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目的 :探讨胃舒胶囊对萎缩性胃炎癌前病变的治疗作用及机理。方法 :75例萎缩性胃炎癌前病变患者随机分为两组 ,治疗组 (45例 )给予胃舒胶囊口服 ,对照组 (3 0例 )给予胃宁冲剂冲服 ,疗程均为 6个月。观察两组患者临床、病理疗效 ,治疗前后萎缩、肠化、异型增生、肠化亚型和癌胚抗原 (CEA)、增殖细胞核抗原 (PCNA)表达积分值的变化。结果 :治疗组临床总有效率为 91 % ,对萎缩、肠化、异型增生的有效率分别为 64 %、67%、65 % ,并能降低其积分值 ,与对照组比较有显著性差异 (P <0 0 1 ,P <0 0 5 ) ;治疗前后免疫组化结果显示胃舒胶囊对肠化亚型和CEA、PCNA的表达也有明显的改善和阻抑作用 (P <0 0 1 )。结论 :胃舒胶囊对萎缩性胃炎癌前病变的临床症状及病理变化有显著改善作用 ,其机理可能与其诱导和促进肠化细胞、异型增生细胞的分化成熟 ,抑制和纠正细胞的异常增殖有关。
Objective: To investigate the therapeutic effect and mechanism of Weishu capsule on precancerous lesions of atrophic gastritis. Methods: Seventy-five patients with atrophic gastritis precancerous lesion were randomly divided into two groups. The treatment group (45 cases) was given Weishu capsule orally. The control group (30 cases) was given Weiweining granule. The course of treatment was 6 months. The clinical and pathological effects, the changes of atrophy, intestinal metaplasia, dysplasia, intestinal metaplasia and carcinoembryonic antigen (CEA) and proliferating cell nuclear antigen (PCNA) expression before and after treatment were observed. Results: The total effective rate of the treatment group was 91%, and the effective rates of atrophy, intestinal metaplasia and dysplasia were 64%, 67% and 65%, respectively. The effective rates of the treatment group and the control group were significantly lower than those of the control group P <0.01, P <0.05). The results of immunohistochemistry before and after treatment showed that Wei Shu capsule had a significant improvement and suppression effect on the expression of intestinal subtype and CEA and PCNA (P <0.01). Conclusion: Weishu capsule can significantly improve the clinical symptoms and pathological changes of atrophic gastritis precancerous lesions. The mechanism may be related to its induction and promotion of the differentiation and maturation of intestinal metaplasia and dysplasia, and the inhibition and correction of abnormal proliferation of cells.