基于Logistic回归模型探析结直肠息肉癌变中西医影响因素  

Analysis of Factors Influencing Canceration of Colorectal Polyp in Traditional Chinese Medicine and Western Medicine Based on Logistic Regression Model

作　　者：陈婷婷[1] 肖君[2] 史丽萍 周青[2] 程海波[1] CHEN Tingting;XIAO Jun;SHI Liping;ZHOU Qing;CHENG Haibo(Nanjing University of Chinese Medicine,Nanjing 210023,China;The Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210046,China)

机构地区：[1]南京中医药大学,江苏南京210023 [2]南京中医药大学附属医院,江苏南京210046

出　　处：《山东中医杂志》2021年第1期15-20,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81730108);国家科技部重点研发计划项目(编号:2017YFC1700602)。

摘　　要：目的:探讨结直肠息肉癌变进程中的主要影响因素及中医证型与不同病理阶段的相关性。方法:采集结直肠息肉确诊患者的住院病历1428份,制定相应信息表,建立中医证型与影响因素数据库,对结直肠息肉疾病进展中结直肠腺瘤病变和结直肠癌变与各影响因素及中医证型之间的关联性进行Logistic回归分析。结果:年龄、胆囊疾病或胆囊切除史、结直肠息肉家族史为疾病进展过程中的危险因素(P<0.05,r>1),胃炎病史、结直肠炎病史、结直肠息肉病史、心脑血管病家族史为疾病进展过程中的保护因素(P<0.05,r<1);中医证型对结直肠息肉腺瘤病变的影响强度由强到弱依次为脾虚湿盛证、湿热蕴肠证、气滞血瘀证、脾胃虚弱证;对结直肠息肉癌变影响强度最大的中医证型为气滞血瘀证。结论:结直肠息肉癌变进程与年龄、胆囊疾病史及结直肠息肉家族史等多种影响因素具有相关性,且特定的中医证型与不同病理阶段存在相关性。Objective:To explore the primary influencing factors in the carcinogenesis of colorectal polyps and the correlation between traditional Chinese Medicine(TCM)syndrome types and different pathological stages.Methods:A total of 1428 cases of colorectal polyps were reviewed,and the corresponding information tables were made.A database of TCM syndrome types and influencing factors was established.Logistic regression was conducted to analyze the correlation between the influencing factors and colorectal adenoma lesions or colorectal canceration in the progression of colorectal polyps,as well as the correlation between TCM syndrome types and colorectal adenoma lesions or colorectal canceration.Results:Age,history of gallbladder disease or cholecystectomy,and family history of colorectal polyp were predicted to be risk factors in the disease progression(P<0.05,r>1),while history of gastritis,history of colonitis or proctitis,history of colorectal polyp,and family history of cardio cerebrovascular disease were predicted to be protective factors in the disease progression(P<0.05,r<1).The influence of TCM syndrome types on colorectal polyp adenoma lesions,from strong to weak,was spleen deficiency and dampness excess syndrome,damp-heat accumulation in intestine syndrome,qi stagnation and blood stasis syndrome,deficiency of spleen and stomach syndrome.Qi stagnation and blood stasis syndrome was the type with the strongest influence on colorectal polyp cancerization.Conclusion:The canceration of colorectal polyp is related to several factors,such as age,history of gallbladder disease,family history of colorectal polyp,and so on.Some specific TCM syndrome types are related to different pathological stages.

关 键 词：结直肠息肉 癌变 LOGISTIC回归 影响因素 中医证型 脾虚湿盛证 气滞血瘀证 

分 类 号：R273[医药卫生—中西医结合]