目的 观察中药复方益胃化瘀散对胃癌前病变的治疗效果及辅助性I型T细胞(Th1)/辅助性II型T细胞(Th2)细胞因子在治疗前后的表达情况。方法 将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型的患者100例, 随机分为治疗组50例, 予益胃化瘀散治疗;对照组50例, 给予替普瑞酮胶囊和叶酸片治疗。两组疗程均为3个月。结果 两组患者治疗后临床症候积分均较治疗前降低(P < 0.05), 且治疗组改善优于对照组(P < 0.05)。两组患者治疗后胃黏膜病理积分均较治疗前改善(P < 0.05), 且治疗组改善更明显(P < 0.05)。两组患者治疗后Th1［白细胞介素-2(IL-2)、γ干扰素(INF-γ)］的水平较治疗前明显升高, 治疗组与对照组治疗后差异显著(P < 0.05);两组患者治疗后Th2(IL-4、IL-6)的水平较治疗前明显降低, 治疗组与对照组治疗后差异显著(P < 0.05)。结论 益胃化瘀散对胃癌前病变有一定的治疗作用, 并通过对细胞因子表达的特异性调控来干预调节免疫漂移, 从而阻断或逆转胃癌前病变的发展。

Objective To observe the curative effect of Yiwei Huayu Powder (YHP) and the expression of Th1/Th2 cytokines in patients with precancerous lesions of gastric cancer (PLGC). Methods There were 100 diagnosed chronic atrophic gastritis (CAG) with gastric mucous membrane dysplasia (Dys) and/or intestinal metaplasia (IM) patients who were randomly divided into treatment group (50 cases) and control group (50 cases). The patients in the treatment group were administrated with YHP for three months, while the other one with Teprenone Capsules and folic acid. Results Compared with the control group, the symptom scores of the patients in the treatment group decreased more obviously (P < 0.05). Compared with the control group, the pathological scores of the patients in the treatment group decreased more obviously (P < 0.05). After the treatment, the expression of the Th1 (IL-2, INF-γ) level escalated and the Th2 (IL-4, IL-6) level decreased in the treatment group, which existed an obvious difference compared to the control group (P < 0.05). Conclusion YHP has played a therapeutic effect in patients with PLGC through intervening immune drift and inducing tumor cell apoptosis, thereby blocking or reversing the development of PLGC.

金华市社会发展类重点科技项目(2013-3-007)