| Objective To evaluate the efficacy and safety of TCM Syndrome Differentiation and Treatment combined with powder in the treatment of CAG with erosion,and to explore the correlation between gastric mucosal changes and syndrome types.Methods 105 CAG patients with erosion were randomly divided into test group(n = 70)and control group(n = 35)according to the ratio of 2:1.According to the differentiation of symptoms and signs,the patients in the test group were treated with the corresponding Chinese medicine prescription combined with powder,while the control group were treated with Almagate Suspension orally.The course of treatment in both groups were 4 weeks.The symptom scores were recorded before treatment,2 weeks after treatment and 4 weeks after treatment,and gastroscopy and pathology scores were recorded before and 4 weeks after treatment.Safety tests were performed before and after 4 weeks of treatment in both groups(blood analysis,urine analysis,stool routine,liver function,renal function,ECG).The effects of symptoms,gastroscopy and pathology were compared between the two groups after the treatment.Thecorrelation between the changes of gastric mucosa and the type of syndrome in the experimental group was analyzed,and the safety of the treatment scheme was evaluated.Results 1.There were no significant differences in sex,age,symptoms,gastroscopy and pathological score between the two groups before treatment(P > 0.05).The data were comparable.2.Comparison and evaluation of the curative effect between the two groups:(1)Symptom effect: After 2 weeks of treatment,the symptom score of the two groups was lower than that of before treatment.And after4 weeks of treatment,the symptom scores of the two groups were lower than that of the 2 weeks after treatment(P < 0.05).After 2 weeks of treatment and 4 weeks of treatment,the scores of symptom in the experimental group were lower than those in the control group(P< 0.05),and the curative effect of the experimental group was better than that of the control group(P < 0.05).(2)Gastroscopy effect: The score of gastric mucosal erosion in the two groups decreased after 4 weeks treatment(P <0.05).However,there was no significant difference between the two groups after 4 weeks' treatment(P>0.05).(3)Pathological effect: After 4 weeks of treatment,the scores of gastric mucosal atrophy in the experimental group were significantly lower than those in the control group(P < 0.05).The gastric mucosal atrophy score in the experimental group was significantly lower than that before treatment(P < 0.05),while there was no significant difference in the control group(P > 0.05).The effect of gastric mucosal atrophy in experimental group was better than that in control group.After 4 weeks of treatment,thescores of gastric mucosal intestinal metaplasia in the experimental group were significantly lower than those in the control group(P< 0.05).The gastric mucosal intestinal metaplasia score in the experimental group was significantly lower than that before treatment(P < 0.05),while there was no significant difference in the control group(P > 0.05).The effect of gastric mucosal intestinal metaplasia in experimental group was better than that in control group.After the treatment,the scores of acute and chronic inflammation were also lower than those before treatment(P < 0.05).But there was no significant difference in the scores of acute and chronic inflammation between the two groups(P > 0.05).3.Correlation of gastric mucosal lesion and its changes after treatment with syndrome types: the proportion of gastric mucosal grade ? erosion in spleen-stomach deficiency syndrome(77.8%)was significantly higher than that of other syndrome types(P < 0.01).The percentage of ? grade erosion in spleen-stomach dampness-heat syndrome(75%)was significantly higher than that in other syndrome types(P < 0.01).The proportion of mild atrophy of gastric mucosa in spleen-stomach deficiency syndrome(88.9%)was significantly higher than that in other syndrome types(P < 0.01),and the proportion of severe atrophy in gastric collateral stasis syndrome(100%)was significantly higher than that in other syndrome types(P < 0.01).The proportion of mild intestinal metaplasia in spleen-stomach dampness-heat syndrome(91.7%)was significantly higher than that in other syndrome types(P < 0.01),and the proportion of severe intestinal metaplasia in stomach collateral stasis syndrome(80%)was significantly higher than that in other syndrome types(P < 0.05).After treatment,the degree ofimprovement of gastric mucosa erosion in spleen-stomach dampness-heat syndrome was the greatest(P< 0.05),the degree of improvement of gastric mucosal atrophy in spleen-stomach deficiency syndrome was the greatest(P < 0.05),and the degree of improvement of gastric mucosal intestinal metaplasia in stomach collateral stasis syndrome was the greatest(P < 0.05).4.Safety evaluation:During treatment,no adverse reaction caused by the drug was found in both groups,and the safety examination was normal at the end of the treatment.Conclusion TCM syndrome differentiation and treatment combined with powder has certain clinical efficacy and safety in patients of CAG with erosion.There is a certain correlation between gastric mucosal lesion and the change of syndrome type after treatment.It is worthy of clinical diagnosis and treatment of CAG with erosion. |
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