Clinical Research On The Effect Of Teprenone And Mucosal Protective Effect For HP-Negative Atrophic Gastritis

Objective: To observe the clinical effect of Teprenone and Mucosal protective effect for Hp-negative patients with atrophic gastritis.Methods: Selected 120 patients by gastroscopy and pathological examination in the diagnosis of atrophic gastritis,and 13 C urea breath test in the diagnosis of Hp-negative from 2016 January to 2016 December in Department of Gastroenterology,Navy General Hospital.The 120 patients were randomly divided into Teprenone group(teprenone capsules),Bismuth group(colloidal bismuth pectin capsules)and Placebo group(starch pills)(n=40).The above three groups were continuously treated for 12 weeks.Three groups of patients were given the endoscopic observation,pathological biopsy and detected the changes of gastric mucosal tissue and microcirculation factors before treatment(0 week)and at 12 weeks.And the symptom scores before and after treatment were collected.Compare the statistical significance of endoscopic gastric mucosal lesion severity score,gastric mucosal pathological score and symptom score before and after treatment with Teprenone group,Bismuth group and Placebo group respectively.Compare the statistical significance of gastric mucosa tissue factors(TFF1,Hexosamine)and microcirculation factors(Gastrin,PGE2)before and after treatment with Teprenone group,Bismuth group and Placebo group respectively.And compare the difference of the score after treatment among the three groups.Results: 1.Evaluated the efficacy of endoscopic treatment in the 12 th weeks,the total effective rate of Bismuth group,Teprenone group and Placebo group was 75%,85% and 10%,respectively;compared with Teprenone group,Bismuth group was no significant difference(?2=1.25,P > 0.05).Bismuth group and Teprenone group were better than in the placebo group(P<0.05).2.At the 12 th week,evaluated gastric mucosa pathological changes.The total effective rate of Bismuth group,Teprenone group and Placebo group was 87.5%,95.0%,7.5%,respectively;Bismuth group compared with Teprenone group was no significant statistical difference(?2=0.63,P > 0.05);either Bismuth group or Teprenone group was significantly better than the placebo group(P<0.05).3.Compared the Changes of gastric mucosal tissue factors(TFF1,Hexosamine)and microcirculation factors(Gastrin,PGE2)in the 12 weeks,Teprenone and Bismuth group compared with the placebo group were statistically significant difference(P<0.05),Bismuth group compared with Teprenone group was no significant statistical difference(P>0.05);With Teprenone group and Bismuth group after treatment than before treatment,there were statistically significant difference(P<0.05),the placebo group was no statistically significant difference(P>0.05).4.The symptom improvement was assessed at 12 weeks of treatment,the total effective rate with Teprenone group,Bismuth group and Placebo group was 80%,75% and 7.5%,respectively;There was no significant difference between Teprenone group and Bismuth group(P>0.05);Teprenone group and Bismuth group symptoms were better than the placebo group(P<0.05).5.3 cases of constipation and 2 cases of nausea happened in Bismuth group.There was 1 case of headache in Teprenone group.The incidence of adverse reaction with Teprenone group and Bismuth group were 2.5% and 12.5% respectively.Conclusion:(1)When gastric mucosa become atrophic.The secretion of trefoil factor 1(TFF1)is reduced in the atrophic part.On the contrary,when the gastric body is atrophic,the serum gastrin is increased.(2)After the patients with atrophic gastritis are treated,the content of TFF1 is increased significantly.That indicates that the atrophy is better.After treatment,the serum gastrin level is significantly increased,which may be related to the improvement of atrophy.(3)After three groups of patients are treated,the observation group of gastric mucosal hexosamine and serum PGE2 levels were significantly increased than those before treatment,the observation group was statistically significant compared with the control group.The gastric mucosal protective agent can significantly increase the hexosamine and PGE2 content,enhance the protective factors of gastric mucosa.(4)Teprenone combined with healthy diet education can significantly improve epigastric fullness,epigastric pain,belching,nausea,loss of appetite and other symptoms with the patients of Hp-negative atrophic gastritis,and can regulate tissue factor in the gastric mucosa and microcirculation factor to normal level,repair injured gastric mucosa.And It has a good therapeutic effect on Hp-negative atrophic gastritis,and has a low incidence of adverse reactions,so it can be widely used in clinical practice.