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中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2017, Vol. 11 ›› Issue (14) : 2013 -2018. doi: 10.3877/cma.j.issn.1674-0785.2017.14.001

所属专题： 文献；

临床论著

胃复春联合复方尿囊素、多维片对萎缩性胃炎伴肠上皮化生逆转治疗的效果评估
唐燕锋1, 邵君2, 俞庆宪1, 许佳怡1, 周静1, 高泽立3,†()   
  1. 1. 200023　上海市黄浦区东南医院/上海市瑞金康复医院（筹）消化内科
    2. 201318　上海市浦东新区周浦医院老年科
    3. 201200　上海健康医学院附属浦东新区人民医院
  • 收稿日期:2017-01-05 出版日期:2017-07-15
  • 通信作者: 高泽立
  • 基金资助:
    上海市黄浦区卫生和计划生育委员会和科学技术委员会科研基金(HKW201428)

Therapeutic effect of Weifuchun tablets combined with compound allantoin and multi-vitamin B tablets on chronic atrophic gastritis with intestinal metaplasia

Yanfeng Tang1, Jun Shao2, Qingxian Yu1, Jiayi Xu1, Jing Zhou1, Zeli Gao3,†()   

  1. 1. Department of Gastroenterology, Dongnan Hospital of Huangpu District, Shanghai 200023, China
    2. Department of Geriatrics, Shanghai Pudong New District Zhoupu Hospital, Shanghai 201318, China
    3. People′s Hospital of Shanghai Pudong New District, Shanghai University of Medicine & Health Sciences, Shanghai 201200, China
  • Received:2017-01-05 Published:2017-07-15
  • Corresponding author: Zeli Gao
  • About author:
    Corresponding author: Gao Zeli, Email:
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唐燕锋, 邵君, 俞庆宪, 许佳怡, 周静, 高泽立. 胃复春联合复方尿囊素、多维片对萎缩性胃炎伴肠上皮化生逆转治疗的效果评估[J/OL]. 中华临床医师杂志(电子版), 2017, 11(14): 2013-2018.

Yanfeng Tang, Jun Shao, Qingxian Yu, Jiayi Xu, Jing Zhou, Zeli Gao. Therapeutic effect of Weifuchun tablets combined with compound allantoin and multi-vitamin B tablets on chronic atrophic gastritis with intestinal metaplasia[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2017, 11(14): 2013-2018.

目的

探讨胃黏膜萎缩伴肠上皮化生与慢性胃炎的关系，同时评价药物联合治疗对逆转萎缩和肠上皮化生的效果。

方法

选择2014年2月至2015年9月上海市黄浦区东南医院/上海市瑞金康复医院内镜病理活检诊断为慢性胃炎伴萎缩和肠上皮化生的患者（共114例），随机化分为2组，对照组（n=56）单用胃复春治疗，治疗组（n=58）采用胃复春、多维片、复方尿囊素联合治疗，疗程均为6个月，之后复查胃镜及病理活检，比较治疗前后黏膜炎症程度、萎缩、肠化缓解程度，采用SPSS 20.0软件进行分析，计量资料采用均值±标准差表示，差异显著性采用t检验，计数资料采用χ2检验，以P<0.05为差异具有统计学意义。

结果

复查胃镜及活检显示，治疗后，治疗组、对照组分别有10例（17.24%）、3例（5.36%）萎缩阳性转为阴性，治疗组萎缩逆转率显著高于对照组（χ2=3.983，P=0.046）。治疗组、对照组分别有20例（34.48%）、8例（14.29%）肠上皮化生转阴性，治疗组肠化逆转率显著高于对照组（χ2=6.272，P=0.012）。进一步按照萎缩程度、肠化程度比较，治疗组胃黏膜萎缩程度、肠化程度和对照组相比均显著减轻（χ2=14.856，P=0.002；χ2=11.469，P=0.009）。对照组治疗后胃黏膜肠化程度较治疗前显著减轻（χ2=8.949，P=0.030），但萎缩程度差异无统计学意义（χ2=4.308，P=0.230）。

结论

恰当的药物治疗有助于逆转慢性胃炎的萎缩和肠上皮化生，同时胃复春联合使用多维片、复方尿囊素的治疗效果明显优于胃复春的单药治疗，部分病例有显著的效果。

关键词: 慢性胃炎, 萎缩, 肠上皮化生, 复方尿囊素, 联合治疗
Objective

To investigate the relationship between gastric mucosal atrophy with intestinal metaplasia and chronic gastritis, and to evaluate the therapeutic effect of combined drug therapy on chronic atrophic gastritis with intestinal metaplasia.

Methods

One hundred and fourteen patients who were diagnosed with chronic gastritis with atrophy and intestinal metaplasia by endoscopic pathological biopsy at our hospital from February 2014 to September 2015 were randomly divided into two groups: a control group (treated with Weifuchun tablets alone; n=56) and a combination treatment group (treated with Weifuchun tablets combined with compound allantoin and multi-vitamin B tablets; n=58). Six months after treatment, gastroscopic biopsy was performed to assess the degree of mucosal inflammation, atrophy, and intestinal metaplasia. SPSS 20.0 software was used for statistical analysis.

Results

After treatment, gastroscopic biopsy revealed that atrophy was reversed in ten (17.24%) cases in the combination treatment group and three (5.36%) cases in the control group, and the cure rate of atrophy was significantly higher in the combination treatment group than in the control group (χ2=3.983, P=0.046); and that intestinal metaplasia was reversed in 20 (34.48%) cases in the combination treatment group and eight (14.29%) cases in the control group, and the cure rate of intestinal metaplasia was significantly higher in the combination treatment group than in the control group (χ2=6.272, P=0.012). After treatment, the degree of atrophy and intestinal metaplasia in the combination treatment group was significantly lower than that of the control group (χ2=14.856, P=0.002; χ2=11.469, P=0.009). The degree of atrophy and intestinal metaplasia in the combination treatment group was significantly reduced after treatment compared with before treatment (χ2=41.970, P=0.000; χ2=32.253, P=0.000). The degree of intestinal metaplasia in the control group was significantly reduced after treatment compared with before treatment (χ2=8.949, P=0.03), but atrophy showed no significant improvement (χ2=4.308, P=0.230).

Conclusion

Appropriate drug therapy is useful to treat atrophy and intestinal metaplasia in chronic gastritis. Combined Weifuchun tablets, multi-vitamin B tablets, and compound allantoin have significantly better therapeutic effect than Weifuchun tablets alone, especially in some cases.

Key words: Chronic gastritis, Atrophy, Intestinal metaplasia, Compound allantoin, Combined therapy
表1 2组患者一般情况的比较
组别 例数 性别（男/女，例） 年龄（±s，岁） 吸烟[例（%）] 饮酒[例（%）]
治疗组 58 24/34 57.29±7.68 17（29.3） 21（36.2）
对照组 56 21/35 60.00±5.85 15（26.8） 18（32.1）
统计值 ? χ2=0.179 t=3.173 χ2=0.09 χ2=0.209
P值 ? 0.705 0.078 0.464 0.696
表2 2组患者治疗前后病理炎症程度及转归的比较（例）
组别 例数 治疗前 治疗后
阴性 轻度 中度 重度 阴性 轻度 中度 重度
治疗组 58 0 5 35 18 0 19 37 2
对照组 56 0 9 39 8 0 19 33 4
表3 2组患者治疗前后病理萎缩程度及转归的比较（例）
组别 例数 治疗前 治疗后
阴性 轻度 中度 重度 阴性 轻度 中度 重度
治疗组 58 0 17 37 4 10 40 8 0
对照组 56 0 24 30 2 3 28 24 1
表4 2组患者治疗前后病理肠化生程度及转归的比较（例）
组别 例数 治疗前 治疗后
阴性 轻度 中度 重度 阴性 轻度 中度 重度
治疗组 58 0 30 19 9 20 29 3 6
对照组 56 0 33 18 5 8 30 13 5
图2 轻度萎缩、肠化图像2a、2b为内镜下表现；2c为病理染色图像（苏木精-伊红染色，×200）
[1]
Shimoyama T, Fukuda S, Tanaka M, et al. Evaluation of the applicability of the gastric carcinoma risk index for intestinal type cancer inJapanese patients infected with Helicobacter pylori [J]. Virchows Arch, 2000, 436(6):585-587.
[2]
Zhou L, Zhao Y, Zhu W, et al. Influencing factors of reverse of gastric precancerous lesions: a retrospective cohort study [J]. Chin J Public Health, 2013, 29(8):1154-1158.
[3]
周亮，赵瑶，朱伟, 等. 胃癌前病变转归影响因素回顾性队列研究 [J]. 中国公共卫生, 2013, 29(8):1154-1158.
[4]
Tosh D, Slack JM. How cells change their phenotype [J]. Nat Rel Mol Cell Biol, 2002, 3(3):187-194.
[5]
Ito M, Haruma K, Kamada T, et al. Helicobacter pylori eradication therapy improves atrophic gastritis and intestinal metaplasia: a 5-year prospective study on patients with atrophic gastritis [J]. Aliment Pharmacol Ther, 2002, 16(8):1449-1456.
[6]
赵霞，潘华峰，刘静. 慢性萎缩性胃炎与细胞凋亡和增殖的研究进展[J]. 江西中医学院学报, 2005, 17(3):79-80.
[7]
Genta RM. Atrophy and atrophic gastritis: one step beyond the Sydney system [J]. Ital Gastroenterol Hepatol, 1998, 30(Suppl 3):S273-S275.
[8]
葛振华，周凡，谢冰颖, 等. 慢性胃炎肠化生CD44、CD44V6及Cyclin D1、Cyclin E表达和意义 [J]. 中国组织化学与细胞化学杂志, 2007, 16(6):649-653.
[9]
Shah MA, Schwartz GK. Treatment of metastatic esophagus and gastric cancer [J]. Semin Oncol, 2004, 31(4):574-587.
[10]
Wenger NK, Lewis SJ, Welty FK, et al. Beneficial effects of aggressive low density lipoprotein cholesterol lowering in women with stable coronary heart disease in the Treating to New Targets(TNT) study [J]. Heart, 2008, 94(4):434-439.
[11]
Nardone G, Rocco A. Chemoprevention of gastric cancer: role of COX-2 inhibitors and other agents [J]. Digestive Diseases, 2004, 22(4):320-326.
[12]
周桑玉，殷文惠，冯仁秀. 胃复春联合麦滋林-S治疗Hp阴性萎缩性胃炎的疗效观察 [J]. 中华全科医学, 2012, 10(6):865-866.
[13]
芦兰，金建军，刑鲁奇, 等. 胃复春治疗胃癌前病变的疗效观察[J]. 河南科技大学学报(医学版), 2010, 28(2):86-88.
[14]
Correa P, Fontham ET, Bravo JC, et al. Chemoprevention of gastric dysplasia: randomized trial of antioxidant supplements and anti-helicobacter pyloritherapy [J]. J Natl Cancer Inst, 2000, 92(23):1881-1888.
[15]
Lan L, Yu J, Chen YL, et al. Symptom-based tendencies of Hellcobacter pylori eradication in patients with functional dyspepsia [J]. World J Gastroenterol, 2011, 17(21):3242-3247.
[16]
Wang J, Xu L, Shi R, et al. Gastric atrophy and intestinal metaplasiabefore and after Helicobacter pylori eradication: a meta-analysis [J]. Digestion, 2011, 83(4):253-260.
[17]
Zhou Y, Zhou ZJ, Xu QH. Effect of Helicobacter pylori eradication on gastric atrophy and intestinal metaplasia in patients with atrophic gastritis [J]. World Chin J Digestol, 2013, 21(21):2086-2090.
[18]
周颖，周忠杰，许琦华. 幽门螺杆菌根除对胃粘膜萎缩和肠上皮化生的影响 [J]. 世界华人消化杂志, 2013, 21(21):2086-2090.
[19]
Wang R, Jiang K, Wang BM, et al. Changes of gastric intestinal metaplasia after Helicobacter pylori eradication [J]. Tianjin Med J, 2011, 39(4):322-324.
[20]
王锐. 姜葵, 王邦茂, 等. 根除幽门螺杆菌后胃粘膜肠上皮化生的变化 [J]. 天津医药, 2011, 39(4):322-324.
[21]
周世明，林小英，王利娟. 复方尿囊素片联合奥美拉哩治疗糜烂性胃炎疗效观察 [J]. 浙江医学, 2009, 31(6):85-86.
[22]
程流芳，赵永伟，孙国辉, 等. 尿囊素铝颗粒治疗胃炎及消化性溃疡的疗效及安全性 [J]. 中国新药杂志, 2004, 13(11):1043-1046.
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