大肠腺瘤性息肉中医证型、体质及高危因素的实证研究  

TCM syndrome type,physical constitution and high risk factors of colorectal adenomatous polyps

作　　者：楚永庆 陈英群[3] 李力 吕若云 张文杰 CHU Yongqing;CHEN Yingqun;LI Li;LU Ruoyun;ZHANG Wenjie(Department of Traditional Chinese Medicine,Yangpu Hospital,School of Medicine,Tongji University,Shanghai 200092,China;School of Medicine,Tongji University,Shanghai 200092,China;Department of Traditional Chinese Medicine,Shanghai Tenth People s Hospital,School of Medicine,Tongji University,Shanghai 200072,China;Department of Gastroenterology,Yangpu Hospital,School of Medicine,Tongji University,Shanghai 200092,China;Division of Teaching Affair of Yangpu Hospital,School of Medicine,Tongji University,Shanghai 200092,China)

机构地区：[1]同济大学附属杨浦医院中医科,上海200092 [2]同济大学医学院,上海200092 [3]同济大学附属第十人民医院中医科,上海200072 [4]同济大学附属杨浦医院消化科,上海200092 [5]同济大学附属杨浦医院教学管理部,上海200092

出　　处：《同济大学学报（医学版）》2023年第3期345-349,共5页Journal of Tongji University(Medical Science)

基　　金：上海市卫生健康委员会临床研究专项(201940369);上海市进一步加快中医药传承创新发展三年行动计划(2021—2023)“上海市中医药高层次人才引领计划项目(中医药创新群体类)”。

摘　　要：目的分析腺瘤性息肉患者中医证型与体质的临床分布规律,探讨大肠腺瘤性息肉的相关因素。方法收集经结肠镜与病理检查诊断为腺瘤性息肉的患者108例,采集相关信息,采用描述性统计、单样本t检验、χ^(2)检验以及Logistic回归法进行统计分析。结果纳入研究的腺瘤性息肉患者,以老年居多(84.26%),饮食习惯、不良嗜好与腺瘤性息肉的发生具有相关性,嗜食肥甘厚腻者占78.70%,有不良嗜好(吸烟、喝酒)的男性患者占78.43%。腺瘤息肉发病位置以乙状结肠为主(占45.37%),息肉直径<0.5 cm的患者最多(占85.19%),息肉数量与不同性别之间的差异有统计学意义。中医证型分布以肝郁脾虚证为主(63.89%),其次为肝郁气滞证(12.96%)、脾胃虚弱证(9.26%)。腺瘤性患者症状积分区间为512分,平均值为8.213分。中医体质主要为气虚质(85.19%),其次是气郁质(69.44%)、湿热质(14.81%)。结论腺瘤性息肉男性患者更多喜食肥甘厚腻或有不良嗜好,女性患者饮食多清淡或无不良嗜好。男性患者更多为多发息肉;女性患者更多为单发息肉。饮食习惯是腺瘤性息肉的高危因素。腺瘤性息肉患者临床以肝郁脾虚证为主,体质上多见于气虚质、气郁质。Objective To analyze the TCM syndrome types,physical constitution and risk factors of colorectal adenomatous polyps.Methods One hundred and eight patients diagnosed with adenomatous polyps by colonoscopy and pathological examination were enrolled in the study.Descriptive statistics,one-sample t-test,χ^(2) test and logistic regression were used for statistical analysis.Results The mean age of patients were(64.9±6.35)years(3675 year)and 84.2%(91/108)were aged≥65 year.The development of adenomatous polyps was significantly correlated with dietary behavior,unhealthy habits;78.70%of the patients preferred fatty,sweet and greasy food,and 78.43%of male patients had unhealthy habits(smoking and drinking).The location of adenomatous polyps was predominantly in the sigmoid colon(45.37%)and most polyps were<0.5 cm in diameter(85.19%),and there was significant difference in the number of polyps between males and females.The liver-depression and spleen-deficiency type was dominate TCM syndrome type(63.89%),followed by liver-depression and qi-stagnation type(12.96%)and spleen-stomach weakness type(9.26%).Adenomatous patients had a symptom score range of 5 to 12,with a mean score of 8.213.The main TCM physical constitution was Qi-deficiency(85.19%),followed by Qi-depression(69.44%)and Damp-heat(14.81%).Conclusion Male patients with adenomatous polyps commonly prefer fatty and greasy food or have bad habits,while female patients tend to have a lighter diet or no bad habits.Multiple polyps were common in male patients,while women mostly have single lesion.Dietary habits and symptoms are high risk factors for adenomatous polyps.Patients with adenomatous polyps are dominated by liver-depression and spleen-deficiency type,and more likely to have a qi-deficiency or qi-depression physical constitution.

关 键 词：大肠腺瘤性息肉 中医体质 中医证型 

分 类 号：R4[医药卫生—临床医学]