| BackgroundChronic atrophic gastritis is one of chronic digestive diseases with shrinking of gastric glands, reducing of the number of gastric mucosal, thickening of muscularis as the main pathological features, and often accompanied by intestinal metaplasia, and dysplasia. Western clinical examination could find upper abdominal pain, fullness, belching, loss of appetite or weight loss, anemia. TCM checks to epigastric fullness, pain, pay less noisy, or dry stools or dilute the main performance. The disease belongs to "fullness","stomachache" and other symptoms category, is the vacuity of the imaginary to stomach Qiyinliangxu based, standard real blood stasis, heat toxin.ObjectiveTo investigate the clinical efficacy of Weiyan I Hao on patients with chronic atrophic gastritis, and to study its therapeutic mechanism in animal models. Gastric pathology and expression of GSK-3β,β-catenin, cyclin Dl, COX-2protein were observed in rats. Our clinical trials and animal experiments could provide evidence for the use of Weiyan I Hao to treat chronic atrophic gastritis clinically.MethodsThe study included literature research, clinical and experimental studies.Chinese medicine is not include the disease name of chronic atrophic gastritis. We first collate literature from the disease and its evolution corresponds to the name of disease, and the ancient dynasties of ancient physicians and modern medicine home of the disease pathogenesis, classification and treatment of dialectical principles of the system are discussed. With the development of science and technology, modern medicine on the causes of the disease, aspects of pathogenesis and treatment techniques, such as the deepening of research, this paper also reviewed its progress.Clinical studies based on Western diagnostic criteria for the diagnosis of chronic atrophic gastritis, according to TCM syndrome diagnostic criteria for the diagnosis of spleen deficiency and blood stasis syndrome, and through the inclusion and exclusion criteria for screening, and ultimately establish60chronic atrophic gastritis patients for the study.60patients were randomly divided into Weiyan I Hao group, Weimeisu group.30cases were in Weiyan I Hao group with Weiyan I Hao therapy alone;30cases were in Weimeisu group with Weimeisu therapy alone. The clinical symptoms, TCM syndrome, endoscopic gastric mucosa pathological changes and circumstances of the histological changes were observed before and after treatment.50SD rats were used for experimental studies and divided to five groups: control group, model group, Weiyan I Hao A group, Weiyan I Hao B group and Weimeisu group, with10rats in each group. Except, the control group received normalsaline, the rest groups underwent intragastric MNNG and ranitidine hydroehloride capsules administration to made CAG models. High dose (8.26g·d-1) and low dose (4.13g·d-1) Weiyan I Hao were used in A group and B group respectively. Weimeisu (0.06g·d-1) was used in Weimeisu group. Rat were sacrificed after12weeks, and HE staining was performed to observe gastric mucosa processing, and immunohistochemical analysis was used to observe GSK-3β, β-catenin, cyclin D1and COX-2protein expression.ResultsThe change in endoscopy, pathology of chronic inflammation, the inherent glandular atrophy, intestinal metaplasia in Weiyan I Hao group was superior that Weimeisu groups. Weiyan I Hao can improve TCM and Western syndromes symptoms in chronic atrophic gastritis (P<0.01), better than Weimeisu. Animal experiment:The changes of chronic atrophic gastritis were observed in CAG groups but not in control group. After treatment with Weiyan I Hao A group, the changes were disappeared. However, there is no apparent effect with Weiyan I Hao B group and Weimeisu group. The expression of GSK-3β was downregulated in CAG groups, while β-catenin, cyclin Dland COX-2were upregulated. GSK-3β increaced in Weiyan I Hao A group, and minor increased in Weiyan I Hao B group and Weimeisu group.β-catenin, cyclin Dland COX-2decreased in Weiyan I Hao A group, and minor decreased in Weiyan I Hao B group and Weimeisu group.Conclusion Weiyan I Hao can improve TCM syndromeWeiyan I Hao can improve the clinical curative effectWeiyan I Hao can improve gastroscope expression of chronic atrophic gastritis patientsWeiyan I Hao can improve the pathological changes in chronic atrophic gastritis patients.Weiyan I Hao can improve the pathological changes in rat chronic atrophic gastritis models.The expression of GSK-3β was decreased in CAG groups, while β-catenin, cyclin Dland COX-2were increasedWeiyan I Hao can increase the expression of GSK-3β, while decrease β-catenin, cyclin Dland COX-2, and this may be the mechanism for its effects on chronic atrophic gastritis. |
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