善胃Ⅰ号方对血瘀热毒型胃粘膜异型增生p21蛋白的影响

Influence of Chinese medicine Shanwei I on p21 protein in cases from intestinalmetplasia with blood stasis and heat-toxin

关键词:  萎缩性胃炎  胃粘膜异型增生  善胃Ⅰ号方  p21  清热活血

Key words:  atrophic gastritis  intestinal metaplasia  Shanwei I  p21 protein  clearing away heat and promoting blood circulation

摘要:

[目的]观察中药善胃I号方对慢性萎缩性胃炎(CAG)胃粘膜异型增生的治疗效果,并观察ras癌基因蛋白p21在治疗前后的表达情况。[方法]将内镜和病理确诊为CAG胃粘膜异型增生的患者且符合中医血瘀热毒证型82例,随机分为治疗组和对照组。治疗组34例,予善胃Ⅰ号方;对照组48例,予市售猴头菌片,两组均用药12周。[结果]1)治疗组患者治疗前后症状缓解总有效率为81%;对照组患者治疗前后症状缓解总有效率为44.74%,P<0.005;2)病理改变:中药治疗后多数患者病理改善,粘膜萎缩消失8例,转为轻度12例,重度转为中度7例,无变化6例,加重1例;而对照组消失2例,转为轻度4例,转为中度5例,无变化33例,加重4例,中药组明显优于对照组,P<0.005;3)中药治疗组治疗前后 p21蛋白表达阳性指数下降较对照组更为明显,两者有显着性差异(P<0.05).[结论]中药善胃Ⅰ号方对萎缩性胃炎有良好的治疗作用,并在一定程度上可使胃粘膜异型增生逆转。

Abstract:

[Objective] To observe the therapeutic effect of Chinese medicine Shanwei I on metaplasia of intestinal mucosa in chronic atrophic gastritis (CAG). To evaluate the expression of oncogene p21 protein in the treatment of CAG.[Methods] Eighty-two patients with blood stasis and heat-toxin were divided into treatment group(34, given Shanwei I) and control group(48, given Houtoujun tablets) randomly.The treatment course was 12 weeks.[Results] 1) The total effective rate was 81% in treatment group and 44.74% in control group with a marked difference between them,(P<0.005).2) The pathological changes were improved obviously in treatment group. It was superior to control group,(P<0.005).3) The expression of p21 protein was decreased obviously in treatment group and there was an obvious difference before and after treatment (P<0.05).[Conclusion] Shanwei I has a good effect on chronic atrophic gastritis and can reverse intestinal metaplasia.