目的:研究健脾、化瘀和健脾化瘀中药对胃癌前病变的防治作用及其机制。方法:对120只胃癌前病变模型大鼠进行中药和西药预防及治疗给药,观察大鼠胃黏膜细胞P53表达水平的变化。结果:造模组P53表达增强,与正常组比较有显著差异(P<0.01);经过3组中药和西药预防用药,P53表达下降,与造模组比较有显著差异(P<0.01);中药预防组P53表达均低于西药预防组,有显著差异(P<0.01);造模空白组与中、西药治疗组胃黏膜P53表达亦有显著差异(P<0.01);无论是预防组还是治疗组健脾化瘀中药组P53表达均低于健脾组、化瘀组、西药组,有显著差异(P<0.05或P<0.01)。结论:健脾、化瘀、健脾化瘀中药通过抑制P53基因表达,促进胃黏膜细胞凋亡,使胃黏膜恢复正常,达到对胃癌前病变的防治作用。健脾化瘀中药的防治作用优于健脾药、化瘀药和西药。 Objective: To study the preventive and therapeutic effects of traditional Chinese medicine of strengthening spleen, removing blood stasis and invigorating the spleen and removing blood stasis on gastric precancerous lesions and its mechanism. Methods: 120 gastric precancerous lesion rats were treated with traditional Chinese medicine and western medicine for prevention and treatment, and the changes of P53 expression in gastric mucosal cells were observed. Results: The expression of P53 in model group was significantly higher than that in normal group (P <0.01). After 3 groups of traditional Chinese medicine and prophylaxis of western medicine, the expression of P53 decreased, which was significantly different from that of model group (P <0.01) The expression of P53 in the prevention group was lower than that in the western medicine prevention group (P <0.01). The expression of P53 in the blank control group and the western medicine group was also significantly different (P <0.01), both in the prophylaxis group and in the treatment group The expression of P53 in group of invigorating the spleen and removing blood stasis was lower than that in the group of invigorating spleen, removing blood stasis and western medicine (P <0.05 or P <0.01). Conclusion: Chinese herbs of invigorating the spleen, removing blood stasis and invigorating the spleen and removing blood stasis can inhibit the expression of P53 gene and promote the apoptosis of gastric mucosa cells, and return the gastric mucosa to normal and achieve the prevention and treatment of gastric precancerous lesions. Prevention and treatment of traditional Chinese medicine is better than spleen medicine, blood stasis medicine and western medicine.