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慢性萎缩性胃炎的临床治疗研究进展
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Abstract:
慢性萎缩性胃炎(chronic atrophic gastritis, CAG)是消化系统的常见病，属于胃癌的癌前状态。目前临床上以病因治疗和改善症状为主，尚无疗效确切的药物，且长期的西药治疗存在费用昂贵、易复发、不良反应多等问题。近年来围绕整体观念和辩证论治为特点的民族医药方面的研究越来越多，在CAG的治疗中逐渐展现出巨大的优势。现就近年来关于临床医学、中医、蒙医、藏医在CAG治疗方面的研究进展进行总结和探讨，以期为CAG的临床治疗找到新思路。
Chronic atrophic gastritis (CAG) is a common disease of the digestive system, which belongs to the precancerous state of gastric cancer. At present, the main clinical treatment is etiological treatment and improvement of symptoms, and there is no drug with exact efficacy, and long-term western medicine treatment has problems such as expensive, easy to relapse, and many adverse reactions. In recent years, there has been more and more research on ethnic medicine, which is characterized by holistic concept and dialectical treatment, and has shown great advantages in the treatment of CAG. The research progress of CAG in clinical medicine, traditional Chinese medicine, Mongolian medicine and Tibetan medicine in recent years was summarized and discussed in order to find new ideas for the clinical treatment of CAG.
| [1] | Hwang, Y.J., Choi, Y., Kim, N., Lee, H.S., Yoon, H., Shin, C.M., et al. (2021) The Difference of Endoscopic and Histologic Improvements of Atrophic Gastritis and Intestinal Metaplasia after Helicobacter pylori Eradication. Digestive Diseases and Sciences, 67, 3055-3066. https://doi.org/10.1007/s10620-021-07146-4 |
| [2] | Hwang, Y.-J., Kim, N., Lee, H.S., Lee, J.B., Choi, Y.J., Yoon, H., et al. (2017) Reversibility of Atrophic Gastritis and Intestinal Metaplasia after Helicobacter pylori Eradication—A Prospective Study for up to 10 Years. Alimentary Pharmacology & Therapeutics, 47, 380-390. https://doi.org/10.1111/apt.14424 |
| [3] | Mahmoud, A., Abuelazm, M., Ahmed, A.A.S., Abdalshafy, H., Abdelazeem, B. and Brašić, J.R. (2022) Efficacy and Safety of Polaprezinc-Based Therapy versus the Standard Triple Therapy for Helicobacter pylori Eradication: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients, 14, Article No. 4126. https://doi.org/10.3390/nu14194126 |
| [4] | 雷晓毅, 章金艳, 吴婷娜, 等. 含艾司美拉唑、阿莫西林2种方案根除幽门螺旋杆菌相关慢性胃炎患者疗效和安全性评价[J]. 中国医院药学杂志, 2020, 40(4): 427-431. |
| [5] | 邵俏俏, 马菁, 余雪纯, 等. 雷贝拉唑联合阿莫西林或呋喃唑酮二联疗法根除幽门螺杆菌感染的临床疗效研究[J]. 中国全科医学, 2022, 25(29): 3640-3645. |
| [6] | Qian, H., Li, W., Dang, Y., Li, L., Xu, X., Yuan, L., et al. (2022) Ten-Day Vonoprazan-Amoxicillin Dual Therapy as a First-Line Treatment of Helicobacter pylori Infection Compared with Bismuth-Containing Quadruple Therapy. American Journal of Gastroenterology, 118, 627-634. https://doi.org/10.14309/ajg.0000000000002086 |
| [7] | 王先令, 周国强, 林琳, 等. 伏诺拉生联合阿莫西林、克拉霉素三联七日疗法根除幽门螺杆菌的临床研究[J]. 实用医学杂志, 2022, 38(10): 1271-1275. |
| [8] | Kiyotoki, S., Nishikawa, J. and Sakaida, I. (2020) Efficacy of Vonoprazan for Helicobacter pylori Eradication. Internal Medicine, 59, 153-161. https://doi.org/10.2169/internalmedicine.2521-18 |
| [9] | Zhang, Y., Suo, B., Tian, X., Zhang, H., Lu, H., Yao, X., et al. (2023) New Regimens as First-Line Eradication Therapy for Helicobacter pylori Infection in Patients Allergic to Penicillin: A Randomized Controlled Trial. Helicobacter, 28, e12956. https://doi.org/10.1111/hel.12956 |
| [10] | 周羽翙, 郑欣晔, 叶梦思, 等. 益生菌辅助含铋剂四联疗法根除幽门螺杆菌的临床研究[J]. 中国现代医学杂志, 2021, 31(1): 68-73. |
| [11] | Moreno Márquez, C., Fernández Álvarez, P., Valdés Delgado, T., Castro Laria, L., Argüelles Arias, F., Caunedo Álvarez, A., et al. (2021) Randomized, Double-Blind, Placebo-Controlled Clinical Trial on the Usefulness of Probiotic Lactobacillus reuteri in Bismuth-Containing Quadruple Eradication Therapy for Infection with Helicobacter pylori. Revista Española de Enfermedades Digestivas, 114, 89-95. https://doi.org/10.17235/reed.2021.7931/2021 |
| [12] | 何邦立, 林亚发, 符名勇, 等. 替普瑞酮联合西尼必利对慢性萎缩性胃炎的疗效及胃肠激素的影响[J]. 中国药业, 2022, 31(23): 99-102. |
| [13] | 裘力锋, 赵岚, 方燕飞, 等. 应用定标活组织检查评价替普瑞酮联合叶酸治疗慢性萎缩性胃炎的疗效[J]. 中华消化杂志, 2013, 33(4): 231-234. |
| [14] | Lee, J.S., Jeon, S.W., Lee, H.S., Kwon, Y.H., Nam, S.Y., Bae, H.I., et al. (2021) Rebamipide for the Improvement of Gastric Atrophy and Intestinal Metaplasia: A Prospective, Randomized, Pilot Study. Digestive Diseases and Sciences, 67, 2395-2402. https://doi.org/10.1007/s10620-021-07038-7 |
| [15] | 张路遥, 刘洁, 聂燕, 等. 羔羊胃提取物维B12胶囊治疗240例慢性萎缩性胃炎的疗效分析[J]. 中华消化杂志, 2021, 41(Z1): 33-40. |
| [16] | 刘洁, 张剑, 韩川, 薛鲜敏, 等. 羔羊胃提取物维B12胶囊治疗慢性萎缩性胃炎伴肠化生的病理效果及其影响因素[J]. 胃肠病学, 2020, 25(2): 90-95. |
| [17] | 叶剑飞, 林英. 叶酸联合维生素B12对HP阴性慢性萎缩性胃炎患者临床症状及组织学变化的影响研究[J]. 湖南师范大学学报(医学版), 2019, 16(5): 44-47. |
| [18] | Toh, J.W.T. and Wilson, R.B. (2020) Pathways of Gastric Carcinogenesis, Helicobacter pylori Virulence and Interactions with Antioxidant Systems, Vitamin C and Phytochemicals. International Journal of Molecular Sciences, 21, Article No. 6451. https://doi.org/10.3390/ijms21176451 |
| [19] | 张晓慧. 硒酵母胶囊治疗慢性萎缩性胃炎疗效观察[J]. 实用临床医药杂志, 2013, 17(24): 134+136. |
| [20] | Su, X., Yin, Z., Jin, Q., Liu, Z., Han, X., Hu, Z., et al. (2023) Allium Vegetable Intake Associated with the Risk of Incident Gastric Cancer: A Continuous Follow-Up Study of a Randomized Intervention Trial. The American Journal of Clinical Nutrition, 117, 22-32. https://doi.org/10.1016/j.ajcnut.2022.10.017 |
| [21] | Kong, S., Zhang, G., Yang, Z., Kong, Z. and Ye, F. (2023) Effects of Folic Acid Supplementation on Chronic Atrophic Gastritis Based on MTHFR C677T Polymorphism. Medicine, 102, e33980. https://doi.org/10.1097/md.0000000000033980 |
| [22] | Lei, J., Ren, F., Li, W., Guo, X., Liu, Q., Gao, H., et al. (2022) Use of Folic Acid Supplementation to Halt and Even Reverse the Progression of Gastric Precancerous Conditions: A Meta-Analysis. BMC Gastroenterology, 22, Article No. 370. https://doi.org/10.1186/s12876-022-02390-y |
| [23] | Tao, M., Zhou, X., Hu, M. and Pan, J. (2019) Endoscopic Submucosal Dissection versus Endoscopic Mucosal Resection for Patients with Early Gastric Cancer: A Meta-Analysis. BMJ Open, 9, e025803. https://doi.org/10.1136/bmjopen-2018-025803 |
| [24] | 赵中凯, 王晔, 刘鑫, 等. 内镜黏膜下剥离与外科手术治疗早期胃癌的疗效与安全性分析[J]. 中国微创外科杂志, 2023, 23(6): 416-421. |
| [25] | 李军祥, 陈誩, 吕宾, 等. 慢性萎缩性胃炎中西医结合诊疗共识意见(2017年) [J]. 中国中西医结合消化杂志, 2018, 26(2): 121-131. |
| [26] | 齐乐, 周娟燕, 朱丽丽, 等. 摩罗丹联合伊托必利治疗慢性萎缩性胃炎的临床研究[J]. 现代药物与临床, 2022, 37(8): 1774-1778. |
| [27] | 陶鸣浩, 戴彦苗, 陆喜荣, 等. 参芪桃红汤治疗脾虚瘀阻证慢性萎缩性胃炎的临床观察及其机制研究[J]. 南京中医药大学学报, 2021, 37(4): 503-507. |
| [28] | 梁超, 姚东昀, 冯志涛, 等. 应氏胃灵散配合奇穴埋线对慢性萎缩性胃炎疗效、组织学、中医症候的影响[J]. 中华中医药学刊, 2022, 40(12): 78-81. |
| [29] | 白清云. 中国医学百科全书·蒙医学[M]. 上海: 上海科学技术出版社, 1992: 83. |
| [30] | 佟小风, 蒋栓柱. 蒙药查干乌日勒对慢性萎缩性胃炎血清PG、G-17影响的临床研究[J]. 中国民族医药杂志, 2022, 28(10): 10-12. |
| [31] | 特日格乐, 乌兰. 蒙药复方查干乌日勒联合维酶素片治疗慢性萎缩性胃炎的临床疗效观察[J]. 中国民族医药杂志, 2018, 24(5): 16-17. |
| [32] | 罗小军. 蒙医辨证治疗慢性萎缩性胃炎的临床疗效[J]. 中国民族医药杂志, 2022, 28(4): 15-16. |
| [33] | 恩和. 蒙西医结合治疗慢性萎缩性胃炎疗效观察[J]. 中国民族医药杂志, 2020, 26(10): 11-12. |
| [34] | 赖图雅. 探讨蒙医辨证治疗慢性萎缩性胃炎的临床疗效[J]. 世界最新医学信息文摘, 2019, 19(40): 198-199. |
| [35] | 道日娜. 蒙医火疗结合口服蒙药治疗慢性萎缩性胃炎100例[J]. 中国民族医药杂志, 2017, 9(9): 19. |
| [36] | 白玛, 白张, 米久. 慢性萎缩性胃炎的藏医病因分析[J]. 中国民族医药杂志, 2023, 29(5): 59-60. |
| [37] | 宇妥·元丹贡布. 四部医典[M]. 西宁: 青海省人民出版社, 2020: 250-252. |
| [38] | 仁青东主, 华青措, 斗周才让, 等. 藏药复方治疗慢性萎缩性胃炎的疗效与机理探析[J]. 中华中医药学刊, 2016, 34(11): 2577-2579. |
| [39] | 才项仁增. 藏医治疗萎缩性胃炎的临床疗效[J]. 中国民族医药杂志, 2020, 26(7): 12-13. |
| [40] | 多杰才昂, 加羊卓玛. 藏药治疗慢性萎缩性胃炎的临床疗效研究[J]. 世界最新医学信息文摘, 2018, 18(78): 9-10. |
| [41] | 才让东智. 慢性萎缩性胃炎应用藏医辩证疗法的效果分析[J]. 婚育与健康, 2023, 29(14): 106-108. |
| [42] | 周加太, 南拉卡. 藏医治疗慢性萎缩性胃炎的临床效果分析[J]. 中西医结合心血管病电子杂志, 2020, 8(27): 51-52. |
| [43] | 完玛扎西. 藏医辨证治疗慢性萎缩性胃炎临床研究[J]. 中国民族医药杂志, 2019, 25(5): 15-16. |
