| Objective: To observe the effect of moluodan combined with Panax notoginseng powder on patients with spleen deficiency blood stasis type chronic atrophic gastritis accompanied by intestinal metap lasia by comparison with folic acid tablets,and to compare the clinical efficacy and safety of the two,so as to provide a new idea and clinical basis for the treatment of this disease in traditional Chinese medicine.Methods: Selected patients with splenic deficiency blood stasis type chronic atrophic gastritis with intestinal metaplasia who visited the outpatient clinic and ward of Wuhan hospital of integrated traditional Chinese and Western medicine from August2020 to July 2021.A total of 66 patients were divided into an observation group and a control group with 33 patients in each group using random number table method.Patients in the observation group were orally treated with moluodan combined with Panax notoginseng powder,and patients in the control group were orally treated with folic acid tablets,and the courses were all 24 weeks.Both patients underwent gastroscopy and pathological examination before and after treatment to observe the integral of TCM symptoms before and after treatment in both groups,and to refine the safety examination（the three major routine tests,liver and kidney function,electrocardiogram）before and at week 12 and after treatment,and to record the medication taking,adverse effects and adverse events during treatment in both groups.After completion of treatment,improvement of TCM symptoms,gastroscopic manifestations and histopathology were compared between the two groups,using spss25 The data before and after treatment of the two groups were statistically analyzed by 0 software to evaluate the clinical efficacy and drug safety of the two treatment regimens.Results: 1 General condition comparison: there were no significant differences in gender,age or disease duration between the two groups before treatment（P>0.05）,and the study results were comparable between the two groups.2.Comparison of the scores of the main symptoms of the two groups of patients before and after treatment: compared with before treatment,the scores of epigastric fullness,epigastric pain,eructation,and eating paucimentin were decreased in the observation group,and the differences were statistically significant（P<0.05）;There was a significant（P<0.05）reduction in eructation and eating less Namin scores after treatment in the control group compared to before treatment.After treatment,compared with the control group,the scores of epigastric fullness,epigastric pain,and eating oligophrenia were lower in the observation group,and the differences were statistically significant（P<0.05）.3.Comparison of the total score of TCM symptoms before and after treatment between the two groups: the total score of TCM symptoms decreased after treatment in both groups compared with that before treatment,and the difference was statistically significant（P<0.05）.The decrease in the total score of TCM symptoms in the observation group after treatment was better than that in the control group,and the difference was statistically significant（P<0.05）.4.TCM symptom efficacy analysis: after 24 weeks of treatment,32 patients in the observation group,2 recovered,5 showed efficacy,22 effective and 3 ineffective,with an overall response rate of90.63%;In the control group,32 patients had no recovery,2 showed efficacy,19 were responders and 11 were non responders,giving an overall response rate of 65.63%.The efficacy of TCM symptoms in the observation group was significantly higher than that in the control group（P<0.05）.5.Comparison of the scores of all aspects of the gastroscope before and after treatment between the two groups: the mucosal color score,vascular permeability score,and mucosal texture score were decreased in the observation group compared with those before treatment,with significant differences（P<0.05）;There was a statistically significant（P<0.05）reduction in mucosal color score in the control group when compared to the pre-treatment group.After treatment,the color and color score of the mucosa decreased more obviously in the observation group compared with the control group（P<0.05）.6.Comparison of the total gastroscope scores before and after treatment between the two groups: the total gastroscope scores decreased after treatment in both groups compared with those before treatment,and the difference was statistically significant（P<0.05）.The decrease in the total gastroscope score of the observation group after treatment was better than that of the control group,and the difference was statistically significant（P<0.05）.7.Comparison of the scores of all aspects of histopathology between the two groups of patients before and after treatment: the atrophy score,intestinal metaplasia score,active inflammation score,chronic inflammation score were reduced in the observation group compared with before treatment,with significant differences（P<0.05）;The atrophy score and intestinal metaplasia score of the control group were decreased compared with those of the patients before treatment（P < 0.05）.After treatment,the active inflammatory score,chronic inflammatory score of the observation group decreased more significantly compared with the control group（P<0.05）.8.Comparison of the total score of pathohistology between the two groups of patients before and after treatment: the total score of pathohistology in both groups decreased significantly after treatment compared with that before treatment（P<0.05）.Compared with the control group,the decrease in the total score of pathology in the observation group was more significant after treatment,and the difference was statistically significant（P<0.05）.9.Safety comparison: the results of safety examination in two groups of patients during the medication process and after the completion of the treatment showed no obvious abnormalities,no patients in two groups showed adverse reactions and adverse events related to the study drug during the medication process,and the clinical safety of the drugs in two groups was good.Conclusion: The combination of moradan with Panax Notoginseng Powder and folic acid tablets showed good clinical efficacy in patients with atrophic gastritis of spleen deficiency blood stasis type with intestinal metaplasia,and the drug safety profiles of both groups were good,but the combination of moradan with Panax Notoginseng Powder showed better improvement than folic acid in the total points of TCM symptoms,the total points of gastroscopic manifestations,and the total points of pathological histology in patients,and the combination of moradan with Panax Notoginseng Powder showed much higher efficacy than folic acid alone,And morodan combined with Panax Notoginseng Powder has some advantages in improving epigastric pain,epigastric flatulence symptoms,and acute and chronic inflammation of gastric mucosa. |
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