Clinical Observation On The Therapeutic Effect Of Jian Pi Tong Luo Tang Decoction On Chronic Atrophic Gastritis

Objective:The patients who in treatment in the gastroenterology department of the Guang’an men hospital have to do a questionare, which contains the distribution and the characteristic of the demography information, relevant pathogenesis, medical history, family history, TCM syndrome and so on. This research is a preliminary study of the Clinical observation on the therapeutic effect of Jian Pi Tong Luo tang decoction.To observe and objectively assess the clinical therapeutic of Jian Pi Tong Luo tang decoction on patients with CAG of deficiency of spleen and stomach (deficiency-cold); To study ideas of syndrome differentiation about Chronic atrophic gastritis (CAG) as well as the experience of clinical treatment; to provide some concrete ideas and reference bases for the traditional Chinese medicine treatment of CAG; to elucidate clinical evidence for TCM syndrome differentiation and treatment on CAG of stagnation of spleen and stomach (deficiency-cold) type.Method:65patients accord with the inclusion criteria exclusion criteria and deficiency of spleen and stomach (deficiency-cold) type from208cases who were diagnosed with CAG by pathological biopsy, were chosen to have a treatment with Jian Pi Tong Luo tang decoction for12weeks. Each of them should fill in the CRF questionnaire every2weeks from0to12. Check gastric mucosa by gastroscope and pathological biopsy before and after the treatment. Evaluate the60patients’ response including TCM syndrome, primary symptom, minor symptom and pathologic histology to the treatment through the self control test method.Results:The result of the preliminary study:demograph information shows that there are patients from21provinces, most of them come from Beijing, accounted for46.6%; the Han nationality accounted for98.07%; the solar terms in the turn of the spring/summer and autumn/winter are high, but in the turn of the winter/spring and summer/autumn are fall; women are more than men, the ration is1.93:1; the youngest one is25, the oldest one is83, the average is53.86±10.96years old; Patients who over50years old are the most in the age distribution accounted for72.1%; the shortest course of disease is1years, the longest is26years, the ones below5years accounted for94.71%; retired patients accounted for45.19%; Culture degree of high school in the majority (38.46%); normal BMI up to58.7%. under the investigation of the relevant pathogenesis, bad mood accounted for42.79%, sleep late accounted for36.06%, mental stress accounted ofr 21.15%, long time drugs accounted for20.67%, smoking accounted for20.19%, they are the top five factors that affect the life; eating too much, indisciplined eating, and enjoy peppery food are the main diet factors. Hp infeted person are the most in the medical history accounted for53.86%; the ones have no family history accounted for79.81%; atrophy ones accounted for75%, IM accounted for63.94%, Dys accounted for24.52%in the pathological type.45patients have5parts biopsy accounted for21.63%. In the TCM syndrome, the top five symptoms are hate cold drink (82.7%), enjoy warm and pressing (82.7%), gastric distention (80.3%), vexation (76.9%), gastric distention after eating (75.5%). Dim (80.8%) and thin (70.2%) tongue, greasy (73.1%) and white (54.3%) fur, stringy (62.5%) and joint (53.8%) vein are the majority. Composite TCM types accounted for72.60%, deficiency of spleen and stomach (deficiency-cold) are in majority, deficiency of stomach yin is in minority.Compare with0week, scores of pathologic histology, gastric mucosa atrophy, intestinal metaplasia and dysplasia are all have significant reductions in12week (P<0.001).Compare with0week, aggregate scores of TCM syndrome all have significant reductions in2,4,6,8,10,12week (P<0.001); compare with2week, aggregate scores of TCM syndrome have significant differences in6,8,10,12week (P<0.001); compare with4week, aggregate scores of TCM syndrome have significant differences in10,12week (P<0.001); compare with8week, aggregate scores of TCM syndrome has significant difference in12week (P<0.001); there have no significant differences between the rest of each two weeks in aggregate scores of TCM syndrome.The changes of the division mark in TCM syndrome:the patients with the mild and moderate division mark in TCM syndrome are in the majority before the treatment, especially the moderate ones.After the treatment, there have no moderate patients; patients without symptom and with the mild division mark in TCM syndrome are in the majority, especially the ones without symptom.Compare with0week, scores of primary symptom all have significant reductions in2,4,6,8,10,12week (P<0.0024); compare with2week, scores of primary symptom have significant differences in6,8,10,12week (P<0.0024); compare with4week, scores of primary symptom have significant differences in8,10,12week (P<0.0024); compare with6week, score of primary symptom has significant difference in12week (P<0.0024); compare with8week, score of primary symptom has significant difference in12week (P<0.0024); there have no significant differences between the rest of each two weeks in scores of primary symptom.Compare with0week, scores of minor symptom all have significant reductions in2,4,6,8,10,12week (P<0.0024); compare with2week, scores of minor symptom have significant differences in6,8,10,12week (P<0.0024); compare with4week, scores of minor symptom have significant differences in6,10,12week (P<0.0024); compare with8week, score of minor symptom has significant difference in10week (P<0.0024); there have no significant differences between the rest of each two weeks in scores of minor symptom.Therapeutic evaluation of pathologic histology:recovery25cases, accounted for41.67%; excellent19cases, accounted for31.67%; effective11cases, accounted for18.33%; invalid5cases, accounted for8.33%; the total effective rate is91.67%.Therapeutic evaluation of TCM syndrome:recovery10cases, accounted for16.67%; excellent18cases, accounted for30.00%; effective24cases, accounted for40.00%; invalid8cases, accounted for13.33%; the total effective rate is86.67%.Therapeutic evaluation of primary symptom:recovery18cases, accounted for30.00%; excellent13cases, accounted for21.67%; effective23cases, accounted for38.33%; invalid6cases, accounted for10.00%; the total effective rate is90.00%.Therapeutic evaluation of minor symptom:recovery15cases, accounted for25.00%; excellent18cases, accounted for30.00%; effective15cases, accounted for25.00%; invalid12cases, accounted for20.00%; the total effective rate is80.00%.Conclusions:Jian Pi Tong Luo tang decoction has a good clinical efficacy on treating CAG of deficiency of spleen and stomach (deficiency-cold) type, not only can treat the clinical symptoms, but also can improve the condition of the atrophy, intestinal metaplasia and dysplasia in the gastric mucosa. It has the function of reversing pathologic change and preventing precancerous lesions.