基于“伏毒”理论探讨连理汤在干预结直肠息肉切除术后复发的临床研究

Clinical study on the prevention of recurrence after endoscopic colorectal polypectomy by Lianli decoction based on the“turbiditys and toxicity”theory

目的观察连理汤干预脾虚湿毒型结直肠息肉切除术后复发率、临床疗效及安全性。方法选取2020年1月至2021年9月浙江中医药大学附属湖州中医院收治的结直肠息肉术后患者104例,采用随机数字表法分为观察组(n=52)和对照组(n=52),观察组给予中药连理汤加减治疗,对照组口服双歧杆菌三联活菌胶囊治疗。术后1年复查肠镜,比较两组息肉复发率、中医证候积分及不良反应发生率。结果术后1年观察组息肉复发率显著低于对照组(P<0.05),治疗前两组各项中医证候积分比较,差异均无统计学意义(P>0.05)。治疗后,两组患者中医证候积分均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。观察组的治疗总有效率高于对照组,差异有统计学意义(P<0.05)。患者在口服药物治疗过程中未发生不良事件,血常规、肝肾功能、心电图等检测均未见明显异常。结论根据伏毒致病的特点,连理汤加减能有效降低结直肠息肉术后患者复发率,改善患者临床症状,疗效显著,安全性高,值得进一步研究和普及应用。

Objective To observe the clinical efficacy and safety of Lianli decoction in the treatment of spleen deficiency and dampness turbidity syndromes after endoscopic colorectal polypectomy.Methods A total of 104 patients with colorectal polyps admitted to Huzhou Traditional Chinese Medical Hospital of Zhejiang Chinese Medical University from January 2020 to September 2021 were selected and divided into the observation group(n=52)and the control group(n=52)according to the random number table method.The observation group was treated with Lianli decoction,while the control group was treated with Bifidobacterium triple viable capsule.One year after polypectomy,colonoscopy was observed and compared the recurrence rate,traditional Chinese medical(TCM)syndrome score and adverse reaction rate.Results One year after endoscopic colorectal polypectomy,the recurrence rate of polyps in the observation group was significantly lower than that in the control group(P<0.05).Before treatment,there was no statistically significant difference between the two groups in TCM syndrome score(P>0.05).After treatment,the efficacy of TCM syndrome of both groups were lower than before treatment,and the observation group was lower than the control group,and the differences were statistically significant(P<0.05).The observation group had a higher total effective rate of treatment than the control group,and the difference was statistically significant(P<0.05).There was no adverse event during oral administration,and no obvious abnormality was found in blood routine test,liver and kidney function,electrocardiogram and other examinations.Conclusion According to the characteristics of turbiditys and toxicity theory,Lianli decoction can effectively reduce the recurrence rate and improve the clinical symptoms of patients after endoscopic colorectal polypectomy,with remarkable efficacy and high safety,which is worthy of further study and popular application.