of 490 patients with chronic atrophic gastritis and IM were retrospectively included in this study from August 2016 to March 2023 at the First Affiliated Hospital of Air Force Medical University.All patients were treated with LTEVB_(12)(two capsules TID)for six months.The efficacy was assessed by changes of OLGA and OLGIM stages before and after treatment.Multivariate analyses were performed to analyze related factors.Results After treatment with LTEVB_(12)for 6 months,the reversal rates for gastric mucosal atrophy and IM were 35.1%(172;490)and 39.2%(192;490),respectively,and the overall efficacy was 55.3%(271;490).There were 54.0%(107;198)and 59.1%(75;127)of patients with higher OLGA and OLGIM stages(Ⅲ-Ⅳ)reversed to lower stages(0-Ⅱ),respectively.In addition,patients with higher OLGA and OLGIM stages(Ⅲ-Ⅳ)showed a higher reversal rate than those with lower stages(0-Ⅱ,all P<0.05).The results of multivariate analysis showed that sex(male)was associated with treatment failure of LTEVB_(12)(OR=1.705,95%CI:1.112-2.616,P<0.05).Fruit intake(≥100 g;d),higher OLGA and OLGIM stages(Ⅲ-Ⅳ)were associated with treatment success of LTEVB_(12)(OR=0.600,95%CI:0.367-0.981;OR=0.124,95%CI:0.080-0.193;OR=0.216,95%CI:0.140-0.334,all P<0.05).Conclusion LTEVB_(12)could reverse gastric mucosal atrophy and IM effectively,which suggests that LTEVB_(12)has good potential in prevention of gastric cancer.

关 键 词：羔羊胃提取物维B_(12)胶囊 慢性萎缩性胃炎 肠化生 

分 类 号：R256.3[医药卫生—中医内科学]