A Retrospective Study On The Long-term Curative Effect Of Guben Tongluo Decoction In The Treatment Of Chronic Atrophic Gastritis With Spleen And Stomach Weakness

Research objective:Explore the long-term efficacy of the tutor experience prescription Guben Tongluo Decoction in the treatment of chronic atrophic gastritis with spleen and stomach weakness syndrome.Research methods:Chose patients with chronic atrophic gastritis and spleen and stomach weakness syndrome,who had been cured by pathology and stopped medication for more than 12 months.All the recruited patients had participated in the previous clinical study on the efficacy of Guben Tongluo Decoction from March 2011 to Octorber 2017.Through telephone and outpatient follow-up,researcher could record the basic data,collect the current symptoms,and obtain the gastroscope report and pathological results.On this basis,the long-term efficacy of Guben Tongluo Decoction was evaluated by comparing the changes of symptoms and pathology between post-treatment and follow-up duration,and related factors that affect prognosis was explored.Research results:(1)General information:According to the Inclusion and exclusion criteria,93 patients were enrolled,including 50 males and 43 females,with a male to female ratio of 1.16:1.The average age of the patients was 50.15±9.64 years old,and the ages were mainly distributed between 51-60 years old,followed by 41-50 years old and 61-70 years old.The average duration of treatment for patients was 14.35±9.52 months,and the average duration of drug withdrawal was 33.67±16.75 months.There were 37 patients with family history of chronic atrophic gastritis or gastrointestinal malignant tumors,accounting for 39.78%of the total number.The Hp infection rate of patients before treatment was 65.59%,and all were successfully eradicated.The reinfection rate of Hp at the time of follow-up was 4.92%.The proportions of unhealthy lifestyle before treatment from high to low were eating fast,irritating food,drinking,smoking,irregular diet,staying up late,overeating,and skipping breakfast,and the proportions at follow-up decreased.(2)Observation of the long-term effect of symptoms:Compared with the end of the treatment,there was no significant change in the main symptom scores of patients who stopped medication for 12-23 months and 24-35 months(P>0.05).The main symptom scores of patients who stopped medication for 36-47 months and>48 months increased(P<0.05).There was no significant change in the scores of secondary symptoms of patients with different duration of withdrawal(P>0.05).There was no significant change in the total symptom scores among patients with drug withdrawal for 12-23 months,24-35 month and 36-47 months(P>0.05),and the total symptom score increased in patients who stopped medication for>48 months(P<0.05).Most patients were asymptomatic after treatment and during follow-up,and some patients had mild symptoms and few had moderate symptoms.There was no significant difference in the distribution of symptom level after treatment and during follow-up(P>0.05).The main symptoms include fullness,hidden pain,and preference for warmth and pressure.The relieved accounted for 7.53%,2.15%and 2.15%respectively,the stable ones accounted for 77.42%,81.72%and 88.17%respectively,and the aggravators accounted for 15.05%,16,13%and 9.68%respectively.Secondary symptoms include loose stools,stuffy stomach after eating,poor appetite,fatigue,shortness of breath,and lack of desire to speak.The relieved accounted for 5.38%,8.60%,0.00%,10.75%,4.30%and 1.08%respectively,the stable ones accounted for 82.80%,82.80%,96.77%,81.72%,92.47%and 97.85%respectively,and the aggravators accounted for 11.83%,8.60%,3.23%,7.53%,3.23%and 1.08%respectively.No patient had symptom of vomiting clear water.The incentives for aggravating symptoms were distributed from high to low in order of improper diet,poor mood,cold,drinking,fatigue and staying up late.(3)Observation of long-term curative effect of pathology:Among the 93 patients,80.65%of patients had no recurrence in atrophy,82.80%of patients had no recurrence in intestinal metaplasia,76.34%of patients had no change in the overall pathology.And pathological recurrence was dominated by mild pathological changes.The recurrence rate of atrophy,intestinal metastasis and overall pathology showed an upward trend with the increase of the duration of withdrawal.Compared with patients who stopped medication for 12-23 months,the recurrence rate of intestinal metastasis and overall pathology were significantly increased in patients who stopped medication for≥48 months(P<0.05).Gender,age,duration of treatment,and family history had no significant effect on recurrence of atrophy,intestinal metastasis,and overall pathology(P>0.05).The recurrence rate of atrophy,intestinal metastasis and overall pathology were higher in those with unhealthy lifestyles than in those without unhealthy lifestyles,and the difference of recurrence rate was statistically significant in atrophy(P<0.05),but not in intestinal metastasis and overall pathology(P>0.05).Among the various unhealthy lifestyles,the top three factors affecting the recurrence of atrophy were drinking,eating fast and irritating food,the top three factors affecting the recurrence of intestinal metastasis were irregular diet,irritating food and overeating,and the top three factors affecting the recurrence of overall pathology were irritating food,drinking and eating fast.Research conclusions:(1)Guben Tongluo Decoction has a good long-term effect in the treatment of chronic atrophic gastritis with spleen and stomach weakness syndrome.(2)Improper diet,poor mood and cold are the main incentives for aggravating symptoms.Unhealthy lifestyles especially drinking,eating fast,and irritating food,will promote pathological recurrence.So the guidance should be strengthened on the health conditioning of patients after recovery.(3)The main symptoms show aggravating trend after 36 months of drug withdrawal,and consolidation treatment should be performed in time Symptoms and pathologies are likely to aggravate after 48 months of drug withdrawal,which should be followed closely.Patients should review the gastroscopy and pathology,and find possible lesions in time to prevent the recurrence and aggravation of the disease.