Study on Treatment Principles for Chronic Atrophic Gastritis

Based on records in medical literature and clinical practice, the author have studied the treatment principles on chronic atrophic gastritis as reported in the following.     

A Long-Term Follow-up Study of Chronic Gastritis with Fibergastroscope

ＡＬｏｎｇＴｅｒｍＦｏｌｏｗｕｐＳｔｕｄｙｏｆＣｈｒｏｎｉｃＧａｓｔｒｉｔｉｓｗｉｔｈＦｉｂｅｒｇａｓｔｒｏｓｃｏｐｅＨｕａＺｈｅｎｑｉｎｇ（花珍庆）ＮａｎｊｉｎｇＣｉｔｙＧｏｖｅｒｎｍｅｎｔＨｏｓｐｉｔａｌ，Ｎａｎｊｉｎｇ２１０００８Ａｂｓｔｒ...     

Prof.Shan Zhaowei's Experience in Treating Chronic Atrophic Gastritis

Having been engaged in clinical practice for 40 years,Prof. Shan Zhaowei of Jiangsu Provincial Hospital ofTraditional Chinese Medicine is good at treatingchronic atrophic gastritis (CAG). In clinical practice,he often pays great attention to the combination ofTCM syndrome-differentiation with disease-differentiation as well as the combination ofmacroscopic differentiation with microscopic     

One Hundred and Six Cases of Chronic Gastritis Treated byAcupuncture

In recent years, the authors have treated 106 cases of chronic gastritis with acupuncture, and achieved satisfactory therapeutic results. A report follows.     

Comparison be ween Effects of Ulcerlmin and Gentamycin on Chronic Gastritis

Sichuan Medicine 1989; 10(2):78. This paper reports the effects and theircomparison of treatment for 76 cases of chronicgastritis with ulcerlmin and gentamycin forthree months, respectively. No significant dif-ference was found in the effective rate betweenthe two drugs (P>0.05). In the treatment of66 cases of active chronic gastritis, gentamycin     

Clinical Research on Acupuncture and Moxibustion Treatment of Chronic Atrophic Gastritis

Objective: To observe the clinical therapeutic effects of acupuncture and moxibustion in treating chronic atrophic gastritis. Methods: Patients who met the criteria were randomly divided into the treatment groups consisting of the acupuncture group (30 cases) and the acupuncture-moxibustion group (30 cases), and the control group (28 cases). After two months of treatment, observed were safety and the curative effects, through general physical check ups, routine examinations of blood, urine and feces, and symptoms, pathology and gastrin before, during and after the treatment. Results: 1) The treatment groups showed significant superiorities in the improvement of symptoms, with the acupuncture-moxibustion group showing the best therapeutic effects. 2) The acupuncture-moxibustion group showed marked differences before and after the treatment in the improvement of glandular atrophy and intestinal metaplasia, with a total effective rate of 66.67%. 3) After the treatment, the three groups all showed marked improvement in the level of serum gastrin, with the acupuncture-moxibustion group showing the best effects. Conclusion: Acupuncture and moxibustion have definite therapeutic effects for chronic atrophic gastritis, especially in improving the symptoms. Acupuncture or acupuncture combined with moxibustion can provide possibilities in reversing the pathologic changes of glandular atrophy and intestinal metaplasia for patients with chronic atrophic gastritis. Acupuncture-moxibustion is really an effective and safe therapy for chronic atrophic gastritis.     

Dr. Zhu Hongming‘s Experience in Treating Chronic Gastritis

Dr. Zhu Hongming has engaged in TCM internal medicine for more than 40 years and accumulated rich clinical experience, especially in the treatment of diseases of the spleen and stomach. The following is a brief introduction to his experience in TCM differential treatment of chronic gastritis.     

Prof. Shan Zhaowei＇s Experience in Treating Chronic Atrophic Gastritis

Having been engaged in clinical practice for 40 years, Prof. Shan Zhaowei of Jiangsu Provincial Hospital of Traditional Chinese Medicine is good at treating chronic atrophic gastritis (CAG). In clinical practice, he often pays great attention to the combination of TCMsyndrome-differentiation with diseasedifferentiation as well as the combination of macroscopic differentiation with microscopic differentiation.     

Acupuncture Treatment of Chronic Superficial Gastritis by the Eight Methods of Intelligent Turtle

With the clinical manifestations and the point electric conduction volume as the indexes, the authorsobserved the immediate effects of the acupuncture treatment on chronic superficial gastritis with the pointsselected according to the date and time set by Ling Gui Ba Fa (灵龟八法 Eight Methods of IntelligentTurtle), which was compared with the effects in the control group treated with the points selectedaccording to syndrome-differentiation. A higher symptom improvement rate (P<0.01) and a higherchannel's balance-inverting rate were noticed in the former (P<0.01), indicating that Ling Gui Ba Fa cangive a better therapeutic results.     

Protective Action of Acupuncture and Moxibustion on Gastric Mucosa in Model Rats with Chronic Atrophic Gastritis

To probe the mechanism of acupuncture and moxibustion in atrophic gastritis so as to provide a basis for clinical treatment. Method: Observe the effects of acupuncture and moxibustion at the points of Zusanli, Zhongwan and Tianshu on gastric mucosa in model rats with chronic atrophic gastritis. Results:Acupuncture and moxibustion can increase the contents of PGE2α, PGF2α and cAMP, and decrease the content of cGMP in the tissue of gastric mucosa. Conclusion: Acupuncture and moxibustion shows cytoprotection on gastric mucosa, so it is an effective method for treating chronic atrophic gastritis.     

1670例慢性浅表性胃炎感染幽门螺杆菌情况分析

为进一步阐明慢性浅表性胃炎 (CSG)与幽门螺杆菌 (HP)感染的关系及CSG患者HP感染与年龄和性别的关系 ,对 1 670例经临床、胃镜及病理均诊断为CSG的活检标本的HE及Giemsa染色切片进行回顾性观察 ,观察HE染色切片确定CSG的程度及是否伴有活动性炎症 ,观察Giemsa染色切片确定有无HP感染。结果 :非活动性轻、中、重度CSG的HP检出率分别为 7.3 5 %、3 1 .0 2 %和 5 2 .0 3 % ,两两比较统计学上有显著性差异 (P <0 .0 1 )。活动性轻、中、重度CSG的HP检出率分别为 66.67% ,71 .81 %和 89.43 % ,与相对应的非活动性轻、中、重度CSG的HP检出率相比差异非常显著 (P <0 .0 1 )。HP检出率男性为 3 6.92 % ,女性为 3 3 .0 1 % ,两者比较无显著性差异 (P >0 .0 5 )。 3 0岁以下组、3 1～ 60岁组、61岁以上组HP检出率分别为 3 3 .92 %、3 7.90 %和 2 8.74% ,经检验 3 1～ 60岁组与 61岁以上组差异非常显著 (P <0 .0 1 )。结果提示 :HP是使CSG产生活动性并且使CSG程度加重的重要原因 ,但不是唯一因素。CSG病人HP感染率无性别差异 ,感染多发生在 3 1～ 60岁人群。     

幽门螺旋菌感染部位、菌量及形态与慢性活动性胃炎关系的病理组织学观察

对350例胃粘膜活检标本进行病理组织学观察及计算机图象分析，幽门螺旋菌（HP）的检出率为70．85％，胃内HP感染的菌量，尤其是HP侵入组织的深度及HP的形态与慢性胃炎的活动性有密切关系。观察结果提示侵入胃粘膜组织深部可能是HP引致活动性胃炎的重要条件，HP的形态与其侵入组织的能力有一定关系。     

Synthesis of Glycoproteins by Mucosa of Gastric Antrum in Chronic GastritisB

ＳｙｎｔｈｅｓｉｓｏｆＧｌｙｃｏｐｒｏｔｅｉｎｓｂｙＭｕｃｏｓａｏｆＧａｓｔｒｉｃＡｎｔｒｕｍｉｎＣｈｒｏｎｉｃＧａｓｔｒｉｔｉｓＢＴＩＡＮＤｅ－ａｎ（ＤｅｐａｒｔｍｅｎｔｏｆＧａｓｔｒｏｅｎｔｅｒｏｌｅｇｙ，ＴｏｎｇｊｉＨｏｓｐｉｔａｌ，Ｔｏｎｇｊ...     

不同药物对幽门螺旋菌感染性胃炎的疗效观察

作者将224例门诊胃镜与活检粘膜微生物和病理检查证实的幽门螺旋菌阳性胃炎,随机分成12组,分别给予:维酶素,三九胃泰、氟哌酸、硫糖铝、卡那霉素、呋喃唑酮、甲硝唑3周和6周,庆大霉素,迪乐冲剂6周,复方猴头冲剂,迪乐冲剂8周口服治疗。结果幽门螺旋菌转阴率分别为5.9%,12.5%,14.3%,33.3%,40.0%,36.8%,42.8%,50.0%,50.0%,69.0%,96.0%;其中迪乐冲剂8周口服治疗组显著优于其它各组(P<0.001和P<0.05),复方猴头冲剂8周治疗组也优于维酶素、三九胃泰,氟哌酸和硫糖铝组(P<0.001,P<0.01和P<0.05):特别是迪乐冲剂8周使幽门螺旋菌转阴率由6周的50.0%猛增至96.0%     

慢性胃炎证候与幽门螺杆菌及Bcl-2蛋白的相关性研究

研究慢性胃炎证候与幽门螺杆菌 ( HP)及胃粘膜 Bcl-2蛋白的相关性 ,探讨证候形成机理。选择慢性浅表性胃炎患者 89例为对象 ,其中湿热蕴脾证 5 3例 ,脾胃气虚证 3 6例 ,1 0名健康人为对照。采用辨证、HP、胃粘膜 Bcl-2蛋白等指标进行研究。结果 :1 HP感染率湿热蕴脾组显著高于对照组和脾胃气虚组 ;2湿热蕴脾组和脾胃气虚组 Bcl-2有不同程度的异常表达 ,以脾胃气虚组为高 ,但与 HP感染率的相关性未能得到证实。结论 :脾胃虚实证候与 HP感染存在相关性 ,湿热是 HP生长、繁殖的病理基础 ;细胞凋亡相关蛋白 Bcl-2与证候形成有关。     

771例隆起糜烂性胃炎病因及预后的探讨

本文分析了771例隆起糜烂性胃炎幽门螺杆菌（HP）的感染情况及其与异型增生的关系并与同期的慢性胃炎、消化性溃疡相比较，隆起糜烂性胃炎HP阳性率明显增高；伴异型增生的隆起糜烂性胃炎HP阳性率明显高于未合并异型增生的隆起糜烂性胃炎。结果表明，隆起糜烂性胃炎与HP密切相关，异型增生的发病率高，提示可能从HP经隆起糜烂性胃炎异型增生到胃癌的发展。     

中西医联合治疗幽门螺杆菌相关性胃病研究进展

近年来中西药联合治疗幽门螺杆菌相关性胃病取得了较大进展,临床主要采用中药辨证施治联合西药治疗Hp相关性消化性溃疡、慢性萎缩胃炎、慢性糜烂性胃炎的效果确切,与单纯西药或中药相比具有症状消除快,总有效率高,不良反应及复发率低的优势,但治疗方法较多,仍存在不少问题,今后应加强研究总结,逐步形成较为标准统一的治疗方案,进一步提高临床疗效。     

幽门螺杆菌感染与慢性胃炎和消化性溃疡活动期的关系

目的：本文从病理角度来进一步证明幽门螺杆菌（Hp）感染与慢性胃炎和消化性溃疡活动期的关系,观察在Hb感染的慢性胃炎中病理诊断为浅表性胃炎或萎缩性胃炎与在Hp感染的消化性溃疡中病理诊断伴浅表性胃炎或萎缩性胃炎之间的关系。方法：对胃镜诊断为慢性胃炎的416例及消化性溃疡的144例患者,分别在病变部位、溃疡周围及胃窦部处取活组织检查,用苏木素－伊红（HE）染色确定活动期。经改良Giemsa染色查Hp。结果：慢性胃炎和消化性溃疡活动期Hp感染阳性率与非活动期相比,有非常显著性差异（P＜0．01）;由胃活组织检查中发现在Hp感染阳性者中浅表性胃炎显著多于萎缩性胃炎,分别为87.4％和12．6％;而在Hp感染的慢性胃炎中病理诊断为浅表性胃炎或萎缩性胃炎与在Hp感染的消化性溃疡中病理诊断伴浅表性胃炎或萎缩性胃炎,两组相比,无显著性差异（P＞0．05）。结论：与Hp感染密切相关的萎缩性胃炎是浅表性胃炎发展的结果,是胃粘膜慢性炎症活动期的主要致病因子。     

1300例胃粘膜活检的幽门螺旋菌与慢性胃炎的关系

对１３００例慢性胃炎的胃粘膜活检进行病理组织学观察，幽门螺旋菌（ＨＰ）的感染率为６０％（７８０／１３００）。男性感染率明显高于女性。活动性胃炎与非活动性胃炎的感染率分别为８２．２６％（１０２／１２４）和５７．７０％（６６３／１１４９），发现菌量与病变的活动性有密切关系。提示螺旋菌对胃粘膜有直接致病作用，是导致慢性胃炎的病因之一。     

幽门螺杆菌根除后慢性萎缩性胃炎胃粘膜的改变

目的 探讨幽门螺杆菌（Hp)根除后胃腺体萎缩、肠化、不典型增生改变的可能性。方法 155例患者均经胃镜诊断为慢性萎缩性胃炎（CAG）或伴肠化、不典型增生；Hp感染由^13C尿素呼气试验、快速尿素酶试验，组织学检查证实。患者分为两组：治疗组94例，对照组61例。治疗组采用OAC方案，2次/d，共服药10d。治疗结束后4－8周，检测Hp根除情况，对照组不用任何对Hp有影响的药物，且与治疗组在同一时间作Hp检测、胃镜等检查。结果 治疗组4例失访。90例患者中Hp根除率为87．8％，萎缩程度均未减轻，炎症消失69．6％，减轻25．3％；32例肠化患者中，消失21．9％，减轻37．5％；40例不典型增生中消失27．5％，减轻40．0％。对照组61例病情无明显变化。结论 Hp根除后，粘膜炎症、肠化及不典型增生能够减轻或消失，对于预防胃粘膜恶变是有益的。