健脾活血法治疗慢性萎缩性胃炎脾虚血瘀证的临床研究
|
摘要
研究目的：
通过随机、对照的临床试验,观察健脾活血法治疗慢性萎缩性胃炎脾虚血瘀证的临床疗效、安全性及随访3个月的远期疗效。
研究方法：
选取符合纳入标准的患者63例,随机分为试验组32例,对照组31例。试验组患者口服健脾活血方,对照组服用胃复春片,疗程均为3个月。疗程结束后观察临床疗效。停药3个月后进行远期疗效观察。
研究结果：
1.两组治疗后总体疗效比较：试验组32例中,痊愈2例,显效14例,有效13例,无效3例,总有效率为90.63%；对照组31例中,痊愈2例,显效7例,有效12例,无效10例,总有效率为67.74%。经Wilcoxon秩和检验,两组比较有统计学差异(P<0.05)。说明试验组的总体临床疗效优于对照组。组内比较发现：除大便干燥、大便稀溏两组症状未见明显好转外(P>0.05),试验组与对照组对其它症状均有疗效(P<0.05)。经组间比较发现：试验组对胃胀、胃痛、胃中嘈杂及饮食减少的改善程度优于对照组,两组比较有统计学意义(P<0.05或P<0.01)。试验组胃胀、乏力症状的起效时间早于对照组,其余症状起效时间与对照组相当。
2.两组治疗后均复查胃镜,治疗后病理组织学疗效比较：试验组胃黏膜萎缩、肠上皮化生的总有效率分别为65.63%、68.75%,对照组分别为45.16%、48.39%,经统计学分析其差异均有统计学意义(P<0.05)。试验组炎症活动性及Hp感染的改善程度亦优于对照组(P<0.05),但异型增生及慢性炎症的疗效两组比较无明显统计学意义(P>0.05)。
3.停药3个月后随访两组临床疗效,试验组32例中,治愈5例,显效16例,有效9例,无效1例,总有效率96.88%；对照组31例中,治愈1例,显效10例,有效10例,无效10例,总有效率67.74%。经Wilcoxon秩和检验,两组比较有显著统计学差异(P<0.01),治疗组远期疗效明显优于对照组。
4.在观察过程中,两组均无明显不良反应。
研究结论：
健脾活血方治疗慢性萎缩性胃炎脾虚血瘀证有较好的临床疗效,能够改善患者的临床症状及病理表现,并具有良好的安全性。
Objective:
To observe the clinical effect and safety by using the method of JianPiHuoXue prescription in treating Chronic Atrophic Gastritis with Spleen deficiency and Blood stasis Syndrome. And observe the long-term curative effect after following up for3months.
Methods:
This research was based on63cases of outpatients who were conformed to inclusion criteria. They were randomly divided into two groups. One group was the treatment group,32patients of which were treated by JianPiHuoXue prescription. The other group was the control group, with31patients being treated WeiFuChun. Both groups were treated for three months. Then we can observe the clinical effect when the course was finished. Long-term observation would be carry on after stop using treatment for three months.
Result:
1.The overall curative effect comparison of two groups after the treatment:In the test group,2cases recovered and14cases significantly improved,13cases improved,3ineffectual cases. The total effective rate of test group was90.63%. In the control group,2cases recovered and7cases significantly improved,12cases improved,10ineffectual cases. The total effective rate of control group was67.74%. There was statistically significant difference in the total effective rate between the treatment group and control guoup(P<0.05). The effective rate from the test group was clearly superior.Comparison within groups found:Excepting diarrhoea and astriction were of no avail(P>0.05), the two groups both had curative effect to the other syndromes(P<0.05). Comparison among groups found:The test group has symptomatic improvement in stomach bloated,stomach pain.stomach noisy and diet reduction. The comparison of two groups had statistical significance(P<0.05or P<0.01). The time of test group on alleviating stomach bloated and tired was shorter than the control group. Other syndromes had curative effect almost in the same time of the two groups.
2.The two groups both reexamined the gastrofiberscope, and the comparison of curative effect of two groups of histopathology after the treatment found:The total efficiency of gastric atrophy,intestinal metaplasia of two groups was65.63%and68.75%respectively,while the control group was45.16%and48.39%respectively. The comparison of two groups had statistical significance(P<0.05).The improvement rate of inflammatory activity and H.pylori infection of test group was also better than the control group(P<0.05). But dysplasia and chronic inflammation curative effect between the two groups had no obvious statistical significance(P>0.05).
3.After three months of untreatment,5cases recovered,16cases significantly improved,9cases improved and1ineffectual cases in the test group. The total effective rate of test group was96.88%. In the control group,1cases recovered,10cases significantly improved,10cases improved and10ineffectual cases. The total effective rate of control group was67.74%. There was statistically significant difference in the total effective rate between the treatment group and control guoup(P<0.01).The long-term clinical efficacy of the test group was better than the control group.
4.In the observation, the two groups both didn't find significant adverse reaction.
Conclusion:JianPiHuoXue prescription has significant efficacy in treating Chronic Atrophic Gastritis with Spleen deficiency and Blood stasis Syndrome.The prescription can improve clinical symptoms and pathology, besides it also has good security.
通过随机、对照的临床试验,观察健脾活血法治疗慢性萎缩性胃炎脾虚血瘀证的临床疗效、安全性及随访3个月的远期疗效。
研究方法：
选取符合纳入标准的患者63例,随机分为试验组32例,对照组31例。试验组患者口服健脾活血方,对照组服用胃复春片,疗程均为3个月。疗程结束后观察临床疗效。停药3个月后进行远期疗效观察。
研究结果：
1.两组治疗后总体疗效比较：试验组32例中,痊愈2例,显效14例,有效13例,无效3例,总有效率为90.63%；对照组31例中,痊愈2例,显效7例,有效12例,无效10例,总有效率为67.74%。经Wilcoxon秩和检验,两组比较有统计学差异(P<0.05)。说明试验组的总体临床疗效优于对照组。组内比较发现：除大便干燥、大便稀溏两组症状未见明显好转外(P>0.05),试验组与对照组对其它症状均有疗效(P<0.05)。经组间比较发现：试验组对胃胀、胃痛、胃中嘈杂及饮食减少的改善程度优于对照组,两组比较有统计学意义(P<0.05或P<0.01)。试验组胃胀、乏力症状的起效时间早于对照组,其余症状起效时间与对照组相当。
2.两组治疗后均复查胃镜,治疗后病理组织学疗效比较：试验组胃黏膜萎缩、肠上皮化生的总有效率分别为65.63%、68.75%,对照组分别为45.16%、48.39%,经统计学分析其差异均有统计学意义(P<0.05)。试验组炎症活动性及Hp感染的改善程度亦优于对照组(P<0.05),但异型增生及慢性炎症的疗效两组比较无明显统计学意义(P>0.05)。
3.停药3个月后随访两组临床疗效,试验组32例中,治愈5例,显效16例,有效9例,无效1例,总有效率96.88%；对照组31例中,治愈1例,显效10例,有效10例,无效10例,总有效率67.74%。经Wilcoxon秩和检验,两组比较有显著统计学差异(P<0.01),治疗组远期疗效明显优于对照组。
4.在观察过程中,两组均无明显不良反应。
研究结论：
健脾活血方治疗慢性萎缩性胃炎脾虚血瘀证有较好的临床疗效,能够改善患者的临床症状及病理表现,并具有良好的安全性。
Objective:
To observe the clinical effect and safety by using the method of JianPiHuoXue prescription in treating Chronic Atrophic Gastritis with Spleen deficiency and Blood stasis Syndrome. And observe the long-term curative effect after following up for3months.
Methods:
This research was based on63cases of outpatients who were conformed to inclusion criteria. They were randomly divided into two groups. One group was the treatment group,32patients of which were treated by JianPiHuoXue prescription. The other group was the control group, with31patients being treated WeiFuChun. Both groups were treated for three months. Then we can observe the clinical effect when the course was finished. Long-term observation would be carry on after stop using treatment for three months.
Result:
1.The overall curative effect comparison of two groups after the treatment:In the test group,2cases recovered and14cases significantly improved,13cases improved,3ineffectual cases. The total effective rate of test group was90.63%. In the control group,2cases recovered and7cases significantly improved,12cases improved,10ineffectual cases. The total effective rate of control group was67.74%. There was statistically significant difference in the total effective rate between the treatment group and control guoup(P<0.05). The effective rate from the test group was clearly superior.Comparison within groups found:Excepting diarrhoea and astriction were of no avail(P>0.05), the two groups both had curative effect to the other syndromes(P<0.05). Comparison among groups found:The test group has symptomatic improvement in stomach bloated,stomach pain.stomach noisy and diet reduction. The comparison of two groups had statistical significance(P<0.05or P<0.01). The time of test group on alleviating stomach bloated and tired was shorter than the control group. Other syndromes had curative effect almost in the same time of the two groups.
2.The two groups both reexamined the gastrofiberscope, and the comparison of curative effect of two groups of histopathology after the treatment found:The total efficiency of gastric atrophy,intestinal metaplasia of two groups was65.63%and68.75%respectively,while the control group was45.16%and48.39%respectively. The comparison of two groups had statistical significance(P<0.05).The improvement rate of inflammatory activity and H.pylori infection of test group was also better than the control group(P<0.05). But dysplasia and chronic inflammation curative effect between the two groups had no obvious statistical significance(P>0.05).
3.After three months of untreatment,5cases recovered,16cases significantly improved,9cases improved and1ineffectual cases in the test group. The total effective rate of test group was96.88%. In the control group,1cases recovered,10cases significantly improved,10cases improved and10ineffectual cases. The total effective rate of control group was67.74%. There was statistically significant difference in the total effective rate between the treatment group and control guoup(P<0.01).The long-term clinical efficacy of the test group was better than the control group.
4.In the observation, the two groups both didn't find significant adverse reaction.
Conclusion:JianPiHuoXue prescription has significant efficacy in treating Chronic Atrophic Gastritis with Spleen deficiency and Blood stasis Syndrome.The prescription can improve clinical symptoms and pathology, besides it also has good security.
引文
[1]RUGGE M, CORREA P, DIXON M F, et al. Gastric mucosal atrophy; interobserver consistency using new criteria for classification and grading[J]. Aliment Pharmacol Ther,2002,16; 1249-1259.
[2]Kuipers EJ, Klinkenberg-Knol EC, Vandenbroucke-Grauls CM, Appelmelk BJ, Schenk BE, Meuwissen SG. Role of Helicobacter pylori in the pathogenesis of atrophic gastritis. Scand J Gastroenterol Suppl,1997, 223:28-34.
[3]中华中医药学会脾胃病分会.慢性萎缩性胃炎中医诊疗共识意见(2009,深圳)[C].中国中西医结合消化杂志,2010,18(5)：345～349.
[4]马然.慢性萎缩性胃炎中医证候学研究[D].北京中医药大学,2005.
[5]刘赓.唐旭东辨证治疗慢性萎缩性胃炎经验体会[J].辽宁中医杂志,2009,36(5)：734～736.
[6]许红艳.姜树民教授治疗慢性萎缩性胃炎经验[J].辽宁中医药大学学报,2010,12(12)：148～149.
[7]周晓燕.李守朝治疗慢性萎缩性胃炎的经验[J].江苏中医药,2011,43(1)：14～15.
[8]张声生.中医治疗慢性萎缩性胃炎及胃癌前病变的思路[J].江苏中医药,2007,39(8)：3-4.
[9]王冠华,严志林.王少华教授治疗慢性萎缩性胃炎经验简介[J].新中医,2011,43(6)：155-156.
[10]王顺德.郑邦本从气阴两虚分型论治慢性萎缩性胃炎经验[J].现代中西医结合杂志,2011,20(24)：3071.
[11]黎进荣,吕学武.辨证治疗慢性萎缩性胃炎36例临床观察[J].辽宁中医杂志,2005,32(2)：117～118.
[12]孙世常.辨证治疗慢性萎缩性胃炎268例[J].河南中医,2011,31(5)：516～517.
[13]柯莹玲,单兆伟.542例慢性萎缩性胃炎患者中医辨证分型与病因分析[J].辽宁中医杂志,2006,33(2)：161-162.
[14]韩文功.辨证治疗慢性萎缩性胃炎65例[J].实用中医内科杂志,2008,22(6)：77.
[15]蒋永光,王黎民,肖金等.成方配伍治疗慢性萎缩性胃炎疗效观察[J].辽宁中医杂志,2005,32(1)：15-16.
[16]魏道祥.辨证分型治疗慢性萎缩性胃炎1276例[J].山东中医杂志,2003,22(11)：673～674.
[17]牛清华.慢性萎缩性胃炎的分型论证[J].光明中医,2008,23(3)：352.
[18]尹丽华.辨证论治慢性萎缩性胃炎52例[J].陕西中医,2011,32(11)：1477～1478.
[19]陈良金.慢性萎缩性胃炎辨证分型与治法特点探析[J].时珍国医国药,2005,16(11)：1149.
[20]易平钰,朱方石.慢性萎缩性胃炎中医治法分布及方剂运用规律[J].世界华人消化杂志,2011,19(36)：3696～3699.
[21]谭娟,曹阳剑.活络效灵丹加味治疗慢性萎缩性胃炎疗效观察[J].中医临床研究,2011,3(22)：56～57.
[22]王恺.枳实消痞丸合失笑散加减治疗慢性萎缩性胃炎81例[J].中国实验方剂杂志,2011,17(17)：259～260.
[23]王斌强,陈清素.豆蔻苓砂汤加味治疗慢性萎缩性胃炎326例[J].实用中医内科杂志,2011,25(6)：67～68.
[24]侯全忠,张强,晏桂华.归芍六君汤合白头翁汤加减治疗慢性萎缩性胃炎60例临床观察[J].新中医,2011,43(7)：8-10.
[25]胡建军.芪参养胃汤治疗慢性萎缩性胃炎54例[J].实用中医内科杂志,2011,25(6)：74～75.
[26]王贺军,韩艳梅,史海霞等.胃康宁颗粒治疗慢性萎缩性胃炎癌前病变40例临床观察[J].中医杂志,2011,52(18)：1570～1572.
[27]吴莉佳,谢惠民,田锋亮等.益胃消瘀颗粒治疗慢性萎缩性胃炎30例[J].中国中西医结合消化杂志,2007,15(1)：57～58.
[28]路文军,孙成栋,于大猛.夏连杞贞胶囊治疗胃阴亏损型慢性萎缩性胃炎癌前病变临床研究[J].中国中西医结合消化杂志,2007,15(4)：224～230.
[29]李玉兰.针灸治疗慢性萎缩性胃炎35例[J].针灸临床杂志,2001,17(8)：16.
[30]杨瑞春,伦新.温针灸治疗萎缩性胃炎45例临床观察[J].新中医,2008,40(12)：68～70.
[31]陈菲,陈莆,张璇.黄芪注射液穴位注射治疗慢性萎缩性胃炎气虚血瘀证30例[J].陕西中医,2011,32(1)：12～14.
[32]古青.中药与针刺并用治疗慢性萎缩性胃炎临床研究[J].时珍国医国药,2008,19(9)：2292～2293.
[33]杨幼新,袁红霞,代二庆等.慢性萎缩性胃炎癌前病变中医证型与EGF、EGFR、THF-α表达的相关性初探[J].上海中医药杂志,2008,42(7)：5-7.
[34]Prelich G, Tan CK, Kostura M, et al. Functional identity of proliferating cell nuclear antigen and a DN A polymerase-delta auxiliary protein. Nature,1987,326 (6112):517-520.
[35]孙良华,李群,王树庆等.慢性萎缩性胃炎胃黏膜EGF、VEGF、PCNA与中医证型关系的研究[J].中国中西医结合杂志,2008,28(3)：225～228.
[36]Ninomiya I, Yonemura Y, Matsumoto H, et al. Expression of c-myc gene product in gastric carcinoma. Oncology,1991,48 (2):149-153.
[37]徐珊,王常松,周嘉鹤等.慢性萎缩性胃炎不同中医证型模型大鼠胃黏膜细胞增殖基因表达[J].中国中西医结合杂志,2007,27(11)：1004～1006.
[38]Rugge M, Di Mario F, Gassaro M, et al. Pathology of the gastric antrum and body associated with Helicobacter pylori infection in non-ulcerous patients:Is the bacterium a promoter of intestinal metaplasia? Histopathology,1993,22 (1):9.
[39]雷道年,虞积耀.肠上皮化生的类型及其与胃癌的关系.临床与实验病理学杂志,1985,4：37.
[40]Lauwers GY, Riddell RH. Gastric epithelial dysplasia. Gut,1999,45:784-790.
[41]Melanie N W, Hermann B. Prevalence of Chronic Atrophic Gastritis in diffreentparts of the world[J]. Cancer Epidemiol Biomarkers Prev,2006,15:1083-1094.
[42]Ferlay J, Bray F, Pisani P, et al. Globocan 2002:Cancer Incidence, Mortality and Prevalence Worldwide. IARC Cancer Base No 5 version 2.0. Lyon:IARC Press,2004.
[43]Laimas J, Audrius I, Dainius J, et al. Precancerous gastric conditions in high Helicobacter pylori prevalence areas:comparison between Eastern European (Lithuanian, Latvian) and Asian (Taiwanese) patients[J]. Medicina (Kaunas),2007,43:623-629.
[44]朱亮亮,田金徽,拜争刚等.胃复春治疗慢性萎缩性胃炎的系统评价[J].中国循证医学杂志,2009,9(1)：81～87.
[45]杨桂英,熊元治.青海地区慢性萎缩性胃炎流行病学特点研究[J].中国消化内镜,2009,3(2)：22～28.
[46]The Eurohepygast Study Grou. Risk factors for atrophic chronic gastritis in a European population.-results of the Eurohepygast study [J]. Gut,2002,50:779-785.
[47]Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer[J]. N Engl J Med,2001,345:784-789.
[48]Yokata S, Amano K, Fujii N. Comparison of serum antibody to Helicobacter pylori lipopolysaccharides, Cag A, Vac A and partially purified celluar extracts in a Japanese population[J]. Ferns Microbio Lett,2000, 185:193-198.
[49]Asaka M, Sugiyama T, Nobuta A, et al. Atrophic gastritis and intestinal metaplasia in Japan:results of a large muhicenter study[J]. Helicobacter,2001,6 (4):294-299.
[50]Molaei M, Foroughi F, Mashayekhi R, et al. Cag A status and Vac A subtypes of Helicobacter pylori in relation to histopathologic findings in Iranian population[J]. Indian J Pathol Microbiol,2010,53 (1):24-27.
[51]Gehmert S, Velapatino B, Herrera P, et al. Interleukin-1 beta single-nucleotide polymorphism's C allele is associated with elevated risk of gastric cancer in Helicobacter pylori-infectde Peruvians[J]. Am J Trop Med Hyg,2009,81 (5):804-810.
[52]Zhou L, Sung JJ, Lin S, et al. A five-year follow-up study on the pathological changes of gastric mucosa after H.pylori eradication[J]. Chin Med J,2003,116 (1):11-14.
[53]Lahner E, Bordi C, Cattaruzza MS, et al. Longterm follow-up in atrophic body gastritis patients:atrophy and intestinal metaplasia are persistent lesions irrespective of Helicobacter priori infection[J]. Aliment Pharmacol Ther,2005,22 (5):784-789.
[54]Nardone G, Rocco A, Malfertheiner P. Review article:Helicobacter pylori and molecular events in precancerous gastric lesions[J]. Aliment Pharmacol Ther,2004,20:261-270.
[55]Sanduleanu S, Hameeteman W, et al. Double infection of the stomach with hlicobacter pylori and non-Helicobacter pylori bacteria acause for the development of atrophic gastritis during acid-suppressive therapy[J]. European Journal of Gastroenterology and Hepatology,2001,13 (12):A1-A2.
[56]Hirano, Atsuyoshi, Yanai, et al. Evaluation of Epstein-Barr Virus DNA load in Gastric Mucosa with Chronic Atrophic Gastritis Using a Real-Time Quantitative PCR Assay[J]. International Journal of Gastrointestinal Cancer,2003,34 (2-3):87-94.
[57]Chisholm M:Immunoiogy of gastritis[J]. Clin Gastroenterol,1976,5:419.
[58]Hoedemaeker PT, Ito S. Ultrastructural localization of gastric parietal cell antigen with peroxidase-coupled antibody[J]. Lab Invest,1970,22:184.
[59]Johnnesson KA, Hammar E. Mucosal changes in the gastric remnant long-term effeets of biie reflux diversion and Helicobaeter pylori infeetion[J]. Eur J Gastroenteral Hepatal,2003,15:35-40.
[60]Green TJ, Venn BJ, Skeaff CM, etal. Serum Vitamine B12 concentrations and atrophic gastritis in older New Zealanders. Eur J Clin Nutr,2004,13:113-115.
[61]Sipponen P, Laxen F, Huotari Kharkonen M. Prevalence of low vitamin B12, folic acid and High Homocystwine in Serum in an Elderly Male Population:Association with Atrophic Gastritis and Hellicobacter pylori Infection[J]. Scandinavian Journal of Gastroenterology,2003,38 (12):1209-1216.
[62]Possible means of blocking the formation of carcinogeni N-nitrosocompounds[J]. Science,1992,177: 65-68.
[63]赵霞,潘华锋,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.
[64]Dzhula GS, Chemin VV, Iakovlev NA. Chronic gastritis:keys to understanding 调和 internal picture of the disease[J]. Eksp Klin Gastroenterol,2002,3(1):28-30,191.
[65]中华医学会消化病学分会幽门螺杆菌组/幽门螺杆菌科研协作组.第三次全国幽门螺杆菌若干问题共识报告(2007,庐山)[C].胃肠病学,2008,13(1)：42～46.
[66]Cheon JH, Kim N, Lee DH, et al. Efficacy of moxifloxacin-based triple therapy as second-line treatment for Helicobacter pylori infection. Helicobacter,2006,11 (1):46-51.
[67]Megraud F. Update on therapeutic options for Helicobacter pylori-related diseases. Curr Infect Dis Rep, 2005,7 (2):115-120.
[68]Jacob RA, Folate DAN methylation and gene expression:factors of nature and nurture[J].AM J Cline NUTR,2000,72:903-904.
[69]中华医学会消化病学分会.中国慢性胃炎共识意见(2006,上海)[C].胃肠病学,2006,11(11)：674-684.
[70]黎明.太子参的药理研究及临床应用[J].亚太传统医药,2010,6(6)：35～36.
[71]李志华.太子参多糖对东莨菪碱所致小鼠记忆障碍的改善作用[J].泰山医学院学报,2009,30(19)：673.
[72]宿廷敏,王敏娟,阮时宝.白术的化学成分及药理作用研究概述[J].贵阳学院学报,2008,3(2)：32～35.
[73]周进,吴正祥,杨九华等.白芍总苷对TNBS诱导的大鼠实验性结肠炎的影响[J].胃肠病学,2009,14(3)：154～158.
[74]刘晓梅.薏苡仁的药理研究与临床新用[J].中国医药指南,2010,8(2)：36～37.
[75]欧立娟,刘启德.陈皮药理作用研究进展[J].中国药房,2006,17(10)：787～789.
[76]于辉,李春香,甘庆贤.陈皮的药理作用[J].生物磁学,2005,5(1)：44～45.
[77]叶建红,江建国.对药陈皮半夏的药理作用与临床运用体会[J].光明中医,2003,18(104)：52.
[78]范俊,张旭.麦冬多糖药理研究进展[J].中医药学刊,2006,24(4)：626～627.
[79]刘榴,张白嘉.麦冬及有效部位药理作用研究进展[J].四川中医,2010,28(12)：39～41.
[80]成晓静,刘华钢,赖茂祥.莪术的化学成分及药理作用研究概况[J].广西中医学院学报,2007,10(1)：79～82.
[81]洪阁,戴永红,刘培勋等.仙鹤草化学成分和药理作用研究进展[J].药学服务与研究,2008,8(5)：362～366.
[82]吴琳华,郭劲柏,刘红梅等.仙鹤草注射液对人癌细胞生长抑制作用的研究[J].中国中医药科技,2005,12(5)：297～298.
[83]刘丹丹,戴娜,范婧莹.白花蛇舌草抗肿瘤药理研究[J].中医药导报,2009,15(9)：64～67.
[84]赵阳.白花蛇舌草抗肿瘤作用研究进展[J].山东中医杂志,2009,28(7)：517～519.
[85]王晓飞,周金影,金向群等.麦芽的药理研究及临床应用[J].中成药,2007,29(11)：1677～1679.
[2]Kuipers EJ, Klinkenberg-Knol EC, Vandenbroucke-Grauls CM, Appelmelk BJ, Schenk BE, Meuwissen SG. Role of Helicobacter pylori in the pathogenesis of atrophic gastritis. Scand J Gastroenterol Suppl,1997, 223:28-34.
[3]中华中医药学会脾胃病分会.慢性萎缩性胃炎中医诊疗共识意见(2009,深圳)[C].中国中西医结合消化杂志,2010,18(5)：345～349.
[4]马然.慢性萎缩性胃炎中医证候学研究[D].北京中医药大学,2005.
[5]刘赓.唐旭东辨证治疗慢性萎缩性胃炎经验体会[J].辽宁中医杂志,2009,36(5)：734～736.
[6]许红艳.姜树民教授治疗慢性萎缩性胃炎经验[J].辽宁中医药大学学报,2010,12(12)：148～149.
[7]周晓燕.李守朝治疗慢性萎缩性胃炎的经验[J].江苏中医药,2011,43(1)：14～15.
[8]张声生.中医治疗慢性萎缩性胃炎及胃癌前病变的思路[J].江苏中医药,2007,39(8)：3-4.
[9]王冠华,严志林.王少华教授治疗慢性萎缩性胃炎经验简介[J].新中医,2011,43(6)：155-156.
[10]王顺德.郑邦本从气阴两虚分型论治慢性萎缩性胃炎经验[J].现代中西医结合杂志,2011,20(24)：3071.
[11]黎进荣,吕学武.辨证治疗慢性萎缩性胃炎36例临床观察[J].辽宁中医杂志,2005,32(2)：117～118.
[12]孙世常.辨证治疗慢性萎缩性胃炎268例[J].河南中医,2011,31(5)：516～517.
[13]柯莹玲,单兆伟.542例慢性萎缩性胃炎患者中医辨证分型与病因分析[J].辽宁中医杂志,2006,33(2)：161-162.
[14]韩文功.辨证治疗慢性萎缩性胃炎65例[J].实用中医内科杂志,2008,22(6)：77.
[15]蒋永光,王黎民,肖金等.成方配伍治疗慢性萎缩性胃炎疗效观察[J].辽宁中医杂志,2005,32(1)：15-16.
[16]魏道祥.辨证分型治疗慢性萎缩性胃炎1276例[J].山东中医杂志,2003,22(11)：673～674.
[17]牛清华.慢性萎缩性胃炎的分型论证[J].光明中医,2008,23(3)：352.
[18]尹丽华.辨证论治慢性萎缩性胃炎52例[J].陕西中医,2011,32(11)：1477～1478.
[19]陈良金.慢性萎缩性胃炎辨证分型与治法特点探析[J].时珍国医国药,2005,16(11)：1149.
[20]易平钰,朱方石.慢性萎缩性胃炎中医治法分布及方剂运用规律[J].世界华人消化杂志,2011,19(36)：3696～3699.
[21]谭娟,曹阳剑.活络效灵丹加味治疗慢性萎缩性胃炎疗效观察[J].中医临床研究,2011,3(22)：56～57.
[22]王恺.枳实消痞丸合失笑散加减治疗慢性萎缩性胃炎81例[J].中国实验方剂杂志,2011,17(17)：259～260.
[23]王斌强,陈清素.豆蔻苓砂汤加味治疗慢性萎缩性胃炎326例[J].实用中医内科杂志,2011,25(6)：67～68.
[24]侯全忠,张强,晏桂华.归芍六君汤合白头翁汤加减治疗慢性萎缩性胃炎60例临床观察[J].新中医,2011,43(7)：8-10.
[25]胡建军.芪参养胃汤治疗慢性萎缩性胃炎54例[J].实用中医内科杂志,2011,25(6)：74～75.
[26]王贺军,韩艳梅,史海霞等.胃康宁颗粒治疗慢性萎缩性胃炎癌前病变40例临床观察[J].中医杂志,2011,52(18)：1570～1572.
[27]吴莉佳,谢惠民,田锋亮等.益胃消瘀颗粒治疗慢性萎缩性胃炎30例[J].中国中西医结合消化杂志,2007,15(1)：57～58.
[28]路文军,孙成栋,于大猛.夏连杞贞胶囊治疗胃阴亏损型慢性萎缩性胃炎癌前病变临床研究[J].中国中西医结合消化杂志,2007,15(4)：224～230.
[29]李玉兰.针灸治疗慢性萎缩性胃炎35例[J].针灸临床杂志,2001,17(8)：16.
[30]杨瑞春,伦新.温针灸治疗萎缩性胃炎45例临床观察[J].新中医,2008,40(12)：68～70.
[31]陈菲,陈莆,张璇.黄芪注射液穴位注射治疗慢性萎缩性胃炎气虚血瘀证30例[J].陕西中医,2011,32(1)：12～14.
[32]古青.中药与针刺并用治疗慢性萎缩性胃炎临床研究[J].时珍国医国药,2008,19(9)：2292～2293.
[33]杨幼新,袁红霞,代二庆等.慢性萎缩性胃炎癌前病变中医证型与EGF、EGFR、THF-α表达的相关性初探[J].上海中医药杂志,2008,42(7)：5-7.
[34]Prelich G, Tan CK, Kostura M, et al. Functional identity of proliferating cell nuclear antigen and a DN A polymerase-delta auxiliary protein. Nature,1987,326 (6112):517-520.
[35]孙良华,李群,王树庆等.慢性萎缩性胃炎胃黏膜EGF、VEGF、PCNA与中医证型关系的研究[J].中国中西医结合杂志,2008,28(3)：225～228.
[36]Ninomiya I, Yonemura Y, Matsumoto H, et al. Expression of c-myc gene product in gastric carcinoma. Oncology,1991,48 (2):149-153.
[37]徐珊,王常松,周嘉鹤等.慢性萎缩性胃炎不同中医证型模型大鼠胃黏膜细胞增殖基因表达[J].中国中西医结合杂志,2007,27(11)：1004～1006.
[38]Rugge M, Di Mario F, Gassaro M, et al. Pathology of the gastric antrum and body associated with Helicobacter pylori infection in non-ulcerous patients:Is the bacterium a promoter of intestinal metaplasia? Histopathology,1993,22 (1):9.
[39]雷道年,虞积耀.肠上皮化生的类型及其与胃癌的关系.临床与实验病理学杂志,1985,4：37.
[40]Lauwers GY, Riddell RH. Gastric epithelial dysplasia. Gut,1999,45:784-790.
[41]Melanie N W, Hermann B. Prevalence of Chronic Atrophic Gastritis in diffreentparts of the world[J]. Cancer Epidemiol Biomarkers Prev,2006,15:1083-1094.
[42]Ferlay J, Bray F, Pisani P, et al. Globocan 2002:Cancer Incidence, Mortality and Prevalence Worldwide. IARC Cancer Base No 5 version 2.0. Lyon:IARC Press,2004.
[43]Laimas J, Audrius I, Dainius J, et al. Precancerous gastric conditions in high Helicobacter pylori prevalence areas:comparison between Eastern European (Lithuanian, Latvian) and Asian (Taiwanese) patients[J]. Medicina (Kaunas),2007,43:623-629.
[44]朱亮亮,田金徽,拜争刚等.胃复春治疗慢性萎缩性胃炎的系统评价[J].中国循证医学杂志,2009,9(1)：81～87.
[45]杨桂英,熊元治.青海地区慢性萎缩性胃炎流行病学特点研究[J].中国消化内镜,2009,3(2)：22～28.
[46]The Eurohepygast Study Grou. Risk factors for atrophic chronic gastritis in a European population.-results of the Eurohepygast study [J]. Gut,2002,50:779-785.
[47]Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer[J]. N Engl J Med,2001,345:784-789.
[48]Yokata S, Amano K, Fujii N. Comparison of serum antibody to Helicobacter pylori lipopolysaccharides, Cag A, Vac A and partially purified celluar extracts in a Japanese population[J]. Ferns Microbio Lett,2000, 185:193-198.
[49]Asaka M, Sugiyama T, Nobuta A, et al. Atrophic gastritis and intestinal metaplasia in Japan:results of a large muhicenter study[J]. Helicobacter,2001,6 (4):294-299.
[50]Molaei M, Foroughi F, Mashayekhi R, et al. Cag A status and Vac A subtypes of Helicobacter pylori in relation to histopathologic findings in Iranian population[J]. Indian J Pathol Microbiol,2010,53 (1):24-27.
[51]Gehmert S, Velapatino B, Herrera P, et al. Interleukin-1 beta single-nucleotide polymorphism's C allele is associated with elevated risk of gastric cancer in Helicobacter pylori-infectde Peruvians[J]. Am J Trop Med Hyg,2009,81 (5):804-810.
[52]Zhou L, Sung JJ, Lin S, et al. A five-year follow-up study on the pathological changes of gastric mucosa after H.pylori eradication[J]. Chin Med J,2003,116 (1):11-14.
[53]Lahner E, Bordi C, Cattaruzza MS, et al. Longterm follow-up in atrophic body gastritis patients:atrophy and intestinal metaplasia are persistent lesions irrespective of Helicobacter priori infection[J]. Aliment Pharmacol Ther,2005,22 (5):784-789.
[54]Nardone G, Rocco A, Malfertheiner P. Review article:Helicobacter pylori and molecular events in precancerous gastric lesions[J]. Aliment Pharmacol Ther,2004,20:261-270.
[55]Sanduleanu S, Hameeteman W, et al. Double infection of the stomach with hlicobacter pylori and non-Helicobacter pylori bacteria acause for the development of atrophic gastritis during acid-suppressive therapy[J]. European Journal of Gastroenterology and Hepatology,2001,13 (12):A1-A2.
[56]Hirano, Atsuyoshi, Yanai, et al. Evaluation of Epstein-Barr Virus DNA load in Gastric Mucosa with Chronic Atrophic Gastritis Using a Real-Time Quantitative PCR Assay[J]. International Journal of Gastrointestinal Cancer,2003,34 (2-3):87-94.
[57]Chisholm M:Immunoiogy of gastritis[J]. Clin Gastroenterol,1976,5:419.
[58]Hoedemaeker PT, Ito S. Ultrastructural localization of gastric parietal cell antigen with peroxidase-coupled antibody[J]. Lab Invest,1970,22:184.
[59]Johnnesson KA, Hammar E. Mucosal changes in the gastric remnant long-term effeets of biie reflux diversion and Helicobaeter pylori infeetion[J]. Eur J Gastroenteral Hepatal,2003,15:35-40.
[60]Green TJ, Venn BJ, Skeaff CM, etal. Serum Vitamine B12 concentrations and atrophic gastritis in older New Zealanders. Eur J Clin Nutr,2004,13:113-115.
[61]Sipponen P, Laxen F, Huotari Kharkonen M. Prevalence of low vitamin B12, folic acid and High Homocystwine in Serum in an Elderly Male Population:Association with Atrophic Gastritis and Hellicobacter pylori Infection[J]. Scandinavian Journal of Gastroenterology,2003,38 (12):1209-1216.
[62]Possible means of blocking the formation of carcinogeni N-nitrosocompounds[J]. Science,1992,177: 65-68.
[63]赵霞,潘华锋,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.
[64]Dzhula GS, Chemin VV, Iakovlev NA. Chronic gastritis:keys to understanding 调和 internal picture of the disease[J]. Eksp Klin Gastroenterol,2002,3(1):28-30,191.
[65]中华医学会消化病学分会幽门螺杆菌组/幽门螺杆菌科研协作组.第三次全国幽门螺杆菌若干问题共识报告(2007,庐山)[C].胃肠病学,2008,13(1)：42～46.
[66]Cheon JH, Kim N, Lee DH, et al. Efficacy of moxifloxacin-based triple therapy as second-line treatment for Helicobacter pylori infection. Helicobacter,2006,11 (1):46-51.
[67]Megraud F. Update on therapeutic options for Helicobacter pylori-related diseases. Curr Infect Dis Rep, 2005,7 (2):115-120.
[68]Jacob RA, Folate DAN methylation and gene expression:factors of nature and nurture[J].AM J Cline NUTR,2000,72:903-904.
[69]中华医学会消化病学分会.中国慢性胃炎共识意见(2006,上海)[C].胃肠病学,2006,11(11)：674-684.
[70]黎明.太子参的药理研究及临床应用[J].亚太传统医药,2010,6(6)：35～36.
[71]李志华.太子参多糖对东莨菪碱所致小鼠记忆障碍的改善作用[J].泰山医学院学报,2009,30(19)：673.
[72]宿廷敏,王敏娟,阮时宝.白术的化学成分及药理作用研究概述[J].贵阳学院学报,2008,3(2)：32～35.
[73]周进,吴正祥,杨九华等.白芍总苷对TNBS诱导的大鼠实验性结肠炎的影响[J].胃肠病学,2009,14(3)：154～158.
[74]刘晓梅.薏苡仁的药理研究与临床新用[J].中国医药指南,2010,8(2)：36～37.
[75]欧立娟,刘启德.陈皮药理作用研究进展[J].中国药房,2006,17(10)：787～789.
[76]于辉,李春香,甘庆贤.陈皮的药理作用[J].生物磁学,2005,5(1)：44～45.
[77]叶建红,江建国.对药陈皮半夏的药理作用与临床运用体会[J].光明中医,2003,18(104)：52.
[78]范俊,张旭.麦冬多糖药理研究进展[J].中医药学刊,2006,24(4)：626～627.
[79]刘榴,张白嘉.麦冬及有效部位药理作用研究进展[J].四川中医,2010,28(12)：39～41.
[80]成晓静,刘华钢,赖茂祥.莪术的化学成分及药理作用研究概况[J].广西中医学院学报,2007,10(1)：79～82.
[81]洪阁,戴永红,刘培勋等.仙鹤草化学成分和药理作用研究进展[J].药学服务与研究,2008,8(5)：362～366.
[82]吴琳华,郭劲柏,刘红梅等.仙鹤草注射液对人癌细胞生长抑制作用的研究[J].中国中医药科技,2005,12(5)：297～298.
[83]刘丹丹,戴娜,范婧莹.白花蛇舌草抗肿瘤药理研究[J].中医药导报,2009,15(9)：64～67.
[84]赵阳.白花蛇舌草抗肿瘤作用研究进展[J].山东中医杂志,2009,28(7)：517～519.
[85]王晓飞,周金影,金向群等.麦芽的药理研究及临床应用[J].中成药,2007,29(11)：1677～1679.