结直肠息肉病例特点与中医证型分布及其与高脂血症相关性分析  

Investigation of Clinical Characteristics and Traditional Chinese Medicine Syndrome Types of Colorectal Polyp and Their Correlation with Hyperlipidemia

作　　者：郭婉莎 李志青 周美华 董明国[1,2] 卢晓敏 GUO Wansha;LI Zhiqing;ZHOU Meihua;DONG Mingguo;LU Xiaomin(Dongguan Hospital of Guangzhou University of Chinese Medicine,Dongguan 523000 Guangdong,China;Dongguan Traditional Chinese Medicine Hospital,Dongguan 523000 Guangdong,China)

机构地区：[1]广州中医药大学东莞医院,广东东莞523000 [2]东莞市中医院,广东东莞523000

出　　处：《广州中医药大学学报》2025年第4期819-826,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省基础与应用基础研究基金企业联合基金(公共卫生与医药健康领域)项目(编号:2022A1515220059);董明国广东省名中医传承工作室建设项目(编号:粤中医办函[2020]1号)。

摘　　要：【目的】探讨结直肠息肉病例特点、中医证型分布及其与高脂血症等相关危险因素的关联性。【方法】选取2022年1月至2023年12月期间在广州中医药大学东莞医院内镜中心行结肠镜检查或治疗的结直肠息肉患者(息肉组)174例和肠道未见异常者(非息肉组)87例,收集其相关病历资料,包括性别、年龄、体质量指数(BMI)、糖尿病史、高血压史、血脂情况[包括总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、动脉硬化指数(AI)]、是否有脂肪肝以及肠息肉的发病部位、数量、大小和病理类型等数据,并对息肉组患者进行中医辨证分型,统计并分析结直肠息肉患者的病例特点、中医证型分布及其与高脂血症的关联性。【结果】(1)息肉组和非息肉组患者均以41~60岁年龄段为主,前者占59.8%,后者占49.4%,2组年龄比较,差异有统计学意义(P<0.05)。(2)结直肠息肉发病部位多位于左半结肠,占63.2%;息肉数量以单发为主,占69.0%;息肉大小以1~10 mm为主,占90.2%;息肉类型以非腺瘤性息肉为主,占51.1%。(3)息肉组患者的中医证型主要为脾虚湿滞证,占44.8%;其次为大肠湿热证,占30.5%。(4)不同中医证型的BMI、糖尿病史分布比较,差异均有统计学意义(P<0.05),而不同中医证型的性别、年龄、高血压史、脂肪肝史以及息肉发病部位、数量、大小、病理类型比较,差异均无统计学意义(P>0.05)。(5)息肉组患者的高脂血症占比明显高于非息肉组,差异有统计学意义(P<0.01);且息肉组的TC、TG、LDL-C及AI水平均明显高于非息肉组,差异均有统计学意义(P<0.05或P<0.01),而2组的HDL-C水平比较,差异无统计学意义(P>0.05)。(6)不同发病部位的TC、LDL-C水平及不同中医证型的LDL-C水平比较,差异均有统计学意义(P<0.05或P<0.01),其余不同临床特征(包括息肉发病部位、数量、息肉大小、病理类型)及中医Objective To investigate the clinical characteristics and traditional Chinese medicine(TCM)syndrome types of colorectal polyp(CP)and to explore their correlation with hyperlipidemia and other related risk factors.Methods From January 2022 to December 2023,174 patients with CP(polyp group)and 87 patients without intestinal abnormalities(non-polyp group)who underwent colonoscopy or treatment at the Endoscopy Center of Dongguan Hospital of Guangzhou University of Chinese Medicine were selected.Their data of medical records were collected,including gender,age,body mass index(BMI),history of diabetes mellitus,history of hypertension,blood lipid indicators[total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and arteriosclerosis index(AI)],the presence offatty liver or not,and the foci,number,size,and pathological types of polyps.Moreover,TCM syndrome differentiation of patients in the polyp group was carried out,and then the clinical characteristics and TCM syndrome types of CP as well as their correlation with hyperlipidemia were statistically analyzed.Results(1)The age group of 41-60 years old accounted for a higher percentage in patients of the polyp group and non-polyp group,59.8%in the polyp group and 49.4%in the non-polyp group,and the comparison of ages between the two groups showed statistically significant difference(P<0.05).(2)The polyp foci of CP were mostly located in the left colon,accounting for 63.2%;single polyp was common,accounting for 69.0%;the size of polyps was usually 1-10 mm,accounting for 90.2%;the polyps were predominated by non-adenomatous polyps,accounting for 51.1%.(3)In the polyp group,spleen deficiency and dampness retention syndrome was the predominated syndrome type,accounting for 44.8%,and then followed by syndrome of damp-heat in large intestine,which accounted for 30.5%.(4)Comparison of the distribution of BMI and history of diabetes mellitus among various TCM syndrome types showed statistically significant dif

关 键 词：结直肠息肉 病例特点 中医证型 脾虚湿滞证 大肠湿热证 高脂血症 危险因素 相关性 

分 类 号：R259.574[医药卫生—中西医结合]