| Objective: To observe the effect of Helicobacter Pylori(H.pylori) eradication and Hp-Killing Decoction on chronic pathological mucosal changes (including atrophic pathological changes such as intestinal metaplasia and atypical hyperplasia, etc.).Method: Patients with H. pylori positive were orally given Livzon Weisanlian(Bismuth agent 0.22g, b.i.d. + Tinidazole 0.5 g, b.i.d. + Clarithromycin 0.25 g. b.i.d ) for 7 days. The H. pylori and histological changes of gastric mucosa were detected on these patients 1 month after stopping their medicines. Then patients with H. pylori eradication were randomly divided into 3 groups (A, B and C); Patients without H. pylori eradication were treated continuously according to the " Treatment package" regime put forward at Maastricht 2-2000 Conference. Group A (19 cases ) was treated with Hp-Killing Decoction, 1 pouch, b.i.d.; group B (13 cases) served as positive control: Weifuchun 4 tablets, t.i.d.; group C ( 14 cases) served as a negative control: Gastropine 3- 5 tablets, b.i.d. After a 3-month treatment, gastroscopy and histopathological biopsy of antrum and corpus were performed in each patient in order to observe pathological changes of gastric mucosa; At the same time, the content of phospholipid on the mucosa of gastric antrum, the expression of epidermal growth factor ( EGF) and mucosal Epidermal growth factor receptor(EGFR) were also detected. Sydney classification standard of chronic gastritis was used for histological judgment, SP immunohistochemical stain was performed. Image J imaging analysis system was used to analyze the results.Results: H. pylori eradication rate of "Lizhu" Triple Antigastropathy Preparation was 83.5%, and after adopting the supplementary treatment regime, the whole eradication rate was 91.8%. After the eradication of H. pylori, the acute inflammation of gastric mucosa was reduced obviously, and Wilcoxon mean score was decreased. However, the preparation didn't have evident influence on chronic pathological changes of gastritis, and Wilcoxon mean scores didn't changed significantly. After a 3-month treatment with Hp-Killing Decoction and Weifuchun, the chronic pathological changes of gastric mucosa were improved evidently, the infiltration of lymphocyte was alleviated, and Wilcoxon mean score was reduced compared with that before treatment with statistical difference. It showed that Hp eradication can't increase the quanlity of phospholipid in the surface of the gastric mucosa evidently; However, after a 3-month treatment with different regimes, the quality of phospholipid of all patients increased obviously; the increasing degree in Group "Hp-Killing Decoction" and "Weifuchun" was much higher than that of "Gastropine". The detection of EGF and its receptor showed that compared with normal control group, patients with H. pylori positive had lower level of EGF and EGFR ; after H. pylori eradication, EGF and its receptor expression tended to increase gradually; after a 3-month treatment of drug intervention, the serumal level of EGF in group "Hp-Killing Decoction" and "Weifuchun" were decreased significantly; however, the group of "Hp-killing decoction" had evidently increased EGFR expression ,and the goup B hadn't. Although decreased quanlity of EGF and increased expression of EGFR were seen in group "Gastropine", there was no significant difference after a 3-month treatment compared with those before drug treatment. In our research, it showed that "Hp-Killing Decoction " has a certain therapeutic action on chronic atrophic pathological changes. After a 3-month treatment, the alleviation of pathological changes was seen 2 cases of mild atrophy, 1 case of severe atrophy, 1 case of moderate intestinal metaplasia, 2 cases of mild intestinal metaplasia and 1 case of moderate heterotype hyperplastic pathological changes. However, the alleviation of pathological changes was not seen in any case of the negative control group. Because the number of cases of atrophic gastritis in this study is too small , it is necessary to take... |
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