The Study Of The Method Of Tonifying Qi, Clearing Away The Stomach-heat, Protecting Blood Circulating And Removing Blood Stasis On Clinical Efficacy Of Verrucous Gastritis, And The Influence On HIF-1α, VEGF, INOS, COX-2

Objectives:1) To observe the clinical efficacy of the method of Tonifying qi, Clearing away stomach-heat and Blood-Activating on verrucosa gastritis.2) To observe the effect of the method of Tonifying qi, Clearing away stomach-heat and Blood-Activating on the morphology of the verrucosa gastritis under the Gastric mucosal endoscopy.3) To observe the effect of the method of Tonifying qi, Clearing away stomach-heat and Blood-Activating on the factor expression of HIF-la, VEGF, iNOS and COX-2, which is existed in the gastric mucosa organization.4) To observe the possible mechanism of the method of Tonifying qi, Clearing away stomach and Blood-Activating on verrucosa gastritis.Methods:1) 38 patients were randomly divided into two groups:the therapy group:(18 cases) and the control group (20 cases).2) Control group:Rabeprazole (Jinuo) lOmg,2 times a day. Therapy group:The medicine were the same as the control group, In addition, treated with self-made prescription (Tonifying qi,Clearing away stomach and Blood-Activating prescription:Astragalus mongholicus 10g, Codonopsis pilosula 10g, Fried atractylodes 10g, Ophiopogon rootlOg, Dry radix rehmanniae 10g, The root of red-rooted salvia 10g, Curcuma aramatica 10g, Agrimony 10g, Coix Seed 15g, Herba Hedyotis 10g, Scutellaria baicalensis 10g, Prepared Radix Glycyrrhizae 5g, Spina Gleditsiae10g, fructus akebiae 10g). Take a course of treatment (two months) and stop taking all the drugs that may affect the test during the treatment.3) Questionnaire of Nexium scale was used to evaluate the symptom before and after treatment.4) Questionnaire of Nexium scale was used to evaluate the symptom under the Gastric mucosal endoscopy before and after treatment.5) Before and after treatment, take 2 pieces of tissue on the largest gastric mucosal erosion by the Gastric mucosal endoscopy and fixe in Formaldehyde Solution. Then observe the expression of HIF-1, VEGF, iNOS, COX-2 and other factors by immunohistochemistry.Results:Comprehensive efficacy syndromes:The total syndrome scores before and after treatment of the treatment group was(14.73±4.05)> (7.33±2.90), while the control group was (14.65±4.77)、 (9.55±2.28). The total score of two groups before treatment were not statistically different (P>0.05) and were comparable. After treatment, the score of any TCM symptom and the total scores of two groups dropped obviously(P<0.05). Meanwhile, the scores of stomachache, distension, anorexia, lassitude and Gastroscopy score of the therapy group are all lower than which of the control group while the symptom scores of eructation and sour regurgitation had no statistical difference (P<0.05). But the score of belching, acid reflux and pathology were not statistically different (P>0.05) and were comparable.Obviously, the treatment group can improve symptoms better,but there is no differency within other sides between the two groups. Endoscopic score:two groups had no significant difference between the endoscopic score (P>0.05) before treatment, after treatment, the treatment group the number of endoscopic verrucous lesions decreased compared with the control group (1.17±0.79) (1.45±0.76). Total effective rate:The treatment group(83.3%) was higher than the control group(60%) (P<0.05) Immunohistochemistry:Before treatment, There was no significant difference between the two groups of the two groups’ total score of the expression of HIF-1, VEGF, iNOS and COX-2. (P>0.05). After treatment, the two groups’score of the expression of HIF-1, VEGF, iNOS and COX-2 were both reduced. The score of the treatment group lower than the control group’s. There were significant differences between the two groups (P<0.05). The results showed that the effect of the treatment group was more effective than that of the control group.Conclusion:It can be more effective in relieving the gastritis patients’ symptoms by using the method of Tonifying qi, Clearing away stomach-heat and Blood-Activating with the existing western medicine therapy. The possible action mechanism is that the therapy inhibite the inflammation of gastric mucosal and the expression of HIF-1, VEGF, iNOS and COX-2. Thus it can reduce the production of verrucous lesions.