调肠消瘤方治疗结直肠腺瘤患者术后1年复发情况--176例随机对照临床观察  

Recurrence of Colorectal Adenoma Patients One Year after Operation Treated with Tiaochang Xiaoliu Formula(调肠消瘤方):A Randomize-Controlled Trial of 176 Cases

作　　者：张北平 钟彩玲 梁宝仪 李健民 赵喜颖 魏玮[3] ZHANG Beiping;ZHONG Cailing;LING Baoyi;LI Jianmin;ZHAO Xiying;WEI Wei(The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine(Guangdong Provincial Hospital of Traditional Chinese Medicine),Guangzhou 510120;Guangzhou University of Traditional Chinese Medicine;Wangjing Hospital,China Academy of Chinese Medical Sciences)

机构地区：[1]广州中医药大学第二附属医院(广东省中医院),广东省广州市越秀区510120 [2]广州中医药大学 [3]中国中医科学院望京医院

出　　处：《中医杂志》2020年第22期1971-1976,共6页Journal of Traditional Chinese Medicine

基　　金：广东省中医院院内专项(YN2016ZWB02);广东省自筹经费类科技计划项目(2017ZC0169)。

摘　　要：目的评价调肠消瘤方治疗结直肠腺瘤术后1年复发的临床疗效。方法纳入广州中医药大学第二附属医院消化内镜中心结直肠腺瘤术后患者410例,随机分为治疗组及对照组各205例,两组患者术后予常规支持治疗3~5天,并进行健康教育,指导患者合理饮食(增加膳食纤维、减少红肉摄入)、戒烟戒酒、坚持运动、控制体重、规律作息及调节情绪。治疗组再给予调肠消瘤方水煎口服,每日1剂,疗程为3个月。两组患者术后1年复查肠镜,比较两组患者腺瘤复发率,复发腺瘤的数目、病理性质、位置等,记录治疗前及术后1年患者的中医症状积分,并观察不良反应,分析复发相关危险因素。结果359例患者完成了研究,其中治疗组176例,对照组183例。1)术后1年,治疗组结直肠腺瘤复发率为45.5%(80/176),低于对照组的61.7%(113/183)(P<0.05);其中治疗组结直肠进展期腺瘤的比例[1.3%(1/80)]低于对照组[5.3%(6/113)],但差异无统计学意义(P>0.05);两组复发腺瘤数目、分布位置差异无统计学意义(P>0.05)。2)术后1年,两组患者中医症状积分均较本组治疗前降低(P<0.05),且治疗组[(0.62±1.343)分]低于对照组[(1.22±2.062)分](P<0.05)。3)多因素Logistic回归分析提示,调肠消瘤方干预使腺瘤复发的风险降低(OR=0.517,95%CI:0.326~0.821),腺瘤数目、位置及病理是腺瘤复发的独立危险因素。4)治疗期间治疗组患者未出现不良反应。结论调肠消瘤方能有效降低结直肠腺瘤患者术后1年复发率,减轻临床症状。Objective To evaluate the effects of Tiaochang Xiaoliu Formula(调肠消瘤方)in the prevention of colorectal adenoma recurrence one year after colorectal polypectomy.Methods A total of 410 patients who underwent colorectal adenoma resection in the Endoscopy Center of the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine were randomly divided into a treatment group and a control group with 205 patients in each group.Both groups of patients were given routine support therapy for 3-5 days after operation,and health education including reasonable diet such as increasing dietary fiber,reducing red meat intake,quitting smoking and alcohol,insisting on exercise,weight control,regular rest and mood adjustment.The treatment group was additionally treated with Tiaochang Xiaoliu Formula decoction,once a day,for 3 months.Patients in both groups were required to review for colonoscopy 1 year after colorectal adenoma resection.The adenomas recurrence rate,the number of recurrent adenomas,pathological condition and location,were compared between groups.The patient′s symptom score before and after treatment was recorded,the adverse reactions was observed,and the risk of recurrence factor was analyzed.Results A total of 359 patients completed the test including 176 in the treatment group and 183 in the control group.(1)One year after polypectomy,the recurrence rate of adenoma was 45.5%(80/176)in treatment group,lower than that in the control group(61.7%,113/183),the difference was statistically significant(P<0.05).The advanced adenoma rate in treatment group was 1.3%(1/80),lower than that of the control group(5.3%,6/113).The difference was not significant(P>0.05).The number,location and pathology of recurrent adenomas in both groups had no significant difference(P>0.05).(2)One year after operation,the symptom scores of both groups were lower than those before treatment(P<0.05).The scores of the treatment group[(0.62±1.343)points]was lower than that of the control group[(1.22±2.062)points](P<

关 键 词：结直肠腺瘤 复发 调肠消瘤方 危险因素 

分 类 号：R273[医药卫生—中西医结合]