OBJECTIVETo study the therapeutic effect of Weiyan serial recipes (WYSR) in treatment of chronic atrophic gastritis (CAG) accompanied with intestinal metaplasia (IM) and/or dysplasia (Dys) and to explore its molecular mechanisms for reversing the gastric precancerous lesions.

METHODSOne hundred and fifty patients with confirmed diagnosis of CAG accompanied with IM and/or mild Dys were randomly assigned to the treatment group (120 cases) and the control group (30 cases). Patients in the treatment group were respectively treated with WYSR I-IV according to Chinese medicine syndrome typing as incoordination of Gan and Wei syndrome (32 cases), deficiency of Pi and Wei syndrome (35 cases), insufficient Wei-yin syndrome (28 cases), and stasis stagnation in Wei-channel syndrome (25 cases). Patients in the control group orally took Weifuchun Pill. The therapeutic course for all was 3 months, and totally 2 courses. The clinical effects, changes under the gastroscope, the pathological changes, and expressions of gastric mucosal hypoxia-inducible factor-1alpha(HIF-1alpha), vascular endothelial growth factor (VEGF) protein were compared between the two groups before and after treatment.

RESULTSThe total effective rate of the treatment group was 86.7% and the total effective rate of the gastroscopic changes was 78.3%, which was higher than those of the control group (56.7% and 40.0%), showing significant difference (P < 0.01, P < 0.05). The total effective rate of clinical symptoms and that of the pathological changes were higher in the treatment group than in the control group with statistical significance shown (P < 0.05). There was no statistical difference in the expressions of HIF-1alpha and VEGF protein of the control group between before and after treatment (P > 0.05). Compared with before treatment, the post-treatment expressions of HIF-1alpha and VEGF protein both obviously decreased in the treatment group (P < 0.01), and were lower than those in the control group (P < 0.05).

CONCLUSIONSWYSR showed better effects on treating gastric precancerous lesions. It could significantly improve the atrophy, IM, and Dys, and promote the reversal of gastric precancerous lesions. Its mechanisms might possibly be correlated with inhibiting the over-expressions of HIF-1alpha and VEGF protein.

Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gastritis, Atrophic ; drug therapy ; metabolism ; pathology ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Male ; Middle Aged ; Phytotherapy ; Precancerous Conditions ; drug therapy ; metabolism ; pathology ; Stomach Neoplasms ; prevention & control ; Vascular Endothelial Growth Factor A ; metabolism ; Young Adult