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目的探讨加味四逆泻心汤联合西药治疗胃癌癌前病变的疗效及对表皮生长因子受体(EGFR)和P53表达的影响。方法将68例胃癌癌前病变患者随机分为2组,对照组34例予以奥美拉唑肠溶片、硫糖铝、维酶素片治疗,治疗组34例在此基础上予加味四逆泻心汤治疗。治疗6个月后观察2组临床疗效、内镜及病理疗效,比较2组治疗前后癌前病变组织中EGFR、P53蛋白阳性表达情况。结果疗程结束后,治疗组临床总有效率、胃镜疗效总有效率均明显高于对照组(P均<0.05);2组治疗后癌前病变组织中P53、EGFR蛋白表达阳性率均低于治疗前(P均<0.05),且治疗组低于对照组(P均<0.05)。结论加味四逆泻心汤联合西药治疗胃癌癌前病变患者疗效显著,可降低EGFR及P53蛋白阳性表达率,逆转胃癌癌前病变病理状态,值得临床推广应用。
Objective To investigate the therapeutic effect of Jiawei Sini xin xin decoction combined with western medicine on gastric precancerous lesions and its effect on the expression of epidermal growth factor receptor (EGFR) and P53. Methods 68 patients with precancerous lesions of gastric cancer were randomly divided into two groups, 34 patients in the control group were treated with omeprazole enteric-coated tablets, sucralfate, and vetosin tablets. In the treatment group, 34 patients were treated with Jiawei Sini Xie Xin Tang treatment. After 6 months of treatment, the clinical efficacy, endoscopic and pathological effects of the two groups were observed. The positive expression of EGFR and P53 protein in the precancerous lesions were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group and the total effective rate of gastroscopy were significantly higher than those of the control group (all P <0.05). The positive rates of P53 and EGFR protein expression in the precancerous lesions were lower than those in the treatment group (P <0.05), and the treatment group was lower than the control group (P <0.05). Conclusion Jiawei Sini xuespin Decoction combined with Western medicine in the treatment of precancerous lesions of gastric cancer patients with significant effect, can reduce the positive expression rate of EGFR and P53 protein, reverse the pathological state of gastric precancerous lesions, worthy of clinical application.