益胃化瘀方敷脐联合胃复春胶囊治疗脾虚血瘀型慢性萎缩性胃炎伴低级别上皮内瘤变临床研究OA

Objective:To observe the clinical efficacy of umbilical application with Yiwei Huayu Prescription combined with Weifuchun Capsules in treating chronic atrophic gastritis(CAG)complicated by low-grade intraepithelial neoplasia(LGIN)of spleen deficiency and blood stasis type.Methods:A total of 60 patients with CAG complicated by LGIN of spleen deficiency and blood stasis type who visited the outpatient clinic or were admitted to the inpatient department of spleen and stomach diseases at Jiaxing Hospital of Traditional Chinese Medicine from January 2024 to March 2025 were selected as the study subjects.The patients were randomly divided into an observation group and a control group using the random number table method,with 30 cases in each group.One case was excluded from the control group,resulting in 29 cases finally included.The observation group received Weifuchun Capsules orally plus umbilical application with Yiwei Huayu Prescription,while the control group received Weifuchun Capsules orally.Both groups were treated for 12 weeks.Clinical efficacy,traditional Chinese medicine syndrome scores,total histopathological scores of gastric mucosa,LGIN scores,Operative Link on Gastritis Assessment/Operative Link on Gastric Intestinal Metaplasia Assessment(OLGA/OLGIM)stages,and levels of serological indicators[serum pepsinogenⅠ(PGⅠ),pepsinogenⅡ(PGⅡ),pepsinogen ratio(PGR),gastrin-17(G-17)]between the two groups were observed before and after treatment.Results:After treatment,the total effective rate was 96.7%(29/30)in the observation group,significantly higher than that of 75.9%(22/29)in the control group(P＜0.05).Traditional Chinese medicine syndrome scores for epigastric pain,bloating,belching,poor appetite,and sour regurgitation decreased in both groups after treatment(P＜0.05),with lower scores in the observation group(P＜0.05).Total histopathological scores of gastric mucosa and LGIN scores decreased in both groups after treatment(P＜0.05),with lower scores in the observation group(P＜0.05).OLGA and OLGIM stages improved in both groups after treatment(P＜0.05).The improvement in OLGA stage was better in the observation group than in the control group(P＜0.05),while no significant difference was observed in OLGIM stages between the two groups(P＞0.05).PGⅠ,PGR,and G-17 levels increased in both groups after treatment(P＜0.05),while PG Ⅱ levels decreased(P＜0.05).The observation group had higher PGⅠ,PGR,and G-17 levels and lower PGⅡ levels than the control group(P＜0.05).Conclusion:Umbilical application with Yiwei Huayu Prescription combined with Weifuchun Capsules demonstrates definite efficacy in treating CAG complicated by LGIN of spleen deficiency and blood stasis type,improving clinical symptoms,histopathological scores of gastric mucosa,OLGA staging,and related serological indicators.