摘要
目的:评价中药辨证治疗胃癌前病变的有效性与安全性,并探讨其对胃癌前病变组织p53、Ki67、APC蛋白表达的影响。方法:将52例胃癌前病变患者按2:1的比例随机分为中药治疗组和西药对照组,分别给予中药辨证治疗、叶酸口服治疗。治疗时间6个月。于治疗前、治疗结束时行胃镜病理及免疫组化检查,评价病理各项结果积分及p53、Ki67、APC蛋白表达的变化。结果:治疗期间无不良反应发生。治疗6个月后,两组患者病理异型增生、萎缩、肠化病理积分较治疗前明显降低(P<0.05,P<0.01)。与正常对照组比较,胃癌前病变组织中存在p53、Ki67蛋白表达(40.48%vs0%和42.86%vs0%)升高和APC蛋白表达(71.43%vs90%)下调;治疗6个月后,p53、Ki67蛋白表达下调,治疗前后比较差异有统计学意义(P<0.05);APC蛋白表达无明显改变。结论:中药辨证治疗可逆转胃癌前病变患者黏膜异型增生(56.25%)、萎缩(35.50%)、肠化(25.68%),其机制可能为下调p53蛋白异常表达,降低细胞增殖活性,从而逆转癌前病变。
Objective： Evaluate the safety and effect of herb therapy on gastric precancerous lesion, and discuss the effect of this approach on p53, Ki67, APC protein of the precancerous lesion tissue. Methods： All patients with gastric precancerous lesion were divided randomly into two groups and applied herb therapy or folacin therapy separately. The treatment period lasted 6 months. Gastroscope, pathology, immunohistochemistry examination were taken on patients before and after therapy, to evaluate the integral change of pathology and the expression change of p53, Ki67 and APC protein. Results： There was no adverse reaction during the treatment period. After 6-month therapy, the integrals of atypical hyperplasia, atrophy and intestinal metaplasia were obviously decreased in both groups, had statistic significance comparing with before-therapy （P〈0.05, P〈0.01）. The expression of p53 and Ki67 protein（40.48%vs0% and 42.86%vs0%） had increased and APC protein （71.43%vs90%） has decreased in the tissue of precancerous patients. But after 6-month treatment, the expression of p53 and Ki67 protein had descended significantly in both groups comparing with before-therapy （P〈0.05）, while APC protein had not changed much. Conclusion： Herb therapy can invert the lesion of atypical hyperplasia （56.25%）, atrophy（35.50%） and intestinal metaplasia（25.68%） on a certain extent, which may related to decrease the expression of p53 protein for which lower the activity of cell proliferation to reverse precancerous lesion.
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2013年第2期356-360,共5页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
浙江省中医药重点研究计划(No.2008ZA005)
浙江省中医药科学研究基金计划(No.2010ZB037)~~
