健脾消痰法防治多发性结直肠腺瘤内镜术后复发的临床观察  

Clinical Observation of Jianpi Xiaotan Method in Prevention and Treatment of Recurrence of Multiple Colorectal Adenomas after Endoscopic Surgery

作　　者：牛晓玲 孙志广[2] 周芬敏 徐春巍 陆瑞峰 

机构地区：[1]上海市浦东新区周浦医院中医科,上海201318 [2]江苏省中医院消化内科,江苏南京210029

出　　处：《辽宁中医杂志》2015年第4期738-740,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：上海市浦东新区传统型中医临床示范学科建设基金项目(PDZYXK-3-2013008)

摘　　要：目的:运用健脾消痰法治疗脾虚痰阻证结直肠腺瘤患者,观察其对患者的主要症状、体征、结直肠腺瘤复发率、结肠腺瘤性息肉蛋白(APC)、β-连接素(β-catenin)、磷酸酶基因(PTEN)的影响。方法:将符合纳入标准的60例脾虚痰阻证结直肠腺瘤患者采取随机法分为两组,每组30例,其中对照组在内镜下切除后不另做治疗,观察组在内镜下切除后给予健脾消痰汤治疗,28天为1个疗程,观察12个疗程,统计疗效。结果:治疗后12个月观察组在症状、体征积分方面明显优于对照组(P<0.05),在便血、腹痛、腹胀、头重肢困、食少纳差、黏液便、排便不爽、脉象方面较治疗前明显好转(P<0.05),治疗后6个月和12个月结直肠腺瘤复发率明显降低(P<0.05),与对照组比较,APC、PTEN在肠黏膜的表达有明显提高(P<0.05),β-catenin明显下降(P<0.05)。结论:健脾消痰汤能明显改善患者的主要症状、体征、减少结直肠腺瘤的复发,在一定程度上预防了结直肠癌的发生。Objective：Jianpi Xiaotan method was used to treat colorectal adenomas patients of spleen phlegm syndrome.The influence on symptoms and signs,the recurrence rate of colorectal adenoma,adenomatous polyposis coli（APC）,β-catenin（β-catenin） and phosphatase gene（PTEN） were observed.Methods：60 patients consistent with internalizing criteria were divided intothe control group（30 cases） and the observation group（30 cases） by taking random methods.The control group after endoscopic resection was give no another treatment and the observation group was given Jianpi Xiaotan Decoction.A course of treatment was28 days,observing for 12 courses and then the effect was compared.Results：After 12 months in the observation group,the bloating,heavy limbs sleepy head,eat less anorexia,mucous,stool unhappy and pulse conditions were significantly improved compared to those before treatment（P〈0.05）.After 6 months and 12 months treatment,the cure rates of colorectal adenomas were significantly improved（P〈0.05） compared with that of the control group.APC and PTEN expressions in intestinal mucosa were significantly improved（P〈0.05） and β-catenin was significantly decreased（P〈0.05）.Conclusion：Jianpi Xiaotan Decoction can significantly improve the patient＇s main symptoms and signs and reduce the recurrence of colorectal adenomas and to some extent,prevent the occurrence of colorectal cancer.

关 键 词：健脾消痰汤 结直肠腺瘤 结肠腺瘤性息肉蛋白(APC) 磷酸酶基因(PTEN) β-连接素(β-catenin) 

分 类 号：R735.37[医药卫生—肿瘤]