| Objective: Chronic atrophic gastritis (CAG) is a common disease ofdigestive system, characterized by atrophy of the glandular gastric mucosa.The chief symptom of Chronic Atrophic Gastritis is upper abdominal pain orupper abdominal stuffiness, belonging to the Traditional Chinese Medicinecategory of‘chest一abdominal fullness’，‘stomach一painful abdominalmass’or‘gastralgia’. In1978, the WHO formally recognized CAG as aprecancerous state of gastric cancer, and if it is accompanied by intestinalmetaplasia (IM) or atypical hyperplasia (ATP) it will be recognized as aprecancerous lesion of gastric cancer. Patients with CAG suffer from seriousphysical discomfort and mental stress because of its intractable symptoms andcertain rate of canceration. Currently there is no effective method in treatingthis disease by western medicine. On basis of Traditional Chinese Medicinetheory, Professor Li Tiangui considers the turbid toxin intrinsic and bloodstasis in collaterals as the main pathogenesis of this disease, and contrive HuaZhuo Jie Du Fang which has a satisfactory curative effect in treating CAG.The purpose of this study is to observe the influence of the Hua Zhuo Jie DuFang to the TCM syndrome, gastroscopic signs and pathology of CAG withthe syndrome of turbid toxin intrinsic.Methods: All the120cases are collected from Department ofGastroenterology, Traditional Chinese Medicine hospital attached to He BeiMedical University, during March2010to September2011, includinghospitalized and outpatients. All of the cases with the syndrome of turbid toxinintrinsic being selected with diagnostic criteria, inclusion criteria andexclusion criteria, were divided into two groups. Random single-blind methodhad been used.120numbers are selected continuously from random numbertable, each of them corresponding to a patient. The patients with odd number were put into the treatment group (Hua Zhuo Jie Du Fang group), the otherswere put into the control group (Wei Fu Chun group). With the statisticanalysis, the basic information between two groups P>0.05, do not havesignificant differences. They were comparable. The decoction of Hua Zhuo JieDu Fang were given to the treatment group. The decoction was made by theautomatic boiling machine in the preparation department of our hospital. Thedecoction was taken every morning and evening,150ml each, in fastingcondition. Wei Fu Chun Pills were given to the control group,3times per day,4pills per time. A course of treatment lasts12weeks, both of the two groupstreated for two coursed. All the patients didn’t use other drugs for treatingCAG during the course. Pathologic samples were taken before and aftertreatment through gatroscope. Comparing on the aspects of TCM syndromes,gastroscope images and pathologic changes between the two groups, theresults were analyzed by software. Safety evaluation was given by observingthe results of three routines, ECG and liver renal function.Results:1Changes of syndrome and physical signs before and after treatment: the curerate and effective rate of treatment group on “chest-stomach fullness”,eructation, extremities heaviness, and viscosity of stool are better than thecontrol group (P<0.05). The cure rate of two groups on stomach pain, drynessand bitterness of mouth do not have significant differences (P>0.05). But theeffective rate of treatment group is better than control group (P<0.05). Thecure rate of treatment group on stomach distension and tongue pictures isbetter than control group, but the effective rate between the two groups do nothave significant differences (P>0.05).2Comparison of efficacy to TCM syndromes: according to the TCMsyndrome efficacy standard, the above-remarkable effective rate of treatmentgroup is58.33%, the total effective rate is96.67%. The above-remarkableeffective rate of control group is23.33%, and the total effective rate is65%.The chi-square test shows that there are very significant differences ofabove-remarkable rate between the two groups (P<0.05) and there are significant differences of total curative rate between the two groups (P<0.05).(Table6)3The changes of syndrome index before and after treatment: The syndromeindex of the treatment group before is15.64±4.91, and the index aftertreatment is5.78±4.81. Comparing with that before treatment has significantdifference (P<0.05). The syndrome index of the control group before is16.78±4.17, and the index after treatment is9.86±3.23. Comparing with thatbefore treatment has significant difference (P<0.05). The comparison of indexbefore treatment between two groups do not have significant differences(P>0.05), and that after treatment between two groups have significantdifferences (P<0.05).(Table7)4The changes under gastroscope: According to the effect standard ofgastroscope, the above-remarkable effective rate of treatment group is80%,and the total effective rate is93.33%. The above-remarkable effective rate oftreatment group is56.67%, and the total effective rate is68.33%. Thechi-square test shows that there are significant differences of curative rate andabove-remarkable rate between the two groups (P<0.05) and there aresignificant differences of total curative rate between the two groups (P<0.05).(Table8)5The changes of pathologic test: According to the evaluation standard ofpathology, the above-remarkable effective rate to the atrophy of mucosalinherent glands of the treatment groups is78.33%, the total effective rate is93.33%. The above-remarkable effective rate to that of control groups is50%,and the total effective rate is85%. The chi-square test shows that there aresignificant differences of curative rate, remarkable effective rate and totaleffective rate between two groups (P<0.05).(Table9)The above-remarkable effective rate to the intestinal metaplasia of thetreatment groups is75.92%, the total effective rate is92.59%. Theabove-remarkable effective rate to that of control groups is23.08%, and thetotal effective rate is75%. The chi-square test shows that there are significantdifferences of curative rate, remarkable effective rate and total effective rate between two groups (P<0.05)(Table10)The above-remarkable effective rate to the dysplasia of the treatmentgroups is75.68%, the total effective rate is94.59%. The above-remarkableeffective rate to that of control groups is55.56%, and the total effective rate is75%. The chi-square test shows that there are significant differences ofcurative rate, remarkable effective rate and total effective rate between twogroups (P<0.05)(Table11).Conclusion: Hua Zhuo Jie Du Fang has a good effect to the CAG withthe TCM syndrome of the turbid toxin intrinsic, better than Wei Fu Chun Pian.Hua Zhuo Jie Du Fang also has a good effect of treating the precancerous stateof gastric cancer such as IM and ATP based on the CAG. Hua Zhuo Jie DuFang has the function of defusing turbid, detoxification, activating blood anddissolving stasis can accord with the pathogenesis of CAG well. And it hasgood efficacy to CAG. So Hua Zhuo Jie Du Fang is a effective decoction toCAG with the TCM syndrome of the turbid toxin intrinsic. |
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