目的:探讨胃肠道微生态的平衡对胃的癌前病变如息肉等及胃蛋白酶原的影响,旨在探索一种减少胃癌发生、防范胃癌于发生前或发生早期的方法。方法:收治确诊为胃息肉并已行钳除或切除治疗的患者184例,按入组前HP阳性与否进行分层,将研究对象随机分为原HP阳性组(治疗组+对照组)、原HP阴性组(治疗组+对照组),各46例。对照组于息肉治疗后予雷贝拉唑钠肠溶片10 mg/次,2次/d,铝镁加混悬液15 ml/次,3次/d,连续服药1周后停药。治疗组则在对照组的基础上于停药后予加用复方嗜酸乳杆菌片1g/次,3次/d,冷开水送服,连续服药7周,所有受检者均于治疗前及治疗结束后清晨空腹留取血标本检测血清PGⅠ、PGⅡ水平,同期复查胃镜了解息肉复发与否。统计计算各组血清PG水平及PGⅠ/PGⅡ比值、胃息肉复发率是否存在差异。结果:治疗组的PG I平均水平及PGⅠ/PGⅡ平均比值均高于对照组,差异有统计学意义(P〈0.05),而PGⅡ平均水平及胃息肉的复发率均低于对照组,差异有统计学意义((P〈0.05)。结论:胃肠道微生态平衡可望减少胃癌前病变的发生发展。
Objective To search the effect of gastrointestinal micro-ecological balance on gastric precancerous lesions( such as polyps) and pepsinogen,explore a new strategy for reducing and preventing the occurrence of gastric cancer. Method 184 gastric polyps patients,treated with forceps removal or resection and equally divided into HP positive and HP negative groups according to the HP before transmitting,were randomly to receive Rabeprazole Sodium Enteric-coated Tablets 20 mg/d and Almagate Suspension 45 ml/d for one week(92 control group) or sequential with the Compound Eosinophil-Lactobacillus Tablets3 g/d for the other seven weeks(92 treatment group). The levels of serum PG Ⅰ and PG Ⅱ were collected around the treatment on empty stomach at early morning and the polyp recurrence was reviwed through gastroscopy after treatment. Statistical difference of serum PG levels,the ratio of PG Ⅰ/PG Ⅱ,and the polyp recurrence rate were analyzed. Results The average level of PG I and the ratio of PG Ⅰ/PG Ⅱ in experimental groups were higher than those in control groups( P〈0. 05),while the average level of PG Ⅱ and the recurrence rate of gastric polyps were lower than control groups( P〈0. 05). Conclusion Balance of gastrointestinal microecology is expected to reduce the occurrence and development of gastric precancerous lesions.