摘要
目的:探讨清化逆萎汤对慢性萎缩性胃炎(chronic atrophy gastritis,CAG)伴低级别上皮内瘤变(low grade intrapithelial neoplasia,LGIN)的临床疗效及其对PTEN(phosphatase and tension homology deleted on chromosome ten)、AKT(a serine/threonine protein kinase)表达的影响。方法:临床随机筛选出经胃镜、病理确诊CAG伴LGIN且符合幽门螺杆菌阴性或经正规四联疗法治疗后转阴的患者共66例,将其随机分为A、B、C 3组各22例,A组给予口服清化逆萎汤,B组给予胃复春、叶酸,C组密切随访不予特殊治疗,各组疗程均为6个月,观察治疗前后症状、胃镜病理及PTEN、AKT表达变化情况。结果:中医证候疗效方面总有效率A组90.91%,B组68.18%,C组40.91%,3组间比较差异显著(P<0.01);病理改善方面萎缩、低级别上皮内瘤变改善情况A组明显优于B组、C组,病理总体有效率方面,A组68.18%,B组45.45%,C组27.27%,组间比较差异显著(P<0.05);免疫组化结果方面,治疗前后3组PTEN积分均有不同程度升高,AKT积分均有不同程度降低,但A组治疗后PTEN积分升高,AKT积分降低均较B组、C组更明显,差异有统计学意义(P<0.01)。结论:清化逆萎汤能显著改善CAG伴LGIN患者的临床症状、病理组织学表现,其机制可能为上调抑癌基因PTEN和下调癌基因AKT表达,从而调控细胞生长,诱导胃癌前病变细胞凋亡。
Objective:To observe the curative effect of Qinghua Niwei decoction on chronic atrophic gastritis(CAG)with low grade intraepithelial neoplasia(LGIN)and to observe the expressions of PTEN(phosphatase and tension homology deleted on chromosome ten),AKT(a serine/threonine protein kinase)before and after treatment.Methods:66 patients of CAG with LGIN confirmed by gastroscopy and pathology were divided into three groups randomly,22 cases in each group.They must be Helicobacter pylori negative or turned negative after regular quadruple therapy.Group A was given Qinghua Niwei decoction,group B was given Weifuchun and folic acid,and group C was closely followed up without special treatment.The courses of treatment in each group was 6 months.The clinical symptoms,gastroscopic pathology and expression of PTEN and AKT were observed.Results:The total effective rate of clinical symptoms:90.91%in group A,68.18%in group B and 40.91%in group C,with significant difference among the three groups(P<0.01);Pathological improvement:The improvement of atrophy and low-grade intraepithelial neoplasia in group A was significantly better than that in group B and group C.The overall effective rate of pathology was 68.18%in group A,45.45%in group B and 27.27%in group C,with significant difference among the three groups(P<0.05);Immunohistochemical results:Before and after treatment,PTEN scores increased and AKT scores decreased in three groups,but PTEN scores increased and AKT scores decreased in group A after treatment,which was more significant than that in group B and group C(P<0.01).Conclusion:Qinghua Niwei decoction can significantly improve the patients’clinical symptoms and histopathological manifestations of CAG with LGIN.It suggests that increasing the expressions of PTEN and inhibiting the expressions of AKT are the partial mechanism of CAG with LGIN by Qinghua Niwei decoction.
作者
王丽华
张永强
WANG Li-hua;ZHANG Yong-qiang(Jiangyin People's Hospital,Jiangsu,Jiangyin 214400,China)
出处
《中国中医基础医学杂志》
CAS
CSCD
北大核心
2021年第10期1614-1618,共5页
JOURNAL OF BASIC CHINESE MEDICINE
基金
江苏省中医药科技发展计划项目(YB2017052)-清化逆萎汤治疗萎缩性胃炎伴低级别上皮内瘤变的临床观察及对PTEN、AKT表达的影响。
