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中文摘要：
目的：以中药提取物为切入点,观察益气、化瘀、清热中药对胃癌前病变的治疗效果及辅助性Ⅴ型T细胞（Th1）、辅助性Ⅴ型T细胞（Th2）类细胞因子在治疗前后的表达情况。方法：将120例确诊为慢性萎缩性胃炎伴肠上皮化生和/或异型增生且符合中医气阴两虚、瘀热互结型的患者,随机分为益气组（西洋参茎叶总皂苷）、化瘀组（三七总皂苷）、清热组（盐酸小檗碱）、对照组（替普瑞酮）,各30例,每组患者使用相对应的药物治疗。3个月后评价各组药物对胃癌前病变的治疗效果及Th1、Th2各细胞因子表达的影响。结果：与治疗前比较,治疗后4组患者证候积分、病理积分及Th2的细胞因子水平均下降,Th1的细胞因子水平上升,差异具有统计学意义（P〈0-05）。与对照组比较,3个中药组在阻止胃癌前病变病理进展、刺激Th1细胞因子分泌、抑制Th2细胞因子表达方面均更有优势,差异具有统计学意义（P〈0-05）;与其他组别比较,化瘀组在阻止胃癌前病变病理进展方面更有优势,益气组在Th1/Th2免疫漂移的调节上具有较强的能力,差异均有统计学意义（P〈0-05）。结论：益气、化瘀、清热中药对胃癌前病变有一定的治疗作用,但在免疫调节及病理改变方面的具体作用强度不尽相同,如何优化配伍组合3种中药,值得进一步研究。
英文摘要：
OBJECTIVE： To observe the efficacy of medicines for Qi-tonifying, stasisi-dissolving and heat-clearing in the treatment of precancerous lesion of gastric cancer （PLGC） and the expressions of Thl/Th2 cytokines before and after treatment, with the pointcut of TCM extractions. METHODS： 120 patients with chronic atrophic gastritis with intestinal metaplasia and/or dyspla- sia, Qi and Yin deficiency and accumulation of blood and heat were randomly divided into Qi-tonifying group （Panax quinquefolium saponin） , stasisi-dissolving group （Panax notoginseng saponins）, heat-clearing group （berberine hydrochloride） and control group （teprenone）, 30 cases for each. All the patients were treated by corresponding medicines. After 3 months treatment, the effects of corresponding medicines on the efficacy and expressions of Thl/Th2 cytokines of PLGC were evaluated. RESULTS： Compared with before, the scores of symptom and pathological and level of Th2 cytokine in 4 groups were decreased and the level of Thl cytokine was increased, with significant difference （P〈0-05）. Compared with control group, stopping pathological progress of PLGC, stimulating Thl cytokine secretion and inhibiting Th2 cytokine expression in other 3 groups were better, with significant dif- ference （P〈0-05） ; compared with other groups, stasisi-dissolving group had advantage on stopping pathological progress of PLGC, and Qi-tonifying group had advantage on adjusting Thl/Th2 immune drift, with significant differences （P〈0-05）. CON- CLUSIONS： Medicines for Qi-tonifying, stasisi-dissolving and heat-clearing have certain efficacy in the treatment of PLGC. How- ever, it is different in the specific intensity of immune adjustment and pathological change. How to optimize and combine the 3 medicines is worthy of further study.
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