Clinical and experimental study on therapeutic effect of Weixibaonizhuanwan on gastric precancerous lesions

Abstract

AIM: To study the therapeutic effect of Weixibaonizhuanwan on gastric precancerous lesions.

METHODS: Thirty-six patients with gastric precancerous lesions were treated with Weixibaonizhuanwan for 3 mo. Thirteen (36.1%) patients presented with mild atrophic gastritis, 14 (38.9%) with moderate atrophic gastritis, and nine (25.0%) with severe atrophic gastritis. Twenty-two (61.1%) and 27 (75.0%) of the cases were accompanied by intestinal metaplasia (IM) and dysplasia (DYS), respectively. Twenty of the 36 patients were men and 16 were women, ranging from 30 to 67 years in age, with 61.1% of the patients being 40-59 years old. The duration of the disease in these patients ranged from 3 mo to 21 years, with 20 (55.6%) patients experiencing durations of the disease between 5 and 10 years. The clinical manifestations of the disease in these patients included fullness of the abdomen (31 cases), abdominalgia (27 cases), anorexia (30 cases), eructation (26 cases), pantothenic acid (6 cases), and loose stool (9 cases). Patients were treated with Weixibaonizhuanwan and symptom improvement, level of atrophy of the gastric mucosa, and IM and DYS progression were analyzed.

RESULTS: After a 3-mo treatment with Weixibaonizhuanwan, seven patients experienced recovery. The treatment was effective in 11 cases, improved symptoms in 13 cases, and was ineffective in five cases. The overall efficacy rate was 86.1%. In patients with mild atrophic gastritis (n = 13), 11 improved into superficial gastritis and two experienced no improvement. In 14 cases of moderate gastritis, four cases improved into superficial gastritis and seven turned into mild atrophic gastritis, with three patients experiencing no improvement. Among severe atrophic gastritis patients (n = 9), five improved into moderate atrophic gastritis after treatment and four experienced no improvement. The overall efficacy rate in chronic atrophic gastritis patients was 77.8%. Among 9 patients with IM, IM disappeared in six cases, whereas three cases showed no improvement after treatment. In cases with moderate IM (n = 10), IM disappeared in two, turned into mild IM in five, and showed no change in three. Out of four cases with IM, one case turned into moderate IM and three showed no change. The overall efficacy rate in IM patients was 63.6%. Out of 16 cases of mild DYS, DYS disappeared in 11, whereas five cases showed no change. Out of nine cases of moderate DYS, DYS disappeared in two and turned into mild DYS in five cases, with two patients experiencing no change after treatment. No improvement was observed in the two cases of severe DYS after treatment. The overall efficacy rate in DYS patients was 66.7%. After treatment, expression of carcinoembryonic antigen (CEA) and proliferating cell nuclear antigen (PCNA) in gastric mucosa significantly decreased (P < 0.01). Before treatment, cancer staging of these patients by positive CEA expression was I, II, III, and IV in 13, 12, 9, and 2 cases, respectively. After treatment, the number of cases per stage changed to 25, 7, 3, and 1, respectively. Similarly, before treatment, staging by positivity of PCNA expression was I, II, III, and IV in 16, 11, 10, and 4 cases, respectively, and changed to 21, 9, 5, and 1, respectively, after treatment.

CONCLUSION: The use of Weixibaonizhuanwan in the treatment of gastric precancerous lesions showed promising therapeutic effects in patients after 3-mo treatments.

Key Words: Weixibaonizhuanwan, Stomach neoplasms/TCM therapy, Precancerous conditions, Gastric mucosa, Chinese herbal