济生乌梅片预防结直肠腺瘤术后复发的临床研究  

Clinical study of Jisheng Wumei Tablet in preventing postoperative recurrence of colorectal adenoma

作　　者：孙志华 杨小军[2] 黄玉兰 唐小荏 陈宇桥 李飞[1] 范青峰 欧阳非儿 宋梦如 SUN Zhihua;YANG Xiaojun;HUANG Yulan;TANG xiaoren;CHEN Yuqiao;LI Fei;FAN Qingfeng;OUYANG Feier;SONG Mengru(Hunan University of Traditional Chinese Medicine,Changsha,410208,China;Department of Spleen and Stomach?Chongqing Traditional Chinese Medicine Hospital)

机构地区：[1]湖南中医药大学,长沙410208 [2]重庆市中医院脾胃科

出　　处：《中国中西医结合消化杂志》2021年第8期559-563,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：成都中医药大学杏林学者学科人才科研提升计划(No:YYZX20180042)。

摘　　要：目的:研究济生乌梅片预防结直肠腺瘤(CRA)术后复发的临床疗效,分析CRA术后复发的相关因素。方法:2018年3月—2019年3月在重庆市中医院募集行CRA内镜下切除术后患者120例,随机分为治疗组(济生乌梅片)、对照组(碳酸钙D3片)、空白组。治疗组和对照组分别给予济生乌梅片、碳酸钙D3片口服3个月,3组术后1年复查肠镜,评价济生乌梅片的预防效果,分析影响CRA复发的相关因素。结果:(1)术后1年复查肠镜,治疗组复发率明显低于对照组和空白组,差异有统计学意义(P<0.05),而对照组与空白组复发率差异无统计学意义。(2)单因素分析发现腺瘤复发与患者性别、吸烟、饮酒、是否喜食红肉、合并代谢综合征、腺瘤数量、病理类型、是否伴上皮内瘤变、预防方案等因素有显著相关性(P<0.05)。对相关因素进行多因素Logistic回归分析显示:病理为管状绒毛状腺瘤是CRA术后复发的独立危险因素(P<0.05)。结论:(1)济生乌梅片能显著降低CRA患者术后复发。(2)CRA患者术后复发因素包括患者性别、吸烟史、饮酒史、是否喜食红肉、合并代谢综合征、腺瘤数量、病理类型、是否伴上皮内瘤变等。其中病理类型为管状绒毛状腺瘤是CRA复发的独立危险因素。Objective: To study the clinical efficacy of Jisheng Wumei Tablet in the prevention of postoperative recurrence of colorectal adenoma, and analyze the related factors of postoperative recurrence of colorectal adenoma. Methods: From March 2018 to March 2019, 120 patients with colorectal adenoma after endoscopic resection were recruited from Chongqing hospital of Traditional Chinese Medicine and randomly divided into treatment group(Jisheng Wumei Tablets), control group(calcium carbonate D3 tablets) and blank group. The treatment group and the control group were given Jisheng Wumei Tablets and calcium carbonate D3 tablets respectively for 3 months. The three groups were reexamined by colonoscopy one year after operation to evaluate the preventive effect of Jisheng Wumei Tablets and analyze the related factors affecting the recurrence of colorectal adenoma. Results:(1)1 year after operation, the recurrence rate of the treatment group was significantly lower than that of the control group and the blank group(P<0.05), but there was no significant difference between the control group and the blank group.(2)Univariate analysis showed that the recurrence of adenoma was significantly correlated with gender, smoking, drinking, eating red meat, metabolic syndrome, number of adenomas, pathological type, intraepithelial neoplasia and prevention plan(P<0.05). Multivariate logistic regression analysis showed that tubular villous adenoma was an independent risk factor for postoperative recurrence of colorectal adenoma(P<0.05). Conclusion:(1)Jisheng Wumei Tablet can significantly reduce the recurrence of colorectal adenoma.(2)The recurrence factors of colorectal adenoma patients included gender, smoking history, drinking history, red meat preference, metabolic syndrome, adenoma number, pathological type, and intraepithelial neoplasia. Tubular villous adenoma is an independent risk factor for recurrence of colorectal adenoma.

关 键 词：济生乌梅片 结直肠腺瘤 预防复发 复发相关因素 

分 类 号：R735.3[医药卫生—肿瘤]