健胃灵合剂防治胃癌癌前病变的临床研究

对经胃镜及病理学确诊的慢性萎缩性胃炎伴肠化和（或）异型增生的患者，随机分为治疗组（健胃灵合剂）６１例，对照组（维酶素胶囊）３１例。治疗６个月后复查，结果临床总效率分别为９１．８％、５４．８％，胃镜疗效分别为８６．９％、５１．６％，病理疗效分别为７７．０％、４１．６％两组比较均提示有非常显著性差异（Ｐ〈０．０１）。     

健胃灵口服液防治胃癌癌前病变的实验研究

采用N-甲基-N'-硝基-N-亚硝基胍（MNNG）灌服、使大鼠胃粘膜出现癌前病变。给造模大鼠灌服健胃灵口服液后，其胃粘膜细胞异型、结构异型的程度及血清癌胚抗原测定等指标均有好转。与生理盐水组比较，表明健胃灵口服液有较好的保护胃粘膜、阻断MNNG对胃粘膜损害的作用。     

健胃灵口服液防治胃癌癌前病变的实验研究

采用Ｎ－甲基－Ｎ‘０硝基－Ｎ亚硝基胍（ＭＮＮＧ）灌服，使大鼠胃粘膜出现癌前病变。给造模大鼠灌眼健胃灵口服液生，其胃粘膜细胞异型，结构异型的程度及血清癌胚抗原测定等指标均有好转。与生理盐水组比较，表明健胃灵口服液有较好的保护胃粘膜、阻断ＭＮＮＧ对胃粘膜损害的作用。     

胃炎灵治疗慢性萎缩性胃炎的临床研究

为探讨治疗慢性萎缩性胃炎的有效方剂，对采用胃炎灵治疗的50例慢性萎缩性胃炎进行了临床观察，并与45例采用养胃舒治疗的慢性萎缩性胃炎者进行对照。结果治疗组临床症状、病理检查结果及HP清除率较对照组明显改善（P＜0．05），但胃镜检查对比无显著性差异（P＞0．05）。提示中药胃炎灵是一有效的治疗慢性萎缩性胃炎的药物，值得推广使用。     

胃舒合剂治疗萎缩性胃炎癌前病变的临床研究

本文对胃舒合剂治疗４８例萎缩性胃炎癌前病变的疗效，从症状、胃镜、病理三大方面，通过记分法进行了综合判断。其治疗后３个月的总有效率为８３．３％。６个月总有效率为９１．７％。其６个月的症状有效率为９１．７％，与３个月的症状有效率８５．４％比较，经统计学处理无显著差异。而胃镜有效率６６．７％，萎缩有效率６４．６％，肠化有效率６２．５％，异型增生有效率６５．３８％，与３个月相比，均有显著差异。     

胃炎灵治疗慢性萎缩性胃炎的临床研究

为探讨治疗慢性萎缩性胃炎的有效方剂，对采用胃炎灵治疗的５０例慢性萎缩性胃炎进行了临床观察，并与４５例采用养胃舒治疗的慢性萎缩性胃炎者进行对照。结果治疗组临床症状、病理检查结果及ＨＰ清除率较对照组明显改善（Ｐ〈０．０５），但胃镜检查对比无显著性差异（Ｐ〉０．０５）。提示中药胃炎灵是一有效的治疗慢性萎缩性胃炎的药物，值得推广使用。     

猴头健胃灵联合莫沙必利治疗老年人功能性消化不良的临床观察

目的探讨猴头健胃灵联合莫沙必利治疗老年人功能性消化不良(FD)的临床疗效。方法选择符合罗马Ⅲ诊断标准的老年人功能性消化不良患者100例,随机分为对照组50例和治疗组50例,对照组给予莫沙必利5 mg 3次/d口服,治疗组在对照组的基础上联用猴头健胃灵胶囊4粒日3次,疗程均为4周,观察两组患者用药后上腹痛、上腹烧灼感、腹胀、早饱症状改善程度。结果①两组在治疗4周后上腹痛、上腹烧灼感、腹胀、早饱评分以及症状总评分均下降,治疗组优于对照组,差异具有统计学意义(P0.05);②治疗组总有效率为92%,对照组总有效率为70%,治疗组明显优于对照组,P0.05。结论猴头健胃灵联合莫沙必利治疗老年人功能性消化不良可有效改善患者上腹痛、上腹烧灼感、腹胀、早饱临床症状,且不良反应少,安全性高,为临床治疗老年人功能性消化不良提供新的药物选择。     

活血化瘀养阴健胃中药联合西药治疗慢性萎缩性胃炎临床分析

目的观察自拟活血化瘀养阴健胃方联合西药治疗慢性萎缩性胃炎的临床疗效。方法将电子胃镜及病理确诊的慢性萎缩性胃炎患者85例随机分为观察组43例,对照组42例。观察组运用自拟活血化瘀养阴健胃方联合西药治疗;对照组单纯使用西药治疗。连续用药3个月后复查电子胃镜。比较两组临床疗效及胃镜检查结果。结果观察组临床疗效明显优于对照组（P〈0.01）。结论活血化瘀养阴健胃方联合西医药治疗慢性萎缩性胃炎疗效显著。     

中药治疗胃癌前期病变的临床观察

对12年来200余例经病理检查证实的慢性萎缩性胃炎（CAG）患者，根据不同临床分型，以温中和胃为基本大法，配合活血化瘀、清热解毒药物治疗，经过3年反复临床验证，取得良好效果。从资料完整的80例病例与治疗前比较，其临床疗效：显效47例，有效24例，无效9例，有效率88．7％。胃镜检查：显效42例，有效24例，无效14例，有效率82．5％。病理组织检查：显效21例．有效34例，无效23例，癌变2例，有效率68．7％。同时可降低血粘稠度，使胃酸分泌增高。     

Helicobacter Pylori and Precancerous Gastric Lesions

Background: To determine the relationship between Helicobacter pylori (H. pylori) infection and the precancerous gastric lesions: atrophic gastritis (AG) and intestinal metaplasia (IM) and dysplasia. Methods: A total of 347 dyspeptic patients, including 141 H. pylori‐positive patients and 206 H. pylori‐negative patients, were studied alongside age‐ and sex‐matched controls. The patients underwent gastroscopy and endoscopic biopsy for detection of H. pylori, and histological examinations. Helicobacter pylori was detected by a urease test (CLO; Delta West; Bentley, Australia), by histology (H&E stain, Giemsa) and by serology (BioSig; BioMeditech, NJ, USA). Atrophic gastritis, IM and dysplasia were detected by histological examination (Giemsa, H&E stain). Results: There is a higher rate of atrophic gastritis in H. pylori‐positive than in H. pylori‐negative patients (46 vs 13.5%, odds ratio (OR) = 5.4; P < 0.01). Gastritis in H. pylori‐positive patients also has a higher rate of activity than in H. pylori‐negative patients. The rate of IM is higher in H. pylori‐positive patients than in H. pylori‐negative patients (35 vs 11%; OR = 4.3; P < 0.01). Metaplasia is more often diffuse in H. pylori‐positive than in H. pylori‐negative patients. Dysplasia is more common in H. pylori‐positive than in H. pylori‐negative patients (12 and 3.8%; OR = 3.3; P < 0.01). Conclusions: This study supports the suggestion of a relationship between H. pylori infection and precancerous gastric lesions. Wherever H. pylori is present, the precancerous lesions are more common and more severe.     

欣胃颗粒对慢性萎缩性胃炎大鼠胃黏膜病理形态学及胃液pH影响的研究

[目的]探讨欣胃颗粒治疗慢性萎缩性胃炎(CAG)的疗效及其机制.[方法]采用100 μg/ml甲基硝基亚硝基胍(MNNG)自由饮用,0.3 g/kg雷尼替丁喂养,配合饥饱失常等综合方法进行造模,3个月制成大鼠CAG模型.设正常、模型、维酶素组及欣胃颗粒高、中、低剂量治疗组,观察大鼠胃黏膜病理形态学及胃液pH变化.[结果]各药物治疗组大鼠胃黏膜均有不同程度改善,欣胃颗粒高、中、低剂量组与模型组、维酶素组比较,pH值明显降低(P＜0.05,或＜0.01).[结论]欣胃颗粒通过改善胃黏膜的病理形态,从而促进胃酸分泌治疗CAG.     

芪夏连棱汤治疗萎缩性胃炎癌前病变临床研究

目的探讨芪夏连棱汤对慢性萎缩性胃炎(CAG)癌前病变的治疗作用.方法80例CAG癌前病变患者随机分为两组,采用自拟中药方芪夏连棱汤治疗(治疗组)40例,用中成药三九胃泰冲剂治疗(对照组)40例,疗程均为3个月.观察两组患者临床、病理疗效,治疗前后萎缩、肠上皮化生(IM)、不典型增生(ATP)及幽门螺杆菌(Hp)感染的变化.结果治疗组临床总有效率为90.0%,对萎缩、IM、ATP的有效率分别为.77.5%,75.0%,87.5%,与对照组比较有显著性差异(均P＜0.05).结论芪夏连棱汤对CAG癌前病变的临床症状及病理变化有显著改善作用.     

中药治疗慢性萎缩性胃炎伴肠化、间变的临床观察

对166例慢性萎缩性胃炎伴肠化、异型增生患者，运用中药专方--"胃复康"散剂，结合辨证论治的局部与整体相结合的方法治疗。使之"牌为阴土而升阳，胃为阳土而降阴"得到"心肺之阳降，肝肾之阴升"的目的，并发症亦能迎刃而解，结果显效92例，有效51例，无效22例，加重1例，总有效率达86．14％。     

叶酸阻断胃癌形成机理的初步研究

目的:进一步明确叶酸抗萎缩性胃炎和阻断人胃癌发生发展的分子机理。方法:将25例慢性萎缩性胃炎(CAG)病人随机分组,分别用叶酸和安慰剂治疗半年,以放免法观察血浆和胃粘膜组织内叶酸浓度的变化,分别以H-SAM掺入,液闪计数法和HpaⅡ/Mspl酶解,Southern blot法研究其胃癌区、癌旁和外周正常区的总基因组DNA与c-myc癌基因甲基化水平的改变。结果:叶酸(FA)组萎缩性胃炎患者治疗后血浆FA含量明显上升,萎缩和肠化改善显著,两者呈同步变化;治疗后FA组DNA掺入甲基的量明显减少(P<0.01).即其总基因组DNA甲基化水平上升,与血浆叶酸的升高相一致;胃癌病人手术标本甲基化水平的分析显示:c-myc片段低甲基化者,叶酸水平明显低于正常甲基化者(P<0.05)。结论:叶酸对CAG的组织病理具有显著的改善作用。     

Gastric Pit Density and Depth of Foveolae of the Gastric Body Mucosa Assessed by Dye Endoscopy

Abstract: We examined the histological characteristics of the foveolar zone of the gastric body mucosa, using dye endoscopy and endoscopic biopsy. In 63 patients, the gastric area type of the gastric body was placed in one of the following categories; fundic gland type 0 (F₀), where small and fine areas are arranged closely to one another; F₁, where the areas are largest in size, round and high; F₂, where the areas are intemediate in size but not so high; F₃, where small and flat areas are loosely arranged; pseudo-pyloric gland type 1 (Pb₁), where the areas are regular in size and arrangement; and the completely atrophic gland type (Pb₂) with areas irregular in size and arrangement. The histological characteristics of the foveolar zone were emmined on printed microphotographs of the biopsy specimens of the gastric body. The density of the gastric pit was defined as the number of pits in a 1 mm width of the mucosal surface and depth of the foveolae was measured as the distance between the top and bottom (or the isthmus) of the foveolae as seen on vertical sections. The gastric pit density and depth of the foveolae were dense and shallow, respectively, in FO and sparse and deep, in Pbl and Pb₂ respectively. The degree of these factors showed independency in area types F₀, F₁ and Pb₂ and there were correlations of P<0.033 and P<0.001 between F₂ and Pb₁, F₃ and Pb₁, respectively. Our observations may be useful to define atrophic gastritis in the gastric body mucosa, in terms of the gastric area types.     

Gastric carcinoid tumor in a 14-year old girl

Abstract

Gastric carcinoid tumors (GCT) are rare lesions that constitute 2.6–8.7% of all gastrointestinal carcinoids, mostly affect middle-aged females but the incidence in children is unknown. We present a 14-year-old girl, with GCT. She was treated with recombinant human growth hormone (GH) for complete GH deficiency, and endoscopy was performed to identify iron-deficiency anemia. Upper gastrointestinal endoscopy revealed a gastric polyp, and biopsies were compatible with GCT.     

Mucosal Measurements and Gastric Secretion in Gastritis

Fifty-nine suction biopsies were obtained with a Crosby-Kugler's biopsy capsule from the fundus or the body of the stomach in 22 women and 37men with dyspepsia. In none of them were peptic ulcers or gastric tumors found by gastroscopy and X-ray examination of the stomach and duodenal cap. Mucosal measurements were performed in the correctly orientated haematoxylin and eosin stained histological sections. The volume rate and concentration and output of total HCl were determined in the gastric juice before as well as after subcutaneous injection of 0.05 mg histamine-phosphate per kg body weight.

One-third of the patients had normal gastric mucosa, one-third superficial gastritis and one-third atrophic gastritis. Their average age was 50, 55, and 61 years, respectively.

In the patients with superficial gastritis a significantly increased thickness of the foveolar layer was found, whereas the glandular layer thickness and the secretion of gastric juice and hydrochloric acid were not significantly altered.

In the patients with atrophic gastritis a further significantly increased thickness of the foveolar layer was observed. These patients also showed a significantly reduced thickness of the glandular layer and a significantly decreased secretion of gastric juice and hydrochloric acid.