160例大肠息肉患者中医证型与中医体质分布规律研究

The Distribution Characteristics of Traditional Chinese Medicine Syndromes and Constitutions of 160 Patients with Colorectal Polyps

目的探索大肠息肉患者中医证型与体质的分布规律。方法纳入经结肠镜与病理检查确诊为大肠息肉的患者160例,采集患者一般情况(性别、年龄、饮食习惯及不良嗜好等)、临床症状和中医四诊信息,并进行中医体质测评,分析不同病理类型(腺瘤性息肉和非腺瘤性息肉)患者息肉发病情况、中医症状、中医证型及体质分布情况,采用Logistic回归分析筛选出发病因素的独立危险因素。结果 160例患者中≥45岁者159例,临床表现以腹痛(145例,90.63%)为主。中医证型以肝郁脾虚证为主(87例,54.38%),其次为大肠湿热证(26例,16.25%)、肝郁气滞证(19例,11.88%)。中医体质主要为气虚质(111例,32.27%),其次是气郁质(88例,25.58%)、湿热质(41例,11.92%)。腺瘤性息肉患者108例,非腺瘤性息肉患者52例。两种类型患者在中医证型、体质分布方面差异有统计学意义(P<0.01)。腺瘤性息肉中医证型以肝郁脾虚证为证,体质以气虚质及气郁质为主;非腺瘤性息肉多见大肠湿热证,体质以湿热质、血瘀质为主(P<0.05或P<0.01)。结论大肠息肉患者以肝郁脾虚证、大肠湿热证和肝郁气滞证为主,体质多见气虚质、气郁质和湿热质。不同中医体质及中医证型的大肠息肉患者的病理类型发病倾向不同。

Objective To explore the distribution characteristics of traditional Chinese medicine(TCM) syndrome types and TCM constitution of patients with colorectal polyps. Methods Totally 160 patients diagnosed as colorectal polyps through colonoscopy and pathological examination were included. The general conditions(gender, age, eating habits and bad habits, etc.), clinical symptoms, and the information from TCM four examinations were collected;TCM constitution was assessed. TCM symptoms, syndromes and constitutions were analyzed according to different pathological types of polyps(adenomatous polyps and non-adenomatous polyps). Logistic regression analysis was used to screen out the independent risk factors for the incidence of colorectal polyps. Results There were 159 out of 160 patients were ≥45 years old, and abdominal pain was mainly manifested(145, 90.63%). The most commonly seen TCM syndrome was liver constraint and spleen deficiency syndrome(87, 54.38%), followed by large intestine damp-heat syndrome(26, 16.25%) and liver constraint and qi stagnation syndrome(19, 11.88%). Qi deficiency(111, 32.27%), qi constraint(88, 25.58%) and damp-heat(41, 11.92%) were top three TCM constitution types. There were 108 patients with adenomatous polyps and 52 with non-adenomatous polyps. The distribution of TCM syndromes and TCM constitutions between two pathological polyps were significantly different(P<0.01). For adenomatous polyps, liver constraint and spleen deficiency syndrome was the most commonly seen type, as well as qi deficiency and qi constraint constitution type;for non-adenomatous polyps, large intestine damp-heat syndrome had the highest frequency, and the damp-heat and blood stasis were main TCM constitution types(P<0.05 or P<0.01). Conclusion The main syndromes of patients with colorectal polyps are liver constraint and spleen deficiency syndrome, large intestine damp-heat syndrome, and liver constraint and qi stagnation syndrome, and the constitution types are mainly qi deficiency, qi stagnation and damp-heat. The pathological conditions of colorectal polyps patients with different TCM constitutions and TCM syndromes are different.