中药口服加灌肠对结直肠腺瘤性息肉术后肠道菌群的影响研究  

Study on the Effect of Oral Administration of Chinese Medicine Combined with Enema on Intestinal Flora after the Operation of Colorectal Adenomatous Polyps

作　　者：张丽 戴以文 刘海 刘旭 赵锋 郭满 周楠 ZHANG Li;DAI Yiwen;LIU Hai;LIU Xu;ZHAO Feng;GUO Man;ZHOU Nan(Department of Anorectal Department,Nanyang Hospital of Traditional Chinese Medicine,Nanyang,Henan 473000,China)

机构地区：[1]河南省南阳市中医院肛肠科,河南南阳473000

出　　处：《转化医学杂志》2024年第10期1775-1779,共5页Translational Medicine Journal

基　　金：南阳市2022年市级科技计划项目(KJGG062)。

摘　　要：目的探讨结直肠腺瘤性息肉术后采取中药口服加灌肠治疗的效果及对肠道菌群影响。方法回顾性分析2023年1月至2024年1月南阳市中医院肛肠科收治地60例结直肠腺瘤性息肉患者临床资料,根据治疗方法不同将其分为2组,分别为采取手术治疗的对照组(n=30)以及采取手术+术后中药口服及灌肠治疗的观察组(n=30)。比较2组临床疗效,术前及术后2周双歧杆菌、肠球菌、大肠埃希菌、乳酸杆菌含量变化,术前及术后2周患者腺瘤积分、中医证候总积分变化及血清炎症因子白细胞介素-1β(IL-1β)、白细胞介素-17(IL-17)水平变化,并比较2组不良反应及随访6个月的复发率。结果观察组总有效率(93.33%)比对照组(73.33%)高(P<0.05)。2组患者术前双歧杆菌、肠球菌、大肠埃希菌及乳酸杆菌含量,腺瘤积分、中医证候总积分、IL-1β及IL-17水平比较差异均无统计学意义(P>0.05)。术后2周,2组患者双歧杆菌及乳酸杆菌含量显著上升,大肠埃希菌、肠球菌含量、腺瘤积分及中医证候总积分、IL-1β及IL-17水平均降低,且观察组双歧杆菌及乳酸杆菌含量高于对照组,大肠埃希菌、肠球菌、腺瘤积分及中医证候总积分、IL-1β及IL-17水平均低于对照组(均P<0.05)。2组均未见严重不良反应。随访6个月时观察组复发率低于对照组,但比较差异无统计学意义(P>0.05)。结论中药口服加灌肠可提升结直肠腺瘤性息肉手术患者治疗效果,改善患者术后肠道菌群情况,促进患者肠道功能恢复,改善患者病情,治疗安全可靠,未见复发。Objective To investigate the effect of oral administration of Chinese medicine combined with enema on postoperative outcomes and intestinal flora in patients with colorectal adenomatous polyps.Methods A retrospective analysis was conducted on the clinical data of 60 patients with colorectal adenomatous polyps treated at the Anorectal Department of Nanyang Hospital of Traditional Chinese Medicine from January 2023 to January 2024 According to different treatment methods,the patients were divided into two groups:the control group(30 cases)that received surgical treatment alone and the observation group(30 cases)that received surgical treatment plus postoperative oral administration of Chinese medicine and enema.Clinical efficacy,changes in intestinal flora parameters(bifidobacterium,enterococcus,Escherichia coli,and lactobacillus)before and 2 weeks after surgery,changes in adenoma scores and total traditional Chinese medicine(TCM)symptom scores,and levels of serum inflammatory factors interleukin-1β(IL-1β)and interleukin-17(IL-17)were compared.Additionally,adverse reactions and recurrence rates during a 6-month follow-up were analyzed.Results The total effective rate of the observation group(93.33%)was significantly higher than that of the control group(73.33%)(P<0.05).Before surgery,there were no significant differences between the two groups in intestinal flora parameters,adenoma scores,total TCM symptom scores,or IL-1βand IL-17 levels(P>0.05).Two weeks after surgery,bifidobacterium and lactobacillus levels significantly increased,while Escherichia coli and enterococcus levels,adenoma scores,total TCM symptom scores,IL-1β,and IL-17 levels significantly decreased in both groups.Compared to the control group,the observation group showed higher bifidobacterium and lactobacillus levels and lower Escherichia coli,enterococcus,adenoma scores,total TCM symptom scores,IL-1β,and IL-17 levels(all P<0.05).No serious adverse reactions were observed in either group.At the 6-month follow-up,the recurrence rate in the obse

关 键 词：腺瘤性息肉 术后 中药口服 灌肠疗法 肠道菌群 腺瘤积分 复发率 

分 类 号：R656.9[医药卫生—外科学]