目的:通过观察据运脾益肾、化瘀解毒法组方的芪莲舒痞方(QLSP)治疗慢性萎缩性胃炎(CAG)癌前病变的临床疗效,探讨CAG癌前病变的关键病机。方法:筛选72例CAG癌前病变患者,按数字表法随机分为芪莲舒痞组36例,胃复春对照组36例,观察综合疗效、HP根除率、胃镜及病理学疗效。结果:QLSP组总有效率88.9%,胃复春组总有效率63.9%,两组差异显著(P〈0.05);QLSP组HP根除率72%,胃复春组43.5%,两组差异显著(P〈0.05);QLSP组胃镜及病理学总有效率86.1%;胃复春组61.1%,两组比较有统计学差异(P〈0.05);两组病理积分均有明显下降,QLSP组下降更为显著(P〈0.05)。结论:芪莲舒痞方治疗CAG癌前病变疗效显著,提示脾滞肾虚,瘀毒内蕴是CAG癌前病变的关键病机,运脾益肾、化瘀解毒是治疗CAG癌前病变的有效方法。
Objective:To probe into the pharmacodynamic mechanism of Qilian Shupi(QLSP) recipe by way of researching on its treatment on precancerous lesion of Chronic atrophic gastritis(CAG).Method:Seventy-two patients with precancerous lesions of CAG were divided randomly into two groups,36 of them were treated with QLSP and the other with Wei Fuchun tablet.After three months,the total effective rate,Hp-eradicating rates,gastroscopic images and pathological changes of gastric mucous membranes were observed.Result:The clinical research showed that the total effective rate of QLSP group was 88.9%,while it was 63.9% in Wei Fuchun group;the Hp-eradicating rate of QLSP group was 72%,while it was 43.5% in Wei Fuchun group;QLSP could improve gastroscopic images and pathological results of gastric mucous membrane.Conclusion:Invigorating spleen and tonifying kidney,regulating qi to disperse stagnation,and dispersing accumulation of pathogenic factors to resolve masses are the principles in the management of the precancerous lesion of CAG.