306例大肠腺瘤患者中医证型分布特点及其与病理学因素的相关性分析  

Distribution characteristics of TCM syndrome types in patients with colorectal adenoma and their association with pathological factors:An analysis of 306 cases

作　　者：王蕾[1] 林琳[2] 田耀洲[2] WANG Lei;LIN Lin;TIAN Yaozhou(Affiliated Hospital of Jiangnan University,Wuxi 214062,Jiangsu,China;Jiangsu Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing 210028,Jiangsu,China)

机构地区：[1]江南大学附属医院,江苏无锡214062 [2]江苏省中西医结合医院,江苏南京210028

出　　处：《湖南中医杂志》2022年第8期1-5,16,共6页Hunan Journal of Traditional Chinese Medicine

基　　金：国家中医临床研究基地(江苏省中医药研究院)开放课题(JD2019SZXZD03,JD2019SZXYB11)

摘　　要：目的:探讨大肠腺瘤的中医证型分布特点及其与病理学因素、血脂指标的相关性。方法:选择2020年1~12月江南大学附属医院消化内科收治的大肠腺瘤患者306例,收集其临床资料,判定中医证型,分析中医证型与临床特征(性别、年龄、吸烟、饮酒、合并脂肪肝、合并糖尿病、是否行胆囊切除术)、病理特征(腺瘤数量、腺瘤直径、病理类型、异型增生程度)、血脂指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]的相关性。结果:中医证型与年龄、饮酒、合并糖尿病有较大相关性(P<0.05或P<0.01)。湿瘀阻滞证患者年龄在61岁(中位年龄)以上的占比高于其他证型;肠道湿热证中饮酒、合并糖尿病患者的占比高于其他证型。中医证型与腺瘤数量、腺瘤直径、病理类型、异型增生程度均有相关性(P<0.05或P<0.01)。湿瘀阻滞证以多发腺瘤为主,而气滞血瘀证、脾虚瘀滞证及无证型可辨者均以单发腺瘤多见。5个证型腺瘤直径≤5 mm者占比均较少,湿瘀阻滞证以腺瘤直径>10 mm者为主,气滞血瘀证、脾虚瘀滞证及无证型可辨者以腺瘤直径5~10 mm者为主。5个证型均以管状腺瘤、低级别上皮内瘤变为主。气滞血瘀证中TC、LDL水平均高于其他证型,组间比较,差异均有统计学意义(P<0.05或P<0.01)。结论:大肠腺瘤湿瘀阻滞证患者有更易患癌的高风险趋势,气滞血瘀证与血脂异常有一定的相关性。Objective:To investigate the distribution characteristics of TCM syndrome types in patients with colorectal adenoma and their association with pathological factors and blood lipid parameters.Methods:Clinical data were collected from 306 patients with colorectal adenoma who were admitted to Affiliated Hospital of Jiangnan University from January to December 2020,and TCM syndrome types were determined to investigate their association with clinical features(sex,age,smoking,drinking,comorbidities of fatty liver disease and diabetes,and whether cholecystectomy was performed),pathological features(number of adenomas,diameter of adenoma,pathological type,and degree of dysplasia),and blood lipid parameters[total cholesterol(TC),triglyceride,low-density lipoprotein(LDL),and high-density lipoprotein].Results:TCM syndrome type was significantly associated with age,drinking,and diabetes(P<0.05 or P<0.01).Compared with the other TCM syndrome types,dampnessstasis syndrome accounted for a higher proportion in the patients aged>61 years(median age),and intestinal dampness-heat syndrome accounted for a higher proportion in the patients with drinking or diabetes.TCM syndrome type was associated with the number of adenomas,diameter of adenoma,pathological type,and degree of dysplasia(P<0.05 or P<0.01).The patients with dampnessstasis syndrome mainly had multiple adenomas,while those with Qi stagnation and blood stasis syndrome,spleen deficiency and stasis syndrome,or undetermined syndrome type mainly had single adenoma.As for the five TCM syndrome types,the patients with an adenomadiameter of≤5 mm accounted for a relatively low proportion;most of the patients with dampness stasis syndrome had an adenomadiameter of>10 mm;the patients with Qi stagnation and blood stasis syndrome,spleen deficiency and stasis syndrome,or undetermined syndrome type mainly had an adenomadiameter of 5-10 mm.As for the five TCM syndrome types,most patients had tubular adenoma and low-grade intraepithelial neoplasia.The patients with Qi stagnation and blo

关 键 词：大肠腺瘤 中医证型 病理特征 血脂 

分 类 号：R273.53[医药卫生—中西医结合]