Clinical Research On The Mechanism Of Chronic Gastritis And Mucosal Recovery By Traditional Chinese Medicine

AIM: To research on the mechanism of traditional Chinese medicine(TCM)in the repair of gastric mucosa,the changes of epidermal growth factor(EGF),microvessel density(MVD)and relieving the clinical symptoms,erosion of patients with chronic gastritis with antral erosion without Helicobacter pylori(Hp)infection before and after the treatment from Puyuanhewei capsule(PYHW)preliminarily.METHOD: The 90 experimental subject diagnosed by gastroscope and pathology are divided into PYHW group(PYHW+placebo)30 cases,Teprenone group(PYHW+Teprenone)30 cases and Rabeprazole group(PYHW+Rabeprazole)30 cases from the randomised,double-blind,placebo-controlled,double-dummy trials.These subject in PYHW group are treated by PYHW and placebo like Rabeprazole or Teprenone.The patient’s condition of every group are recorded constantly.Specimens can be obtained in the erosion and erosion-adjacent normal mucosa by scaling biopsy before and after treatment in the three groups.Using immunohistochemical technology,the positive expression of EGF and MVD can be detected.RESULTS: The positive expression rate of EGF of erosion of gastric mucosa was 20.0%vs 56.7%,16.7% vs 46.7%,13.3% vs 43.3% before and after treatment from PYHW group,Teprenone group,Rabeprazole group respectively,with statistical significance(P<0.05).The positive expression rate of EGF of erosion-adjacent gastric mucosa was10.0% vs 26.7%,13.30% vs 16.7%,16.7% vs 23.3% before and after treatment from PYHW group,Teprenone group,Rabeprazole group respectively,no statistical significance.(P>0.05).MVD of erosion of gastric mucosa were increased obviously after treatment from PYHW group,Teprenone group,Rabeprazole group than before treatment,the difference had statistical significance(P<0.05).MVD of erosion adjacent gastric mucosa were upregulated at different degrees before and after treatment,no significant difference(P>0.05).MVD expression of erosion of gastric mucosa,erosion-adjacent gastric mucosa were compared among PYHW group,Teprenone group,Rabeprazole group,the difference was not statistically significant(P>0.05).Three groups in the therapeutic effect of abdominal pain,abdominal distention,acid regurgitation,heartburn,belching,nausea,loss of appetite without significant difference(P>0.05).The total effective rate of treatment of mucosal erosion for PYHW group was 70.0%,for Teprenone group was 80.0%,for Rabeprazole group was 76.7%,P=0.483,no statistical significance.CONCLUSION:1.Puyuanhewei capsule could promote the healing of erosive gastric mucosa,could restore the gastric mucosal barrier,and had the function of protecting and repairing the damaged gastric mucosa.2.Single-agent Puyuanhewei capsule could effectively alleviate the clinical symptoms of the patients,with no obvious difference combined with western medicine treatment.Single-agent Puyuanhewei capsule in the treatment of gastric mucosal erosion effect is good,and the economy,the side effect is small,can reduce the economic burden of patients.3.There was no significant difference in the expression of EGF and MVD in the treatment of gastric mucosal erosion with single-agent Puyuanhewei capsule compared with western medicine.The mechanism of Puyuanhewei capsule to repair the gastric mucosa may be related to EGF and MVD.