消蕈化浊方对肠息肉伴代谢综合征的临床疗效及影响因素分析

Clinical effect of Xiaoxun Huazhuo Recipe on colorectal polyps with metabolic syndrome and influencing factors

目的 评价消蕈化浊方对脾虚痰湿型肠息肉伴代谢综合征的临床疗效,并对肠息肉复发的影响因素进行分析。方法 选取2020年1月—2021年6月于浦兴社区卫生服务中心就诊的76例肠息肉伴代谢综合征患者,按随机数字法分为治疗组和对照组各38例。对照组予以对症治疗及健康教育,治疗组予以消蕈化浊方煎剂,2组均连续治疗3个月。比较2组治疗后12个月肠息肉复发率和血清TC、TG、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、体重、BMI、腰围(WC)、腰臀比(WHR)变化,并通过logistic回归模型分析复发的影响因素。结果 最终治疗组37例、对照组38例纳入研究。治疗组治疗后12个月复发率为10.8%(4/37),对照组为31.6%(12/38),差异有统计学意义(χ^(2)=4.818,P=0.028)。2组间代谢指标和形体指数(HbA1c、SBP、WHR、FPG、LDL-C)治疗前后差值比较,差异有统计学意义(均P<0.05)。多因素分析显示,治疗与否、红肉饮食、家族史、原息肉直径、BMI与复发有关。结论 消蕈化浊方可降低肠息肉术后12个月的复发率,应综合饮食控制、运动锻炼、调节代谢异常以及积极治疗相关疾病作为干预策略。

Objective To evaluate the clinical effect of Xiaoxun Huazhuo Recipe on colorectal polyps with metabolic syndrome of spleen deficiency and phlegm dampness type,and to analyse the influence factors of colorectal polyps recurrence.Methods A total of 76 patients with intestinal polyps accompanied by metabolic syndrome were selected from Puxing Community Health Center from January 2020 to June 2021,the patients were randomly divided into treatment group and control group by random number method,with 38 cases in each group.The control group was given symptomatic treatment and health education,while the treatment group was given Xiaoxun Huazhuo Decoction.Both groups were treated continuously for 3 months.The recurrence rate of colorectal polyps and the changes of serum total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),fasting blood glucose(FPG),glycosylated haemoglobin(HbA1c),body weight,BMI,waist circumference(WC)and waist hip ratio(WHR)were compared between the two groups 12 months after the treatment.The influencing factors of recurrence were analysed by logistic regression model.Results The actual numbers of cases included were 37 in the treatment group and 38 in the control group.The recurrence rates of the two groups 12 months after the treatment were 10.8%(4/37)in the treatment group and 31.6%(12/38)in the control group,with a statistically significant difference(χ^(2)=4.818,P=0.028).The differences in metabolic indices and body mass index(HbA1c,SBP,WHR,FPG,LDL-C)between the two groups before and after treatment were compared and found to be statistically significant(all P<0.05).Multivariate analysis showed that treatment or not,red meat diet,family history,primary polyp size,BMI were related to recurrence.Conclusion Xiaoxun Huazhuo Recipe can reduce the recurrence rate of colorectal polyps 12 months after operation.Comprehensive diet control,exercise,regulation of metabolic abnormalities and active treatment of related diseases should be used as intervention strategies.