进展期大肠腺瘤性息肉中医证候特征及危险因素的临床研究  

Clinical study on risk factors and characteristics of Traditional Chinese Medicine syndrome of advanced adenomatous large intestine polyps

作　　者：陈淑妮 何海滨 李峰[2] 洪丹 古凯敏 Chen Shuni;He Haibin;Li Feng;Hong Dan;Gu Kaimin(Department of Spleen and Stomach Diseases,Shenzhen Hospital of Beijing University of Chinese Medicine(Longgang),Shenzhen 518100,China;Doctoral Degree Student of Grade 2021,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学深圳医院(龙岗)脾胃病科,深圳518100 [2]北京中医药大学,北京100029

出　　处：《国际中医中药杂志》2024年第4期434-438,共5页International Journal of Traditional Chinese Medicine

基　　金：深圳市龙岗区经济与科技发展专项资金医疗卫生科技计划项目(LGWJ2021-75)。

摘　　要：目的探讨进展期大肠腺瘤性息肉(Aps)发生发展的危险因素。方法回顾性横断面研究。选择2020年12月-2022年12月北京中医药大学深圳医院(龙岗)400例行大肠息肉切除术且病理诊断为Aps的住院患者作为观察对象,其中进展期腺瘤107例、普通腺瘤293例。收集患者一般资料(姓名、性别、年龄、BMI)、吸烟史、饮酒史、高血压病病史、糖尿病病史、13C尿素呼气试验结果,分析进展期腺瘤发病的危险因素及其证候特征。结果①进展期腺瘤男性患者分布[70.09%(75/107)比57.34%(168/293),P=0.021]、年龄[(52.25±9.81)岁比(48.41±10.23)岁,P=0.001]、BMI[(24.37±3.19)kg/m2比(23.38±3.25)kg/m2,P=0.007]高于普通腺瘤;②进展期腺瘤和普通腺瘤患者常见证型均为肠道湿热证,其中进展期腺瘤肠道湿热证患者分布高于普通腺瘤[43.0%(46/107)比32.1%(94/293);χ^(2)=4.10,P=0.043];③进展期腺瘤饮酒史患者分布高于普通腺瘤[61.7%(66/107)比39.3%(115/293);χ^(2)=15.92,P<0.001];④进展期腺瘤糖尿病病史患者分布高于普通腺瘤[29.9%(32/107)比14.7%(43/293);χ^(2)=19.94,P<0.001];⑤进展期腺瘤患者Hp感染率大于普通腺瘤[66.4%(71/107)比44.7%(131/293);χ^(2)=14.69,P<0.001];⑥Logistic回归分析显示,年龄、BMI、男性、肠道湿热证、饮酒史、糖尿病病史及Hp感染是进展期腺瘤发病的危险因素(P<0.05或P<0.01)。结论肠道湿热证是进展期腺瘤患者的关键证候,且男性、年龄、BMI、饮酒史、糖尿病病史及Hp感染为其发病的危险因素。Objective To investigate the risk factors of adenomatous colorectal polyps in advanced stage.Methods Retrospective cross-sectional study.A total of 400 hospitalized patients with colorectal polypectomy and pathological diagnosis of adenomatous polyps(Aps)were selected from December 2020 to December 2022 in Shenzhen Hospital of Beijing University of Chinese Medicine(Longgang),of which 107 patients with progressive adenomas and 293 patients with common adenomas were selected.General information of patients(name,gender,age,BMI),history of smoking,alcohol consumption,history of hypertension,history of diabetes mellitus,and results of 13C urea breath test were collected to analyze the risk factors for the development of adenomas in patients with progressive adenomas and their syndromic characteristics.Results The distribution of male patients with advanced adenoma was significantly higher than that of common adenoma patients[70.09%(75/107)vs.57.34%(168/293),P=0.021],and the ages were[(52.25±9.81)years vs.(48.41±10.23)years,P=0.001],BMI[(24.37±3.19)kg/m2 vs.(23.38±3.25)kg/m2,P=0.007]significantly higher than those of ordinary adenoma patients.Intestinal damp-heat syndrome was the common witness type in both advanced and common adenomas,and the distribution of intestinal damp-heat syndrome in advanced adenomas was significantly higher than that in common adenomas[43.0%(46/107)vs.32.1%(94/293);χ^(2)=4.10,P=0.043].The distribution of patients with alcohol drinking history in advanced adenomas was significantly higher than that in common adenomas[61.7%(66/107)vs.39.3%(115/293);χ^(2)=15.92,P<0.001].The distribution of diabetic patients with advanced adenoma was significantly higher than that of common adenoma patients[29.9%(32/107)vs.14.7%(43/293);χ^(2)=19.94,P<0.001].The infection rate of Hp in advanced adenoma patients was significantly higher than that in common adenoma patients[66.4%(71/107)vs.44.7%(131/293);χ^(2)=14.69,P<0.001].Logistic regression analysis showed that age,BMI,male,intestinal damp-heat syndrome,

关 键 词：腺瘤性结肠息肉病 进展期腺瘤 普通腺瘤 中医证型 危险因素 

分 类 号：R259[医药卫生—中西医结合]