柴胡疏肝散加味治疗肝胃气滞证慢性萎缩性胃炎癌前病变的临床观察

目的:观察柴胡疏肝散加味对肝胃气滞证慢性萎缩性胃炎癌前病变的临床疗效及胃黏膜病理组织学的影响。方法:选取黑龙江中医药大学附属第一医院2017年12月至2019年4月的73例肝胃气滞证慢性萎缩性胃炎癌前病变患者随机分为两组,有4例患者脱落,最终纳入治疗组34例,对照组35例。对照组予胃复春片口服,治疗组予中药柴胡疏肝散加味治疗,两组均治疗6个月,在治疗前后,分别观察并记录两组患者临床疗效、中医证候积分及胃黏膜萎缩、肠上皮化生(IM)和异型增生(Dys)变化。结果:治疗组临床总有效率显著优于对照组(P<0.05);两组患者治疗后中医症状积分均较治疗前显著改善(P<0.05),其中治疗组主要症状积分显著优于对照组(P<0.05);两组患者胃黏膜萎缩、IM、Dys均显著改善(P<0.05),治疗组显著优于对照组(P<0.05)。结论:柴胡疏肝散加味能有效改善慢性萎缩性胃炎癌前病变患者的临床症状,且对于延缓和逆转胃黏膜萎缩、IM、Dys有着一定的疗效。

Clinical observation of Modified Chaihu Shugan Powder on the treatment of precancerous lesions of chronic atrophic gastritis in liver and stomach qi stagnation syndrome

Objective:To observe the clinical effect of Modified Chaihu Shugan Powder on precancerous lesions of chronic atrophic gastritis in liver and stomach qi stagnation syndrome and the effect of gastric mucosa histopathological grade.Methods:A total of 73 patients in First Afliliated Hospital,Heilongjiang University of Chinese Medicine from December 2017 to April 2019 were randomly divided into two groups.Four cases were off and finally 34 patients in the treatment group and 35 patients in the control group were included.The control group was given weifulun tablets orally,while the treatment group was given the Modified Chaihu Shugan Powder.Both groups were treated for 6 months.Before and after treatment,the clinical efficacy,TCM syndrome score,gastric mucosa atrophy,IM and Dys changes in the two groups were observed and recorded.Results:The total clinical response rate in the treatment group was superior to that in the control group(P<0.05).After treatment,TCM syndrome scores in both groups were significantly improved(P<0.05),and the main syndrome scores in the treatment group were significantly better than those in the control group(P<0.05).The gastric mucosa atrophy,IM and Dys were improved in both groups(P<0.05),and the improvement was significant in the treatment group(P<0.05).Conclusion:Modified Chaihu Shugan Powder can effectively improve the clinical symptoms of patients with precancerous lesions of chronic atrophic gastritis,and has a certain effect on delaying and reversing the atrophy of gastric mucosa,IM and Dys.