Clinical Research Of Weihe ? Treatment Of CAG With IM Cold-heat Mixed Type

Objective To observe the clinical efficacy of Weihe III in the treatment of chronic atrophic gastritis(CAG)with intestinal metaplasia(IM)cold-heat mixed type,and to explore its possible mechanism through the detection of gastric mucosa related factors.Methods Seventy patients with CAG and IM cold-heat mixed type were randomly divided into observation group and control group,with 35 cases in each group.The observation group received oral Weihe III,3 times a day,6g each time(0.2g per capsule);the control group received oral Weifuchun tablets,3 times a day,4 tablets each time.The course of treatment was 6 months.According to the observations of the clinical symptoms,electronic gastroscopy and gastric mucosal pathological results of the two groups before and after the treatment,the treatment were used to determine the clinical efficacy.The immunohistochemical method was used to detect the caudal-type homeobox transcription factor 2 CDX2)in gastric mucosa,protein expression of protein kinase 3 RIP3),p53,and proliferating cell-associated nuclear antigen ki67 were explored the possible mechanism of action of Weihe III treatment of CAG with IM cold-heat mixed type.Results(1)After treatment,the two groups achieved good results.The total effective rate of the observation group was 86.67%,and the total effective rate of the control group was76.67% After statistical analysis,P<0.05,indicating the observation group.The clinical effect was better than that of the control group.(2)TCM symptom scores of the two groups were evaluated before and after the treatment.After statistical analysis,P<0.05,indicating that the overall improvement of symptoms in the observation group was better than that of the control group.After treatment,the symptoms of the two groups were improved by comparing with those before treatment.After treatment,the observation group and the control group were compared in the three symptoms of stomach fullness chilling worse and belch.Statistical analysis showed,P<0.05,the difference was statistically significant,indicating the clinical effect of the observation group was better than that of the control group.(3)the gastroscopy,histopathology and Hp infection were compared between the two groups before and aftertreatment.The performance of gastroscopy,pathological manifestation of gastric mucosa and Hp infection were improved in two groups before and after treatment.After treatment,the changes of gastroscope mucosa in the observation group were significantly higher than those in the control group P<0.05,indicating that the recovery of gastroscope mucosa in the observation group was better than that in the control group.After treatment,the changes of intestinal metaplasia between the observation group and the control group were compared with those of the control group P<0.05,which showed that the observation group and the control group were better than the control group in improving gastric mucosa intestinal metaplasia.There was significant difference in Hp infection between observation group and control group P<0.05 after treatment,indicating that the observation group was superior to the control group in eradicating Hp infection.(4)the expression of CDX2,RIP3,p53,ki67 protein in gastric mucosa of two groups was evaluated before and after treatment.The results were as follows: the expression of CDX2,RIP3,p53,ki67 protein in gastric mucosa of the two groups decreased after treatment compared with the control group P values are less than 0.05,It indicated that the observation group was superior to the control group in inhibiting intestinal metaplasia.Conclusions(1)Comparing with before treatment,the symptoms of TCM,gastroscope,histopathology and Hp infection has a better clinical effect in the two groups,and Weihe III treatment of CAG with IM cold-heat mixed type was better than Weifuchun.(2)The expression of CDX2,RIP3,p53 and ki67 in gastric mucosa of both groups was decreased comparing with that in before treatment.Its mechanism may be involved in the inhibition of IM promoter CDX2 transcription,RIP3 signaling pathway,and decreased IL-33 expression,thereby reducing SP expression,P53 activating NF-?B pathway,inhibiting binding to IM promoter CDX2,and eradicating Hp inhibits ki67-induced cell proliferation and apoptosis.(3)No adverse reactions were found in the course of this study,which indicated that Weihe III were safe and effective in the course of treatment and the prescribed dose.