| Objective: Chronic atrophic gastritis(CAG)with intestinal metaplasia(IM)is a common digestive system disease nowadays,its canceration rate is high,and it is lack of effective treatment.This study use Huazhuojiedu traditional chinese medicine and Moluodan to cure CAG with IM respectively,and compare the corresponding index changes before and after treatment in the two groups,in order to observe the effects of Huazhuojiedu traditional chinese medicine on the CAG with IM patients,and to explore the mechanism of action.Methods: According to the inclusion criteria,120 patients were randomly divided into treatment group and control group,there were 60 cases in each group.The patients in the two groups in gender,age,course of disease had no statistically significant(P >0.05),it is comparable.The treatment group was treated with Huazhuojiedu traditional chinese medicine,150ml/ bag,Bid;the control group was given Moluodan,8 pills,Tid,the course of treatment was 3 months.By comparing before and after treatment in patients with score of clinical symptoms,curative effect,gastroscopic signs and pathology,serum pepsinogen(PG)level,the ratio of serum pepsinogen I to pepsinogen II(PGR),the expression of gastric mucosa caudal type homeobox transcription factor 2(CDX2)and liver intestine cadherin(LI-CD),to evaluat the efficacy of Huazhuojiedu traditional chinese medicine and investigate its mechanism of action.Results:1 Score of clinical symptomsThere was no significant difference between the two groups in score of clinical symptoms and curative effect before treatment(P >0.05).There wassignificant difference between the treatment group before and after treatment in the gastrectasia,stomachache,belching and acid reflux,diet reduction,curative effect(P<0.01),nausea and vomiting score(P<0.05);Compared with before treatment,the control group after treatment in the gastrectasia,stomachache,diet reduction,curative effect(P<0.01),nausea and vomiting score(P <0.05),there was significant difference,in the belching and acid score had no significant difference(P >0.05).After treatment,in four aspects: gastrectasia,stomachache,belching and acid reflux,curative effect score,there was significant difference between two groups(P <0.01),in diet reduced integral there was significant difference(P <0.05),there was no significant difference in nausea and vomiting score(P >0.05).2 Curative effectAfter treatment,in the treatment group 17 cases were cured,24 cases markedly effective,19 cases effective,0 cases were invalid,in the control group 6 cases were cured,13 cases markedly effective,34 cases effective,7cases invalid.Compare the curative effect between two groups statistically,there was significant difference(P <0.01).3 Gastroscoptic signs,Inflammation degree,Atrophy degree of gastric mucosa,Intestinal metaplasia degreeTwo groups before treatment,gastroscoptic signs,inflammation degree,atrophy degree of gastric mucosa,intestinal metaplasia degree showed no significant difference(P >0.05).Comparison of two groups before and after treatment individually,gastroscoptic and inflammation,glandular atrophy,intestinal epithelial metaplasia grading classification had significant difference(P <0.01).After treatment,two groups of gastroscoptic signs,Inflammation degree,atrophy degree of gastric mucosa,intestinal metaplasia degree had significant difference(P <0.05).4 Clinical efficacyAfter treatment,in the treatment group 5 cases were cured,10 cases markedly effective,38 cases effective,7 cases were invalid,effective rate was88.33%,in the control group 1 cases were cured,6 cases markedly effective,in 37 cases effective,16 cases were invalid,effective rate was 73.33%,the treatment group better than the control group(P <0.05).5 PG levelBefore treatment,there was no significant difference in the levels of PG I,PG II,and PGR between the two groups(P >0.05).After treatment,the treatment group compared with before treatment,the level of PG I had significant difference(P <0.01),there was no significant difference between the levels of PG II(P >0.05),there was significant difference in PGR(P<0.05);the control group compared with before treatment,the level of PG I had significant difference(P <0.05),no significant different in level of PG II and PGR(P >0.05).After treatment,there was significant difference between the two groups in PGI and PGII(P <0.05),and there was no significant difference in PGR(P >0.05).6 Expression of CDX2 in gastric mucosaBefore treatment,the expression of CDX2 in gastric mucosa in the two groups had no significantly different(P >0.05).After treatment,compared with before treatment,the expression of CDX2 in gastric mucosa was significantly different between the two groups respectively(P <0.01).After treatment,the expression of CDX2 in gastric mucosa of the two groups was significantly different(P <0.05).7 Expression of LI-CD in gastric mucosaBefore treatment,there was no significant difference in the expression of LI-CD in gastric mucosa between the two groups(P >0.05).Compared with before treatment,the expression of LI-CD in gastric mucosa in the two groups after treatment was significantiy different respectively(P <0.01).After treatment,the expression of LI-CD in gastric mucosa was significantly different between the two groups(P <0.01).8 There was no adverse reaction in the two groups.Conclusions:1 The treatment of CAG and IM was effective in the treatment group and control group,the treatment group was better than the control group.2 Huazhuojiedu decoction can significantly reduce the symptoms of patients,improve the gastroscopic signs and pathological image.Its mechanism may be related to the increase of PG level in gastric mucosa and the expression of CDX2 and LI-CD in gastric mucosa.3 The treatment of Huazhuojiedu decoction to CAG with IM has obvious effect and less adverse reactions,which is worthy of further study and application. |
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