摘要
目的通过分析结直肠癌前病变的腺瘤性息肉的中医证型分布特点,为“浊毒理论”在结直肠息肉中的应用提供临床依据。方法搜集2018年11月—2019年7月河南中医药大学第一附属医院胃肠镜室240例腺瘤性息肉患者作为研究对象,对患者的一般资料、临床症状和中医四诊资料进行分析,总结中医证型分布特点。结果在240例腺瘤性息肉患者中,性别(χ^(2)=17.067,P=0.00)、年龄(χ^(2)=40.075,P=0.00)、主要症状(χ^(2)=249.850,P=0.00)具有统计学意义(均P<0.05)。其中腺瘤性息肉男性(63.3%,152/240)>女性(36.7%,88/240);年龄中年(44.6%,107/240)>老年(41.3%,99/240)>青年(14.2%,34/240);腹胀腹痛(54.2%,130/240)>无症状(14.6%,35/240)>便血(10.0%,24/240)>腹泻(8.8%,21/240)>便秘(6.7%,16/240)>大便干稀不调(5.8%,14/240)。在240例腺瘤性息肉患者中中医证型(χ^(2)=81.950,P=0.00)具有统计学意义(均有P<0.05)。其中湿热内蕴证(34.6%,83/240)>气滞血瘀证(20.8%,50/240)>脾胃虚弱证(17.9%,43/240)>痰浊内蕴证(12.5%,30/240)>肝郁脾虚证(10.8%,26/240)>痰热凝滞证(3.3%,8/240);在240例腺瘤性息肉患者中浊毒内蕴证型分布情况(χ^(2)=87.767,P=0.00)具有统计学意义(P<0.05)。根据浊毒之邪致病的特点,将湿热、痰浊、痰热归属于浊毒内蕴证范畴,其中浊毒内蕴证(50.4%,121/240)>气滞血瘀证(20.8%,50/240)>脾胃虚弱证(17.9%,43/240)>肝郁脾虚证(10.8%,26/240)。结论腺瘤性息肉男性发病率高于女性,中老年的发病率较高,症状有腹痛腹胀、腹泻、便血、便秘及大便干稀不调等存在症状的比例高于无症状,临床中医证型中以浊毒内蕴证为主,尚有气滞血瘀证、脾胃虚弱证及肝郁脾虚证。
Objective To analyze the distribution characteristics of traditional Chinese medicine syndromes of adenomatous polyps in colon precancerous lesions and provide a basis for the application of“turbid toxin theory”in colon polyps.Methods This study collected 240 patients with adenomatous polyps in the gastrointestinal endoscopy room of The First Affiliated Hospital of Henan University of Traditional Chinese Medicine from November 2018 to July 2019 as the research object and analyzed the general information,clinical symptoms and four diagnosis data of traditional Chinese medicine.It summarized the characteristics of traditional Chinese medicine syndrome distribution.Results Among 240 patients with adenomatous polyps,gender(χ^(2)=17.067,P=0.00),age(χ^(2)=40.075,P=0.00),main symptoms(χ^(2)=249.850,P=0.00)were statistically significant(all P<0.05).Among them,adenomatous polyps male(63.3%,152/240)>female(36.7%,88/240);middle age(44.6%,107/240)>elderly(41.3%,99/240)>youth(14.2%,34/240);abdominal distension(54.2%,130/240)>asymptomatic(14.6%,35/240)>blood stool(10.0%,24/240)>diarrhea(8.8%,21/240)>constipation(6.7%,16/240)>dirty stool(5.8%,14/240).In 240 patients with adenomatous polyps,the traditional Chinese medicine syndrome type(χ^(2)=81.950,P=0.00)was statistically significant(all P<0.05).Among them,damp-heat syndrome(34.6%,83/240)>Qi stagnation and blood stasis syndrome(20.8%,50/240)>spleen and stomach weakness syndrome(17.9%,43/240)>phlegm turbidity syndrome(12.5%,30/240)>liver depression and spleen deficiency syndrome(10.8%,26/240)>phlegm heat coagulation stagnation syndrome(3.3%,8/240).The distribution of intrinsic syndrome type(χ^(2)=87.767,P=0.00)in 240 patients with adenomatous polyps was statistically significant(P<0.05).According to the pathogenic characteristics of turbid toxin,damp-heat,phlegm turbidity and phlegm heat were classified as turbid toxin internal syndrome,including turbid toxin internal syndrome(50.4%,121/240)>Qi stagnation and blood stasis syndrome(20.8%,50/240)>spleen and stomach deficiency syndrome(17.9%,43/240)>liver depression and spleen deficiency syndrome(10.8%,26/240).Conclusion The incidence of adenomatous polyps in males is higher than that in females.The incidence of middle-aged and elderly people is higher.The proportion of symptoms with abdominal pain,bloating,diarrhea,blood in the stool,constipation and dry stool is higher than that of asymptomatic syndromes.The main syndromes are turbidity and blood stasis,blood stasis syndrome,spleen and stomach deficiency syndrome and liver depression and spleen deficiency syndrome.
作者
吴瑶麒
李合国
李佃贵
徐伟超
郭敏
WU Yaoqi;LI Heguo;LI Diangui;XU Weichao;GUO Min(Henan University of Traditional Chinese Medicine,Zhengzhou 450000,Henan,China;The First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,Henan,China;The Laboratory of Turbidity and Toxicology of Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,Hebei,China)
出处
《辽宁中医杂志》
CAS
2022年第6期76-79,共4页
Liaoning Journal of Traditional Chinese Medicine
基金
国家自然科学基金青年科学基金(81904161)
关键词
结直肠息肉
癌前病变
腺瘤性息肉
浊毒
中医
证型
colon polyps
precancerous lesions
adenomatous polyps
turbid toxin
traditional Chinese medicine
syndrome type
作者简介
吴瑶麒(1993-),男,河南中牟人,硕士,研究方向:中医药防治消化疾病;通讯作者:李合国(1964-),男,河南平舆人,主任医师,博士,研究方向:中医药防治消化疾病,E-mail:lhg1964@163.com。
