中药自拟方保留灌肠治疗结肠息肉的临床疗效观察  

Clinical Observation on Treating Colon Polyps with Self-Prepared TCM Retention Enemas

作　　者：王向军[1] 张玉娇 秦靖云 苏晓兰[1] WANG Xiang-jun;ZHANG Yu-jiao;QIN Jing-yun;SU Xiao-an(Beijing Key Laboratory of Traditional Chinese Medicine Diagnosis and Treatment on Functional Gastrointestinal Disorders,Department of Gastroenterology,Wanjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102;Department of Gastroenterology,Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang Hebei 050011)

机构地区：[1]中国中医科学院望京医院脾胃病科,功能性胃肠病中医诊治北京市重点实验室(BZ0374),北京100102 [2]河北省中医院脾胃病一科,河北石家庄050011

出　　处：《世界中西医结合杂志》2023年第4期787-790,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：中央级公益性科研院所基本科研业务费专项资金资助项目(ZZ13-YQ-035);国家自然基金资助项目(81973638);国家重大疑难病中西医协作试点项目。

摘　　要：目的 探讨结肠息肉切除术后患者行中药保留灌肠法,对患者体内肠道菌群和粪便性状的影响。方法 选取2019年8月—2020年6月期间以腹痛、腹泻或便秘为主要症状就诊于中国中医科学院望京医院,且肠镜检查确诊为结肠息肉并行肠镜下结肠息肉切除术的患者,共计120例。结肠息肉患者以中医证候诊断标准划分为寒证组和热证组,每组各60例。寒证组行临床热方中药保留灌肠治疗方案,热证组行寒方中药保留灌肠治疗。观察比较两组患者治疗前、治疗2、4周后肠道内菌群数量、粪便形状及微生物定植抵抗力(B/E值)。结果 灌肠治疗2周后,两组患者乳酸杆菌数量明显增加,肠杆菌、肠道双歧杆菌、肠球菌均明显减少,B/E值明显增加,与灌肠前比较,差异有统计学意义(P<0.05);灌肠治疗4周后,两组患者肠道双歧杆菌、乳酸杆菌数量均较灌肠前、灌肠2周后明显增多,肠球菌数量均较灌肠前、灌肠2周后明显减少,B/E值均较灌肠前、灌肠2周后明显升高,差异有统计学意义(P<0.05)。灌肠治疗2周后,两组患者中便秘型患者粪便基本与腊肠状比较接近,腹泻型患者粪便则基本接近柔软团状,与灌肠前比较差异均有统计学意义(P<0.05);灌肠治疗4周后,两组患者均恢复正常,与灌肠前、灌肠2周后比较,差异有统计学意义(P<0.05)。结论 对结肠息肉切除术后患者行中药保留灌肠治疗,可调节肠道菌群数量,调整肠道菌群结构,一定程度上增强了患者肠道菌群的B/E值,改变了患者粪便性状与肠道内环境,在临床可以推广应用。Objective To observe the specific effects of self-prepared retention enemas on the intestinal flora and stool characteristics of the patients after colon polypectomy.Methods A total of 120 patients with abdominal pain,di-arrhea,or constipation as the main symptoms,diagnosed with colon polyps by enteroscopy,and treated by colonoscopic polypectomy in Wanjing Hospital of China Academy of Chinese Medical Sciences from August 2019 to June 2020 were se-lected in this study.The patients were assigned into a cold syndrome group(n=60)and a heat syndrome group(n=60)ac-cording to the TCM diagnostic criteria.The cold syndrome group was treated with a TCM retention enema with warming function,while the heat syndrome group with a TCM retention enema with heat-clearing function.The bacterial count in the intestine,the stool shape,and the intestinal implant resistance(B/E value)were determined before treatment and after 2 and 4 weeks of treatment.Results The treatment with enemas for 2 weeks increased lactobacilli,reduced enterobacteria,bifidobacteria,and enterococci,and elevated the B/E value compared with before treatment(P<0.05).Compared with be-fore treatment and 2 weeks after treatment,the treatment with enemas for 4 weeks increased bifidobacteria and lactobacilli,reduced enterococci,and the elevated the B/E value(P<0.05).After 2 weeks of enema treatment,the patients with con-stipation in both groups showed sausage-shaped stool and the patients with diarrhea showed soft stool,which were signifi-cantly different from those before treatment(P<0.05).After 4 weeks of treatment with enema,the patients in both groups recovered compared with those before and after 2 weeks of treatment(P<0.05).Conclusion TCM retention enemas can regulate the intes tinal flora,increase the B/E value,change the stool shape,and improve the intestinal environment in the patients with colon polyps,and thus can be popularized in clinical application.

关 键 词：结肠息肉 中药保留灌肠 肠道菌群 粪便性状 

分 类 号：R574.62[医药卫生—消化系统]