Chronic atrophic gastritis includes two main types:autoimmune gastritis(AIG),also known as type A gastritis,and non-AIG.AIG primarily affects the fundus and body of the stomach and is characterized by atrophy of the g...Chronic atrophic gastritis includes two main types:autoimmune gastritis(AIG),also known as type A gastritis,and non-AIG.AIG primarily affects the fundus and body of the stomach and is characterized by atrophy of the gastric body mucosa[1,2].The non-AIG category includes type B gastritis,where the lesions mainly occur in the gastric antrum,as well as chronic superficial gastritis,an early stage of stomach disorders.The diagnosis of AIG versus non-AIG heavily relies on gastroscopy,a procedure known for its risks and inconvenience.Therefore,identifying biomarkers that can distinguish between AIG and non-AIG is crucial.However,there are currently no reports on small-molecule biomarkers for distinguishing between AIG and non-AIG.In this study,we investigated the serum metabolomics of AIG and non-AIG patients using ultra-high-performance liquid chromatography-mass spectrometry(UHPLC/MS),and compared their metabolic profile differences.In total 46 differential metabolites were identified,and three of which(L-glutamic acid,anthranilate,and deoxyadenosine)were linked to the regulation of gastric biosynthetic genes.展开更多
BACKGROUND Chronic atrophic gastritis(CAG)is a clinically refractory gastric disease often characterized by high recurrence rates and adverse drug reactions.Anwei decoction(AWD),a traditional Chinese medicine formula,...BACKGROUND Chronic atrophic gastritis(CAG)is a clinically refractory gastric disease often characterized by high recurrence rates and adverse drug reactions.Anwei decoction(AWD),a traditional Chinese medicine formula,has been shown to significantly improve clinical symptoms in patients with CAG,as demonstrated by a multicenter cohort study(overall effective rate:82.5%,P<0.01).However,the unclear molecular mechanisms and therapeutic targets of AWD limit its international acceptance.AIM To investigate the therapeutic mechanisms of AWD against CAG from an integrated perspective.METHODS In this study,N-methyl-N’-nitro-N-nitrosoguanidine was used to establish a CAG rat model.Serum-derived constituents transferred from AWD were first identified using ultra-high-performance liquid chromatography coupled with tandem mass spectrometry.The concentrations of inflammatory cytokines in serum samples were determined by enzyme-linked immunosorbent assay.Moreover,gastric mucosal tissues were analyzed by quantitative realtime polymerase chain reaction to measure messenger RNA(mRNA)levels of the NLRP3 inflammasome.Western blotting was used to detect the protein expression of NLRP3,caspase-1,and interleukin(IL)-1β.To elucidate the regulatory mechanisms underlying AWD treatment,structural alterations of the gut microbiota(GM)and associated metabolites were analyzed using integrated high-throughput sequencing(16S rRNA)and liquid chromatography-mass spectrometry based untargeted metabolomics.This comprehensive approach systematically clarified AWD’s multi-target therapeutic mechanisms against CAG.RESULTS AWD notably reduced serum levels of pro-inflammatory cytokines,such as IL-1β,IL-18,tumor necrosis factor-α,and lipopolysaccharide,demonstrating significant statistical differences(all P<0.01).Additionally,AWD substantially inhibited NLRP3 mRNA expression in gastric mucosal tissue(P<0.01)and concurrently decreased the protein abundance of NLRP3,IL-1β,and caspase-1(all P<0.01),thereby suppressing inflammasome signaling activation.GM analysis indicated that AWD intervention significantly increased the relative abundance of beneficial bacteria.Associated microbial metabolites likely inhibited the NLRP3 inflammasome pathway by modulating immune cell function.Non-targeted metabolomics further indicated that AWD exerted anti-inflammatory effects by regulating critical metabolic pathways,including the Kaposi’s sarcoma-associated herpesvirus infection pathway,autophagy processes,and glycosylphosphatidylinositol-anchor biosynthesis.CONCLUSION AWD alleviates the pathological progression of CAG through multi-target synergistic mechanisms.On one hand,AWD directly suppresses gastric mucosal inflammation by inhibiting NLRP3 inflammasome activation.On the other hand,AWD remodels intestinal microbiota-metabolite homeostasis,enhances intestinal barrier function,and regulates mucosal immune responses.展开更多
Background:The development of gastric cancer(GC)encompasses precancerous conditions like chronic atrophic gastritis(CAG)and premalignant lesions of gastric cancer(PLGC).In these situations,abnormal Notch signaling res...Background:The development of gastric cancer(GC)encompasses precancerous conditions like chronic atrophic gastritis(CAG)and premalignant lesions of gastric cancer(PLGC).In these situations,abnormal Notch signaling results in mucosal impairment and the initiation of cancer.Banxia Xiexin Decoction(BXD),a well-known formula in traditional Chinese medicine(TCM),shows promise in treating gastric disorders,but its mechanisms in gastric restoration remain unclear.Methods:Using MNNG-induced CAG and PLGC rat models,BXD was administered for 12 weeks.Gastric mucosal pathology was assessed via hematoxylin-eosin staining.Proliferation(Ki-67)and angiogenesis(VEGFA)markers were evaluated by immunohistochemistry.Network pharmacology identified BXD’s targets and pathways.Notch pathway components(Notch1,Jagged1,Dll4,Hes1)were analyzed via qPCR,Western blot,and immunohistochemistry.Results:BXD significantly ameliorated mucosal atrophy,glandular structural disorder,and dysplasia in CAG and PLGC rats.Network pharmacology revealed 323 overlapping targets between BXD and PLGC,with Notch signaling as a central pathway.BXD downregulated Notch1,Jagged1,Dll4,and Hes1 expression at transcriptional and protein levels,suppressed Ki-67(proliferation)and VEGFA(angiogenesis)overexpression,and restored gastric mucosal integrity.Conclusion:BXD inhibits Notch signaling,reduces aberrant proliferation and angiogenesis,and interrupts Correa’s gastric carcinogenesis cascade.This study provides mechanistic evidence supporting BXD as a TCM-based intervention for gastric precancerous lesions.展开更多
Although Helicobacter pylori(H.pylori)is implicated in the development of most cases of gastric cancer with autoimmune gastritis,cases of gastric cancer have been reported in patients testing negative for H.pylori.Her...Although Helicobacter pylori(H.pylori)is implicated in the development of most cases of gastric cancer with autoimmune gastritis,cases of gastric cancer have been reported in patients testing negative for H.pylori.Here,we aimed to outline the current research status of the factors involved in the development of gastric cancer in H.pylori-negative autoimmune gastritis.Predictive pathological con-ditions for the development of gastric cancer in H.pylori-negative autoimmune gastritis are postulated to be:(1)Severe atrophy;(2)Hypergastrinemia;(3)Bile reflux;and(4)Low acidity,which are directly related to the pathophysiology of autoimmune gastritis,as well as smoking and family history,which are not re-lated to autoimmune gastritis.In autoimmune gastritis,where there is a possi-bility of spontaneous disappearance of H.pylori in advanced atrophy,it is diffi-cult to assess H.pylori.Since H.pylori infection begins in the antrum and subse-quently progresses to the proximal stomach,it is interpreted as H.pylori-negative autoimmune gastritis if histologically consistent with autoimmune gastritis in the body with spared antrum,and negative for other H.pylori tests.However,it is essential to examine whether the currently prevailing histological interpretation used to evaluate H.pylori infection status is appropriate.展开更多
BACKGROUND Autoimmune gastritis(AIG)is recognized endoscopically by the presence of antrum-sparing corpus-dominant atrophy,known as reverse atrophy.However,a past Helicobacter pylori(H.pylori)infection can obscure thi...BACKGROUND Autoimmune gastritis(AIG)is recognized endoscopically by the presence of antrum-sparing corpus-dominant atrophy,known as reverse atrophy.However,a past Helicobacter pylori(H.pylori)infection can obscure this classic pattern.We present two cases of AIG with past H.pylori infection and highlight a novel endoscopic sign that may aid AIG recognition when typical features are absent.CASE SUMMARY One patient reported postprandial fullness,while the other was asymptomatic.Neither had a history of H.pylori eradication therapy.Both tested negative on a urea breath test and positive for anti-parietal cell antibodies.In both patients,endoscopy revealed mucosal atrophy involving both the corpus and antrum,which was counter to the characteristic reverse atrophy pattern typically seen in AIG.Beyond the atrophic border,we observed a distinct pattern of gyrus-like changes,manifesting as elevated mucosa between deep fissures.Histologically,targeted biopsies from these gyrus-like areas revealed parietal cell degeneration,lymphocytic infiltration,and hyperplasia of enterochromaffin-like cells,consistent with early histopathologic changes seen in AIG.These results supported diagnoses of AIG with past H.pylori infection.CONCLUSION Gyrus-like changes may serve as a novel endoscopic clue of AIG with past H.pylori infection.展开更多
Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medic...Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medicine(TCM)has shown multi-targeted efficacy in CAG treatment,with advantages in enhancing gastric mucosal barrier defense,improving microcirculation,modulating inflammatory and immune responses,and promoting lesion healing,etc.Clinical studies and meta-analyses indicate that TCM provides significant benefits,with specific Chinese herbal compounds and monomers demonstrating protective effects on the gastric mucosa through mechanisms including anti-inflammation,antioxidation,and regulation of cellular proliferation and apoptosis,etc.Finally,it is pointed out that the efficacy of TCM in the treatment of CAG requires standardized research and unified standards,and constantly clarifies and improves the evaluation criteria of each dimension of gastric mucosal barrier function.展开更多
This article focuses on the clinical efficacy and mechanism of action of heatclearing and detoxifying traditional Chinese medicines(TCMs)in the treatment of erosive gastritis,providing a reference for the treatment of...This article focuses on the clinical efficacy and mechanism of action of heatclearing and detoxifying traditional Chinese medicines(TCMs)in the treatment of erosive gastritis,providing a reference for the treatment of this disease.In the clinical treatment of erosive gastritis,TCM combinations such as Qing Gastric San,Semixia Diarrheal Heart Soup,and single-flavored heat-clearing and detoxifying drugs such as dandelion and Huanglian have specific efficacies and effectively improve the patient's symptoms,including killing or inhibiting Helicobacter pylori,reducing inflammatory reactions,protecting the gastric mucosa,inhibiting gastric acid secretion,regulating gastrointestinal hormones,and regulating immune function,playing therapeutic roles through multi-level and multi-target mechanisms.Thus,heat-clearing and detoxifying TCMs have broad application prospects in clinical practice for erosive gastritis.展开更多
Helicobacter pylori-associated gastritis(HPAG)is a common condition of the gastrointestinal tract.However,extensive and long-term antibiotic use has resulted in numerous adverse effects,including increased resistance,...Helicobacter pylori-associated gastritis(HPAG)is a common condition of the gastrointestinal tract.However,extensive and long-term antibiotic use has resulted in numerous adverse effects,including increased resistance,gastrointestinal dysfunction,and increased recurrence rates.When these concerns develop,traditional Chinese medicine(TCM)may have advantages.TCM is based on the concept of completeness and aims to eliminate pathogens and strengthen the body.It has the potential to prevent this condition while also boosting the rate of Helicobacter pylori eradication.This review elaborates on the mechanism of TCM treatment for HPAG based on cellular signalling pathways,which reflects the flexibility of TCM in treating diseases and the advantages of multi-level,multipathway,and multi-target treatments for HPAG.展开更多
BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double c...BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.展开更多
Bile reflux gastritis (BRG) is a gastro-intestinal condition especially characterized by the reflux of bile into the stomach, further leading to mucosal inflammation along with various other clinical manifestations. D...Bile reflux gastritis (BRG) is a gastro-intestinal condition especially characterized by the reflux of bile into the stomach, further leading to mucosal inflammation along with various other clinical manifestations. Despite its increasing recognition, BRG remains understudied, with limited understanding of its epidemiology, pathophysiology, and optimal therapeutic strategies. Present narrative review aimed to comprehensively examine the available literature on BRG, focusing on its prevalence, risk factors, pathophysiology, clinical presentation, diagnostic modalities, and available therapeutic strategies. A comprehensive literature search was conducted using PubMed, Embase, Google Scholar and Cochrane databases. Relevant studies were included based on predefined inclusion and exclusion criteria. A narrative synthesis was conducted to summarize and interpret the findings. The prevalence of BRG remains uncertain due to diagnostic challenges. Risk factors include impaired gastrointestinal motility, sphincteric dysfunction (pyloric sphincter and the lower oesophageal sphincter), biliary tract disease, and certain medications. The pathophysiology involves bile acid-induced mucosal injury, inflammation, and impaired gastric defence mechanisms. Clinical manifestations are often nonspecific. Diagnostic modalities primarily include endoscopy and bile acid reflux testing. Management strategies encompass lifestyle modifications, medical therapy, and in severe cases, surgery. BRG is a complex condition with significant clinical implications. Further research is needed to refine diagnostic criteria, elucidate pathophysiological mechanisms, and develop effective therapeutic interventions. Addressing knowledge gaps in epidemiology, risk factors, and long-term outcomes is crucial for improving patient care.展开更多
Gastritis cystica profunda(GCP)is a rare gastric disorder.It is characterized by non-specific symptoms and diagnostic complexity.This case report enriches the medical literature by highlighting challenges in diagnosin...Gastritis cystica profunda(GCP)is a rare gastric disorder.It is characterized by non-specific symptoms and diagnostic complexity.This case report enriches the medical literature by highlighting challenges in diagnosing and treating GCP.CASE SUMMARY Two patients presented with non-specific abdominal symptoms,such as abdominal distension and epigastric discomfort.Initial misdiagnosis occurred due to GCP’s non-typical manifestations.After thorough investigations,GCP was diagnosed.Endoscopic mucosal resection and endoscopic submucosal dissection were carried out.Both patients recovered uneventfully.CONCLUSION GCP diagnosis demands caution,and endoscopic treatment is effective.展开更多
Li et al’s recent work on the risk factors for autoimmune gastritis provides clinical context for the vast majority of gastric neuroendocrine tumors(G-NETs).However,a deeper understanding of the underlying pathology ...Li et al’s recent work on the risk factors for autoimmune gastritis provides clinical context for the vast majority of gastric neuroendocrine tumors(G-NETs).However,a deeper understanding of the underlying pathology is needed for precise clinical management.Our letter details the predictable stepwise progression of type 1 G-NETs from autoimmune-driven corporal atrophy and hypergastrinemia to a clear microscopic sequence of enterochromaffin-like cell precursor lesions,including linear hyperplasia,micronodular hyperplasia,and dysplasia.We highlight the definitive diagnostic thresholds that separate these precursors from overt neoplasia:The 0.5 mm size rule and the presence of submucosal invasion.We advocate for a“prognostic biopsy protocol”in which pathologists actively report these precursor lesions and use Ki-67 to grade G-NETs,providing a quantitative risk assessment.This pathology-centric approach transforms surveillance,allowing clinicians to act on objective microscopic milestones rather than waiting for macroscopically visible tumors.展开更多
Current experimental models struggle to simulate the complex process of the transformation from atrophic gastritis to gastric cancer,while gastric organoid technology,especially region-specific modeling,provides a mor...Current experimental models struggle to simulate the complex process of the transformation from atrophic gastritis to gastric cancer,while gastric organoid technology,especially region-specific modeling,provides a more precise in vitro platform for studying this carcinogenic mechanism.Helicobacter pylori activates carcinogenic signaling pathways through virulence factors,inducing DNA damage,epigenetic dysregulation,and immune microenvironment imbalance,driving inflammation-cancer conversion.Intestinal metaplasia and spasmolytic polypeptide-expressing metaplasia serve as critical precursor lesions,gradually developing into dysplasia and adenocarcinoma under the influence of chronic inflammation and genetic instability through intestinal cell transformation and high trefoil factor 2-expressing cell expansion.The immune suppression,metabolic reprogramming,and matrix remodeling within the tumor microenvironment collaboratively create a pro-cancer ecosystem that accelerates inflammationcarcinogenesis transformation.The gastric organoid model successfully simulates the spatiotemporal dynamics of the carcinogenesis process in atrophic gastritis,and its future integration with single-cell omics,real-time imaging technologies,and artificial intelligence technologies could provide a more precise platform for elucidating molecular mechanisms and screening intervention strategies.These advances position gastric organoids as pivotal tools for clinical translation,enabling personalized risk stratification,early intervention targeting precancerous transitions,and ex vivo prediction of patient-specific therapeutic responses to guide precision management of gastric cancer.展开更多
BACKGROUND Emphysematous gastritis(EG)is a rare and serious condition that has fatal consequences.Although its clinical presentation is not specific,radiological imaging is characterized by intramural gastric gas.Defe...BACKGROUND Emphysematous gastritis(EG)is a rare and serious condition that has fatal consequences.Although its clinical presentation is not specific,radiological imaging is characterized by intramural gastric gas.Defects in the stomach mucosal barrier and invasion of gas-producing organisms are believed to be the cause.CASE SUMMARY An 88-year-old male with multiple comorbidities presented to our center with abdominal pain and increased stoma output as chief complaints.Upon further investigation he was found to have EG.Despite the high mortality risk without intervention,the patient and family declined operative intervention.CONCLUSION This case report underscored the challenges of managing a critically ill elderly patient with a history of multiple comorbidities and extensive abdominal surgeries and highlighted the successful use of conservative measures in treating EG.展开更多
BACKGROUND Gastritis cystica profunda(GCP)is a rare submucosal gastric lesion characterized by the extension of cystically dilated gastric mucosal glands into or below the muscularis mucosa,often due to various underl...BACKGROUND Gastritis cystica profunda(GCP)is a rare submucosal gastric lesion characterized by the extension of cystically dilated gastric mucosal glands into or below the muscularis mucosa,often due to various underlying causes.Typically,asymptomatic or associated with mild symptoms,GCP is most commonly discovered incidentally during surgery or endoscopy.To the best of our knowledge,this is the first documented case of GCP accompanied by acute inflammation and abscess formation.CASE SUMMARY A 37-year-old woman presented with upper abdominal pain.Laboratory tests showed elevated inflammatory markers and carbohydrate antigen 19-9 levels.Gastroscopy revealed a submucosal bulge.Based on enhanced computed tomography findings,an ectopic pancreas with cyst was suspected.Clinically,we decided to perform distal gastrectomy.Postoperative pathology confirmed that the patient had GCP complicated by acute inflammation and abscess formation.The patient had an uneventful postoperative recovery.CONCLUSION This case provides information on new complications of GCP and emphasizes the diagnostic value of enhanced computed tomography.展开更多
BACKGROUND Autoimmune gastritis(AIG)is frequently associated with one or more comorbid conditions,among which type I gastric neuroendocrine tumors(gNETs)warrant significant clinical concern.However,risk factors for th...BACKGROUND Autoimmune gastritis(AIG)is frequently associated with one or more comorbid conditions,among which type I gastric neuroendocrine tumors(gNETs)warrant significant clinical concern.However,risk factors for the development of gNETs in AIG populations remain poorly defined.AIM To characterize the clinical and endoscopic profiles of AIG and identify potential risk factors for gNETs development.METHODS In this single-center cross-sectional study carried out at a tertiary hospital,303 patients with AIG over an 8-year period were retrospectively categorized into gNETs(n=116)and non-gNETs(n=187)groups.Endoscopic and clinical pa-rameters were analyzed.Endoscopic features were systematically reevaluated according to the 2023 Japanese diagnostic criteria for AIG.Feature selection was performed using the Boruta algorithm,and the model discriminative ability was evaluated via receiver operating characteristic curve analysis.RESULTS Among the 303 patients with AIG,116 had gNETs and 187 did not.Compared with the non-gNETs group,patients in the gNETs group were younger(54.3 years vs 60.6 years,P<0.001),had higher rate of vitamin B12 deficiency(77.2%vs 55.8%,P<0.001),lower pepsinogen I(4.3 ng/mL vs 7.4 ng/mL,P<0.001)and pepsinogen I/II ratios(0.7 vs.1.1,P<0.001),and lower prior Helicobacter pylori infection rate(3.4%vs 21.4%,P<0.001).Endoscopically,the gNETs group showed a lower incidence of oxyntic mucosal remnants,hyperplastic polyps,and patchy antral redness.The predictive model incorporating age,prior Helicobacter pylori infection,vitamin B12 level,gastric hy-perplastic polyps,and patchy antral redness showed an area under the curve of 0.830.CONCLUSION Patients with AIG or gNETs exhibit specific clinical and endoscopic features.The predictive model demonstrated favorable discriminative ability and may facilitate risk stratification of gNETs in patients with AIG.展开更多
Traditional Chinese medicine(TCM)has been extensively explored with various naturally derived compounds as a potential therapeutic agent for chronic atrophic gastritis(CAG).In addition to the aspects discussed in the ...Traditional Chinese medicine(TCM)has been extensively explored with various naturally derived compounds as a potential therapeutic agent for chronic atrophic gastritis(CAG).In addition to the aspects discussed in the reviewed article,this invited commentary explores the initial available evidence on a fungus from TCM,Hericium erinaceus,in the context of CAG.Initial clinical data suggest the potential of this fungus in inducing clinical and histological improvements in patients with CAG,as well as a marked antimicrobial activity against Helicobacter pylori infection.Preclinical cellular evidence also indicates an antineoplastic role in gastric carcinogenesis,mediated by two components:Erinacine A and S.Further evidence is needed to propose this fungus as a potential complementary thera-peutic approach for CAG.展开更多
Objective:To evaluate the therapeutic effects of Huangqi Sijun Decoction on chronic atrophic gastritis(CAG).Methods:Sixty CAG patients hospitalized between January 2020 and December 2022 were selected and randomly div...Objective:To evaluate the therapeutic effects of Huangqi Sijun Decoction on chronic atrophic gastritis(CAG).Methods:Sixty CAG patients hospitalized between January 2020 and December 2022 were selected and randomly divided into two groups using a random number table.The Traditional Chinese Medicine(TCM)group(n=30)was treated with Huangqi Sijun Decoction,while the Western medicine group(n=30)received omeprazole.The total effective rate,TCM syndrome scores,and serological indicators were compared.Results:The total effective rate in the TCM group was higher than that in the Western medicine group,while the adverse reaction rate was lower(P<0.05).Before treatment,there were no significant differences in TCM syndrome scores or serological indicators between the two groups(P>0.05).After treatment,the TCM group had lower TCM syndrome scores and better serological indicators compared to the Western medicine group(P<0.05).Conclusion:Huangqi Sijun Decoction can enhance the clinical efficacy of CAG patients,prevent adverse reactions,alleviate TCM symptoms,and regulate specific levels of serological indicators,demonstrating significant therapeutic advantages.展开更多
AG(atrophic gastritis)is characterized by precancerous lesions associated with gastric cancer and can cause serious adverse health effects.The high incidence coupled with a low diagnosis rate and the mediocre effectiv...AG(atrophic gastritis)is characterized by precancerous lesions associated with gastric cancer and can cause serious adverse health effects.The high incidence coupled with a low diagnosis rate and the mediocre effectiveness of clinical treatment raises concerns.This article reviews the pathologic features,clinical manifestations,and treatment progress of AG.展开更多
This study summarizes the clinical experience of professor LIAN Jianwei, a nationally renowned traditional Chinese medicine (TCM) practitioner, in treating chronic atrophic gastritis (CAG) with syndrome differentiatio...This study summarizes the clinical experience of professor LIAN Jianwei, a nationally renowned traditional Chinese medicine (TCM) practitioner, in treating chronic atrophic gastritis (CAG) with syndrome differentiation based on pulse-taking. Professor LIAN emphasizes the importance of pulse diagnosis in TCM clinical practice, focusing on the normal and variant aspects of pulse methods, and centers on the dynamic changes of the “Guan pulse” to accurately determine the functional status of the spleen and stomach based on pulse variations, thereby formulating personalized treatment plans. For patients with a slow and moderate pulse, spleen and stomach deficiency and dampness due to spleen deficiency are often identified, and treatment mainly focuses on strengthening the spleen, resolving dampness, and boosting Qi to aid transportation, usually with modifications of Shenling Baizhu San. When the left Guan pulse is string-like and the right Guan pulse is slow and moderate, it indicates liver depression and spleen deficiency, and Xiaoyao San is commonly used to soothe the liver, nourish the blood, and strengthen the spleen, harmonizing the liver and spleen. If the right Guan pulse is large and the left Guan pulse is string-like, it mostly belongs to liver and stomach Qi stagnation, and Bupleurum Liver-soothing powder is often used to soothe the liver, regulate Qi, and harmonize the stomach. A large and empty right Guan pulse suggests insufficiency of Central Qi, and Buzhong Yiqi Tang is commonly used to tonify Qi and soothe the liver. In terms of medication, professor LIAN pays attention to patients’ dietary habits and combines methods of eliminating dampness, promoting digestion, and activating blood circulation to improve symptoms and reverse atrophy.展开更多
基金supported by the National Natural Science Foundation of China(Grant Nos.:82122073 and 82173950)the National High Level Hospital Clinical Research Funding,China(Grant Nos.:BJ-2023-101 and BJ-2023-075).
文摘Chronic atrophic gastritis includes two main types:autoimmune gastritis(AIG),also known as type A gastritis,and non-AIG.AIG primarily affects the fundus and body of the stomach and is characterized by atrophy of the gastric body mucosa[1,2].The non-AIG category includes type B gastritis,where the lesions mainly occur in the gastric antrum,as well as chronic superficial gastritis,an early stage of stomach disorders.The diagnosis of AIG versus non-AIG heavily relies on gastroscopy,a procedure known for its risks and inconvenience.Therefore,identifying biomarkers that can distinguish between AIG and non-AIG is crucial.However,there are currently no reports on small-molecule biomarkers for distinguishing between AIG and non-AIG.In this study,we investigated the serum metabolomics of AIG and non-AIG patients using ultra-high-performance liquid chromatography-mass spectrometry(UHPLC/MS),and compared their metabolic profile differences.In total 46 differential metabolites were identified,and three of which(L-glutamic acid,anthranilate,and deoxyadenosine)were linked to the regulation of gastric biosynthetic genes.
基金Supported by the National Natural Science Foundation of China,No.81860843Guangxi Administration of Traditional Chinese Medicine Project,No.GZSY23-36 and No.GXZYA20240150。
文摘BACKGROUND Chronic atrophic gastritis(CAG)is a clinically refractory gastric disease often characterized by high recurrence rates and adverse drug reactions.Anwei decoction(AWD),a traditional Chinese medicine formula,has been shown to significantly improve clinical symptoms in patients with CAG,as demonstrated by a multicenter cohort study(overall effective rate:82.5%,P<0.01).However,the unclear molecular mechanisms and therapeutic targets of AWD limit its international acceptance.AIM To investigate the therapeutic mechanisms of AWD against CAG from an integrated perspective.METHODS In this study,N-methyl-N’-nitro-N-nitrosoguanidine was used to establish a CAG rat model.Serum-derived constituents transferred from AWD were first identified using ultra-high-performance liquid chromatography coupled with tandem mass spectrometry.The concentrations of inflammatory cytokines in serum samples were determined by enzyme-linked immunosorbent assay.Moreover,gastric mucosal tissues were analyzed by quantitative realtime polymerase chain reaction to measure messenger RNA(mRNA)levels of the NLRP3 inflammasome.Western blotting was used to detect the protein expression of NLRP3,caspase-1,and interleukin(IL)-1β.To elucidate the regulatory mechanisms underlying AWD treatment,structural alterations of the gut microbiota(GM)and associated metabolites were analyzed using integrated high-throughput sequencing(16S rRNA)and liquid chromatography-mass spectrometry based untargeted metabolomics.This comprehensive approach systematically clarified AWD’s multi-target therapeutic mechanisms against CAG.RESULTS AWD notably reduced serum levels of pro-inflammatory cytokines,such as IL-1β,IL-18,tumor necrosis factor-α,and lipopolysaccharide,demonstrating significant statistical differences(all P<0.01).Additionally,AWD substantially inhibited NLRP3 mRNA expression in gastric mucosal tissue(P<0.01)and concurrently decreased the protein abundance of NLRP3,IL-1β,and caspase-1(all P<0.01),thereby suppressing inflammasome signaling activation.GM analysis indicated that AWD intervention significantly increased the relative abundance of beneficial bacteria.Associated microbial metabolites likely inhibited the NLRP3 inflammasome pathway by modulating immune cell function.Non-targeted metabolomics further indicated that AWD exerted anti-inflammatory effects by regulating critical metabolic pathways,including the Kaposi’s sarcoma-associated herpesvirus infection pathway,autophagy processes,and glycosylphosphatidylinositol-anchor biosynthesis.CONCLUSION AWD alleviates the pathological progression of CAG through multi-target synergistic mechanisms.On one hand,AWD directly suppresses gastric mucosal inflammation by inhibiting NLRP3 inflammasome activation.On the other hand,AWD remodels intestinal microbiota-metabolite homeostasis,enhances intestinal barrier function,and regulates mucosal immune responses.
基金supported by the National Natural Science Foundation of China(Grant No.82274442)the Key Research Project in Traditional Chinese Medicine of Tianjin Municipal Health Commission(Grant No.202007)the Integrated Traditional Chinese and Western Medicine Research Project of Tianjin Municipal Health Commission(Grant No.2023134).
文摘Background:The development of gastric cancer(GC)encompasses precancerous conditions like chronic atrophic gastritis(CAG)and premalignant lesions of gastric cancer(PLGC).In these situations,abnormal Notch signaling results in mucosal impairment and the initiation of cancer.Banxia Xiexin Decoction(BXD),a well-known formula in traditional Chinese medicine(TCM),shows promise in treating gastric disorders,but its mechanisms in gastric restoration remain unclear.Methods:Using MNNG-induced CAG and PLGC rat models,BXD was administered for 12 weeks.Gastric mucosal pathology was assessed via hematoxylin-eosin staining.Proliferation(Ki-67)and angiogenesis(VEGFA)markers were evaluated by immunohistochemistry.Network pharmacology identified BXD’s targets and pathways.Notch pathway components(Notch1,Jagged1,Dll4,Hes1)were analyzed via qPCR,Western blot,and immunohistochemistry.Results:BXD significantly ameliorated mucosal atrophy,glandular structural disorder,and dysplasia in CAG and PLGC rats.Network pharmacology revealed 323 overlapping targets between BXD and PLGC,with Notch signaling as a central pathway.BXD downregulated Notch1,Jagged1,Dll4,and Hes1 expression at transcriptional and protein levels,suppressed Ki-67(proliferation)and VEGFA(angiogenesis)overexpression,and restored gastric mucosal integrity.Conclusion:BXD inhibits Notch signaling,reduces aberrant proliferation and angiogenesis,and interrupts Correa’s gastric carcinogenesis cascade.This study provides mechanistic evidence supporting BXD as a TCM-based intervention for gastric precancerous lesions.
文摘Although Helicobacter pylori(H.pylori)is implicated in the development of most cases of gastric cancer with autoimmune gastritis,cases of gastric cancer have been reported in patients testing negative for H.pylori.Here,we aimed to outline the current research status of the factors involved in the development of gastric cancer in H.pylori-negative autoimmune gastritis.Predictive pathological con-ditions for the development of gastric cancer in H.pylori-negative autoimmune gastritis are postulated to be:(1)Severe atrophy;(2)Hypergastrinemia;(3)Bile reflux;and(4)Low acidity,which are directly related to the pathophysiology of autoimmune gastritis,as well as smoking and family history,which are not re-lated to autoimmune gastritis.In autoimmune gastritis,where there is a possi-bility of spontaneous disappearance of H.pylori in advanced atrophy,it is diffi-cult to assess H.pylori.Since H.pylori infection begins in the antrum and subse-quently progresses to the proximal stomach,it is interpreted as H.pylori-negative autoimmune gastritis if histologically consistent with autoimmune gastritis in the body with spared antrum,and negative for other H.pylori tests.However,it is essential to examine whether the currently prevailing histological interpretation used to evaluate H.pylori infection status is appropriate.
基金Supported by the General Program of the National Natural Science Foundation of China,No.81973920.
文摘BACKGROUND Autoimmune gastritis(AIG)is recognized endoscopically by the presence of antrum-sparing corpus-dominant atrophy,known as reverse atrophy.However,a past Helicobacter pylori(H.pylori)infection can obscure this classic pattern.We present two cases of AIG with past H.pylori infection and highlight a novel endoscopic sign that may aid AIG recognition when typical features are absent.CASE SUMMARY One patient reported postprandial fullness,while the other was asymptomatic.Neither had a history of H.pylori eradication therapy.Both tested negative on a urea breath test and positive for anti-parietal cell antibodies.In both patients,endoscopy revealed mucosal atrophy involving both the corpus and antrum,which was counter to the characteristic reverse atrophy pattern typically seen in AIG.Beyond the atrophic border,we observed a distinct pattern of gyrus-like changes,manifesting as elevated mucosa between deep fissures.Histologically,targeted biopsies from these gyrus-like areas revealed parietal cell degeneration,lymphocytic infiltration,and hyperplasia of enterochromaffin-like cells,consistent with early histopathologic changes seen in AIG.These results supported diagnoses of AIG with past H.pylori infection.CONCLUSION Gyrus-like changes may serve as a novel endoscopic clue of AIG with past H.pylori infection.
基金Supported by the Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences,No.CI2021A00806High Level Chinese Medical Hospital Promotion Project,No.HLCMHPP2023086the Fundamental Research Funds for the Central Public Welfare Research Institutes,No.ZZ17-XRZ-041.
文摘Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medicine(TCM)has shown multi-targeted efficacy in CAG treatment,with advantages in enhancing gastric mucosal barrier defense,improving microcirculation,modulating inflammatory and immune responses,and promoting lesion healing,etc.Clinical studies and meta-analyses indicate that TCM provides significant benefits,with specific Chinese herbal compounds and monomers demonstrating protective effects on the gastric mucosa through mechanisms including anti-inflammation,antioxidation,and regulation of cellular proliferation and apoptosis,etc.Finally,it is pointed out that the efficacy of TCM in the treatment of CAG requires standardized research and unified standards,and constantly clarifies and improves the evaluation criteria of each dimension of gastric mucosal barrier function.
基金Supported by National Science and Technology Major Project,No.2024ZD0521002The Innovation Team Project of Traditional Chinese Medicine of Liaoning Province,No.LNZYYCXTD-CCCX-003+1 种基金General Program of the National Natural Science Foundation of China,No.82074296Construction Project of Inheritance Studios of Famous Chinese Medicine Experts in China,No.[2022]No.75.
文摘This article focuses on the clinical efficacy and mechanism of action of heatclearing and detoxifying traditional Chinese medicines(TCMs)in the treatment of erosive gastritis,providing a reference for the treatment of this disease.In the clinical treatment of erosive gastritis,TCM combinations such as Qing Gastric San,Semixia Diarrheal Heart Soup,and single-flavored heat-clearing and detoxifying drugs such as dandelion and Huanglian have specific efficacies and effectively improve the patient's symptoms,including killing or inhibiting Helicobacter pylori,reducing inflammatory reactions,protecting the gastric mucosa,inhibiting gastric acid secretion,regulating gastrointestinal hormones,and regulating immune function,playing therapeutic roles through multi-level and multi-target mechanisms.Thus,heat-clearing and detoxifying TCMs have broad application prospects in clinical practice for erosive gastritis.
基金Supported by National Natural Science Foundation of China,No.82374323and Hunan Graduate Research Innovation Project,No.2023CX15.
文摘Helicobacter pylori-associated gastritis(HPAG)is a common condition of the gastrointestinal tract.However,extensive and long-term antibiotic use has resulted in numerous adverse effects,including increased resistance,gastrointestinal dysfunction,and increased recurrence rates.When these concerns develop,traditional Chinese medicine(TCM)may have advantages.TCM is based on the concept of completeness and aims to eliminate pathogens and strengthen the body.It has the potential to prevent this condition while also boosting the rate of Helicobacter pylori eradication.This review elaborates on the mechanism of TCM treatment for HPAG based on cellular signalling pathways,which reflects the flexibility of TCM in treating diseases and the advantages of multi-level,multipathway,and multi-target treatments for HPAG.
基金Supported by the Health Technology Project of Pudong New District Health Commission,No.PW2020D-12.
文摘BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.
文摘Bile reflux gastritis (BRG) is a gastro-intestinal condition especially characterized by the reflux of bile into the stomach, further leading to mucosal inflammation along with various other clinical manifestations. Despite its increasing recognition, BRG remains understudied, with limited understanding of its epidemiology, pathophysiology, and optimal therapeutic strategies. Present narrative review aimed to comprehensively examine the available literature on BRG, focusing on its prevalence, risk factors, pathophysiology, clinical presentation, diagnostic modalities, and available therapeutic strategies. A comprehensive literature search was conducted using PubMed, Embase, Google Scholar and Cochrane databases. Relevant studies were included based on predefined inclusion and exclusion criteria. A narrative synthesis was conducted to summarize and interpret the findings. The prevalence of BRG remains uncertain due to diagnostic challenges. Risk factors include impaired gastrointestinal motility, sphincteric dysfunction (pyloric sphincter and the lower oesophageal sphincter), biliary tract disease, and certain medications. The pathophysiology involves bile acid-induced mucosal injury, inflammation, and impaired gastric defence mechanisms. Clinical manifestations are often nonspecific. Diagnostic modalities primarily include endoscopy and bile acid reflux testing. Management strategies encompass lifestyle modifications, medical therapy, and in severe cases, surgery. BRG is a complex condition with significant clinical implications. Further research is needed to refine diagnostic criteria, elucidate pathophysiological mechanisms, and develop effective therapeutic interventions. Addressing knowledge gaps in epidemiology, risk factors, and long-term outcomes is crucial for improving patient care.
文摘Gastritis cystica profunda(GCP)is a rare gastric disorder.It is characterized by non-specific symptoms and diagnostic complexity.This case report enriches the medical literature by highlighting challenges in diagnosing and treating GCP.CASE SUMMARY Two patients presented with non-specific abdominal symptoms,such as abdominal distension and epigastric discomfort.Initial misdiagnosis occurred due to GCP’s non-typical manifestations.After thorough investigations,GCP was diagnosed.Endoscopic mucosal resection and endoscopic submucosal dissection were carried out.Both patients recovered uneventfully.CONCLUSION GCP diagnosis demands caution,and endoscopic treatment is effective.
基金Supported by the Chongqing Health Commission and Science and Technology Bureau,No.2023MSXM060.
文摘Li et al’s recent work on the risk factors for autoimmune gastritis provides clinical context for the vast majority of gastric neuroendocrine tumors(G-NETs).However,a deeper understanding of the underlying pathology is needed for precise clinical management.Our letter details the predictable stepwise progression of type 1 G-NETs from autoimmune-driven corporal atrophy and hypergastrinemia to a clear microscopic sequence of enterochromaffin-like cell precursor lesions,including linear hyperplasia,micronodular hyperplasia,and dysplasia.We highlight the definitive diagnostic thresholds that separate these precursors from overt neoplasia:The 0.5 mm size rule and the presence of submucosal invasion.We advocate for a“prognostic biopsy protocol”in which pathologists actively report these precursor lesions and use Ki-67 to grade G-NETs,providing a quantitative risk assessment.This pathology-centric approach transforms surveillance,allowing clinicians to act on objective microscopic milestones rather than waiting for macroscopically visible tumors.
基金Supported by National Traditional Chinese Medicine Advantageous Specialty Project of National Administration of Traditional Chinese MedicineShuguang Hospital Siming Foundation Research Special Project,No.SGKJ-202304.
文摘Current experimental models struggle to simulate the complex process of the transformation from atrophic gastritis to gastric cancer,while gastric organoid technology,especially region-specific modeling,provides a more precise in vitro platform for studying this carcinogenic mechanism.Helicobacter pylori activates carcinogenic signaling pathways through virulence factors,inducing DNA damage,epigenetic dysregulation,and immune microenvironment imbalance,driving inflammation-cancer conversion.Intestinal metaplasia and spasmolytic polypeptide-expressing metaplasia serve as critical precursor lesions,gradually developing into dysplasia and adenocarcinoma under the influence of chronic inflammation and genetic instability through intestinal cell transformation and high trefoil factor 2-expressing cell expansion.The immune suppression,metabolic reprogramming,and matrix remodeling within the tumor microenvironment collaboratively create a pro-cancer ecosystem that accelerates inflammationcarcinogenesis transformation.The gastric organoid model successfully simulates the spatiotemporal dynamics of the carcinogenesis process in atrophic gastritis,and its future integration with single-cell omics,real-time imaging technologies,and artificial intelligence technologies could provide a more precise platform for elucidating molecular mechanisms and screening intervention strategies.These advances position gastric organoids as pivotal tools for clinical translation,enabling personalized risk stratification,early intervention targeting precancerous transitions,and ex vivo prediction of patient-specific therapeutic responses to guide precision management of gastric cancer.
文摘BACKGROUND Emphysematous gastritis(EG)is a rare and serious condition that has fatal consequences.Although its clinical presentation is not specific,radiological imaging is characterized by intramural gastric gas.Defects in the stomach mucosal barrier and invasion of gas-producing organisms are believed to be the cause.CASE SUMMARY An 88-year-old male with multiple comorbidities presented to our center with abdominal pain and increased stoma output as chief complaints.Upon further investigation he was found to have EG.Despite the high mortality risk without intervention,the patient and family declined operative intervention.CONCLUSION This case report underscored the challenges of managing a critically ill elderly patient with a history of multiple comorbidities and extensive abdominal surgeries and highlighted the successful use of conservative measures in treating EG.
文摘BACKGROUND Gastritis cystica profunda(GCP)is a rare submucosal gastric lesion characterized by the extension of cystically dilated gastric mucosal glands into or below the muscularis mucosa,often due to various underlying causes.Typically,asymptomatic or associated with mild symptoms,GCP is most commonly discovered incidentally during surgery or endoscopy.To the best of our knowledge,this is the first documented case of GCP accompanied by acute inflammation and abscess formation.CASE SUMMARY A 37-year-old woman presented with upper abdominal pain.Laboratory tests showed elevated inflammatory markers and carbohydrate antigen 19-9 levels.Gastroscopy revealed a submucosal bulge.Based on enhanced computed tomography findings,an ectopic pancreas with cyst was suspected.Clinically,we decided to perform distal gastrectomy.Postoperative pathology confirmed that the patient had GCP complicated by acute inflammation and abscess formation.The patient had an uneventful postoperative recovery.CONCLUSION This case provides information on new complications of GCP and emphasizes the diagnostic value of enhanced computed tomography.
文摘BACKGROUND Autoimmune gastritis(AIG)is frequently associated with one or more comorbid conditions,among which type I gastric neuroendocrine tumors(gNETs)warrant significant clinical concern.However,risk factors for the development of gNETs in AIG populations remain poorly defined.AIM To characterize the clinical and endoscopic profiles of AIG and identify potential risk factors for gNETs development.METHODS In this single-center cross-sectional study carried out at a tertiary hospital,303 patients with AIG over an 8-year period were retrospectively categorized into gNETs(n=116)and non-gNETs(n=187)groups.Endoscopic and clinical pa-rameters were analyzed.Endoscopic features were systematically reevaluated according to the 2023 Japanese diagnostic criteria for AIG.Feature selection was performed using the Boruta algorithm,and the model discriminative ability was evaluated via receiver operating characteristic curve analysis.RESULTS Among the 303 patients with AIG,116 had gNETs and 187 did not.Compared with the non-gNETs group,patients in the gNETs group were younger(54.3 years vs 60.6 years,P<0.001),had higher rate of vitamin B12 deficiency(77.2%vs 55.8%,P<0.001),lower pepsinogen I(4.3 ng/mL vs 7.4 ng/mL,P<0.001)and pepsinogen I/II ratios(0.7 vs.1.1,P<0.001),and lower prior Helicobacter pylori infection rate(3.4%vs 21.4%,P<0.001).Endoscopically,the gNETs group showed a lower incidence of oxyntic mucosal remnants,hyperplastic polyps,and patchy antral redness.The predictive model incorporating age,prior Helicobacter pylori infection,vitamin B12 level,gastric hy-perplastic polyps,and patchy antral redness showed an area under the curve of 0.830.CONCLUSION Patients with AIG or gNETs exhibit specific clinical and endoscopic features.The predictive model demonstrated favorable discriminative ability and may facilitate risk stratification of gNETs in patients with AIG.
文摘Traditional Chinese medicine(TCM)has been extensively explored with various naturally derived compounds as a potential therapeutic agent for chronic atrophic gastritis(CAG).In addition to the aspects discussed in the reviewed article,this invited commentary explores the initial available evidence on a fungus from TCM,Hericium erinaceus,in the context of CAG.Initial clinical data suggest the potential of this fungus in inducing clinical and histological improvements in patients with CAG,as well as a marked antimicrobial activity against Helicobacter pylori infection.Preclinical cellular evidence also indicates an antineoplastic role in gastric carcinogenesis,mediated by two components:Erinacine A and S.Further evidence is needed to propose this fungus as a potential complementary thera-peutic approach for CAG.
基金Inner Mongolia Autonomous Region Education Science“14th Five-Year Plan”Project(Project No.NGJGH2023467)Inner Mongolia Medical University Higher Education Teaching Reform Research Project(Project No.NYJXGG2022054)。
文摘Objective:To evaluate the therapeutic effects of Huangqi Sijun Decoction on chronic atrophic gastritis(CAG).Methods:Sixty CAG patients hospitalized between January 2020 and December 2022 were selected and randomly divided into two groups using a random number table.The Traditional Chinese Medicine(TCM)group(n=30)was treated with Huangqi Sijun Decoction,while the Western medicine group(n=30)received omeprazole.The total effective rate,TCM syndrome scores,and serological indicators were compared.Results:The total effective rate in the TCM group was higher than that in the Western medicine group,while the adverse reaction rate was lower(P<0.05).Before treatment,there were no significant differences in TCM syndrome scores or serological indicators between the two groups(P>0.05).After treatment,the TCM group had lower TCM syndrome scores and better serological indicators compared to the Western medicine group(P<0.05).Conclusion:Huangqi Sijun Decoction can enhance the clinical efficacy of CAG patients,prevent adverse reactions,alleviate TCM symptoms,and regulate specific levels of serological indicators,demonstrating significant therapeutic advantages.
文摘AG(atrophic gastritis)is characterized by precancerous lesions associated with gastric cancer and can cause serious adverse health effects.The high incidence coupled with a low diagnosis rate and the mediocre effectiveness of clinical treatment raises concerns.This article reviews the pathologic features,clinical manifestations,and treatment progress of AG.
基金supported by the Zhejiang Science and Technology Program of TCM(No.2025ZF017)the Clinical Young-Talent Trainning Project in TCM under the Young Eagle Program of the China Association of Chinese Medicine(No.CYJH2024048).
文摘This study summarizes the clinical experience of professor LIAN Jianwei, a nationally renowned traditional Chinese medicine (TCM) practitioner, in treating chronic atrophic gastritis (CAG) with syndrome differentiation based on pulse-taking. Professor LIAN emphasizes the importance of pulse diagnosis in TCM clinical practice, focusing on the normal and variant aspects of pulse methods, and centers on the dynamic changes of the “Guan pulse” to accurately determine the functional status of the spleen and stomach based on pulse variations, thereby formulating personalized treatment plans. For patients with a slow and moderate pulse, spleen and stomach deficiency and dampness due to spleen deficiency are often identified, and treatment mainly focuses on strengthening the spleen, resolving dampness, and boosting Qi to aid transportation, usually with modifications of Shenling Baizhu San. When the left Guan pulse is string-like and the right Guan pulse is slow and moderate, it indicates liver depression and spleen deficiency, and Xiaoyao San is commonly used to soothe the liver, nourish the blood, and strengthen the spleen, harmonizing the liver and spleen. If the right Guan pulse is large and the left Guan pulse is string-like, it mostly belongs to liver and stomach Qi stagnation, and Bupleurum Liver-soothing powder is often used to soothe the liver, regulate Qi, and harmonize the stomach. A large and empty right Guan pulse suggests insufficiency of Central Qi, and Buzhong Yiqi Tang is commonly used to tonify Qi and soothe the liver. In terms of medication, professor LIAN pays attention to patients’ dietary habits and combines methods of eliminating dampness, promoting digestion, and activating blood circulation to improve symptoms and reverse atrophy.
