结直肠腺瘤中医证候分布规律及其方药干预研究  

Study on the Distribution Rules of Traditional Chinese Medicine Syndromes and the Intervention of Prescriptions in Colorectal Adenoma

作　　者：惠逸帆 李晨[1,2,3] 郭天灏 李柳 程海波[1,2,3] 廖星 HUI Yifan;LI Chen;GUO Tianhao;LI Liu;CHENG Haibo;LIAO Xing(The First Clinical Medical College,Nanjing University of Chinese Medicine,Nanjing 210023,China;Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China;Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine in Prevention and Treatment of Tumor,Nanjing 210023,China;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]南京中医药大学第一临床医学院,南京210023 [2]南京中医药大学附属医院,南京210029 [3]江苏省中医药防治肿瘤协同创新中心,南京210023 [4]中国中医科学院中医临床基础医学研究所,北京100700

出　　处：《中国中医基础医学杂志》2023年第11期1866-1870,共5页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：国家中医药管理局中医药创新团队及人才支持计划项目(ZYYCXTD-C-202208);中华中医药学会团体标准项目(20211001-BZCACM);中国中医科学院科技创新工程项目(CI2021A05503);中国中医药循证医学中心“业务研究室主任专项”项目(2020YJSZX-2)。

摘　　要：目的 通过文献整理与分析探讨结直肠腺瘤的中医证候分布与方药运用规律,为临床中医药辨治本病提供参考。方法 检索建库至2022年4月3日中国期刊全文数据库(CNKI)、中文科技期刊数据库(VIP)、万方数据库(WANFANG)中中医药治疗结直肠腺瘤的相关文献,统计结直肠腺瘤中医证型、方药使用频次及不同病理与中医证型之间的关系,并对药物进行聚类分析。结果 共纳入文献105篇,获得中医证型27个,最常见的5个证型为湿热内蕴证、脾虚湿蕴证、脾气亏虚证、气滞血瘀证、脾虚湿瘀证;共纳入方剂54首,其中成方12首,以参苓白术散、乌梅丸、六君子汤为主;共出现中药141味,多类属补虚药、清热药、利水渗湿药、理气药、活血化瘀药,出现频次最多的前5味中药为白术、茯苓、甘草、党参、薏苡仁;聚类分析发现4组具有关联性的药物组合。管状腺瘤、管状绒毛状腺瘤、绒毛状腺瘤3种病理分型患者中医证型组间比较差异有统计学意义(P<0.001)。结论 结直肠腺瘤患者中医证型分布以湿热内蕴证最为常见,其次为脾虚湿蕴证、脾气亏虚证,遣方用药时多运用清热化湿、补益脾气之法,兼顾理气行滞、活血化瘀、解毒散结,临证需对症加减,病证结合。Objective To study the rules of traditional Chinese medicine(TCM)syndrome distribution and prescription rule in the treatment of colorectal adenoma through literature review and analysis,so as to provide guidance for the clinical treatment of the disease based on TCM differentiation.Methods Literatures on TCM syndrome and prescription rule of colorectal adenoma in CNKI,VIP and WANFANG databases from establishment to April 3,2022 were searched and collected.TCM syndrome distribution,the prescription rule of colorectal adenomas,as well as the relationship between different pathologies and TCM syndrome were analyzed.Results A total of 105 literatures were included.27 TCM syndromes were obtained.The five most common syndromes included dampness and heat accumulation syndrome,spleen deficiency and dampness accumulation syndrome,spleen-Qi deficiency syndrome,Qi stagnation and blood stasis syndrome and spleen deficiency and damp stasis syndrome.54 prescriptions were included and 12 of them were setting prescriptions,such as Shenling Baizhu Powder,Wumei Pill and Liujunzi Decoction.141 Chinese herbs were found,among which belong to tonifying deficiency,clearing heat,improving water and dampness,regulating Qi,activating blood circulation and removing stasis.The five most frequently Chinese herbal medicines were Atractylodes macrocephala,Poria cocos,Glycyrrhiza uralensis,Codonopsis pilosula,and Coix seed.Cluster analysis revealed 4 groups of associated drug combinations.There were statistical differences in the TCM syndrome of colorectal adenoma in tubular adenoma,tubular villous adenoma and villous adenoma(P<0.001).Conclusion The most common TCM syndrome of colorectal adenoma patients were dampness and heat accumulation syndrome,followed by spleen deficiency and dampness accumulation syndrome and spleen-Qi deficiency syndrome.Doctors should pay attention to not only clearing heat,eliminating dampness and tonifying spleen Qi,but also regulating Qi stagnation,activating blood circulation and removing stasis,resolving toxin an

关 键 词：结直肠腺瘤 中医药 中医证候 方药规律 湿热内蕴 

分 类 号：R273[医药卫生—中西医结合]