基于中医治未病思想探讨中医体质理论防治大肠息肉

Prevention and treatment of large intestine polyps based on the theories of TCM constitution and TCM preventive treatment of diseases

目的:分析大肠息肉患者的中医体质、证型的分布规律及其发病特点,探索体质理论在防治大肠息肉方面的应用。方法:收集在遵义医科大学附属医院住院行肠镜检查及治疗的大肠息肉患者的一般资料,并进行中医体质及中医证型的问卷调查,再运用统计学软件统计分析,探讨大肠息肉患者的中医体质规律及应用体质理论防治大肠息肉。结果:统计结果显示8种体质及占比,由高到低分别为痰湿质26.21%、气虚质23.78%、阳虚质13.41%、阴虚质8.54%、气郁质7.93%、血瘀质7.93%、湿热质7.32%、平和质4.88%。6种证型及占比由高到低分别为脾虚夹湿28.67%、阳虚寒凝14.63%、肠道湿热14.63%、气滞血瘀11.59%、肝郁脾虚5.49%、血虚肠燥3.66%。此外还有无证型患者占21.34%。痰湿质、阳虚质、湿热质、血瘀质、阴虚质以及平和质的男性比例多于女性,而气虚质和气郁质的女性比例多于男性,差异有统计学意义[χ~2=17.412,P=0.014(<0.05)]。青年患者各型体质占比均较低,中年痰湿质、阳虚质、湿热质、气郁质、血瘀质、阴虚质及平和质这7种体质占比均高于青年和老年段,老年气虚质占比高于青年和中年段,差异有统计学意义[χ~2=31.484,P=0.005(<0.05)]。结论:大肠息肉患者体质受年龄、性别等多因素影响,体质与证型有一定的对应关系,特别是痰湿质、气虚质与大肠息肉的中医证型有明显的相关性,可参考体质学说防治大肠息肉。

Objective:To analyze the distribution law of traditional Chinese medicine constitution,syndrome types and its pathogenesis of patients with large intestine polyps,and explore the application of constitution theory in the prevention and treatment of large intestine polyps.Methods:General data of patients with large intestine polyps who were hospitalized for colonoscopy and treatment in Affiliated Hospital of Zunyi Medical University was collected,and questionnaires of TCM constitution and TCM syndrome types were conducted,and statistical software was used for statistical analysis to explore the law of TCM constitution of patients with large intestine polyps and the application of constitution theory to prevent and treat large intestine polyps.Results:The statistical results showed that the eight constitutions and their proportion from high to low were phlegm-dampness constitution type of 26.21%,Qi-deficiency(气虚质) constitution type of 23.78%,Yang-deficiency(阳虚质) constitution type of 13.41%,Yin-deficiency(阴虚质) constitution type of 8.54%,Qi-stagnation constitution type of 7.93%,blood-stasis constitution type of 7.93%,dampheat constitution type of 7.32%,and harmony constitution type of 4.88%.The six syndrome types and their proportion from high to low were spleen deficiency dampness type of 28.67%,Yang deficiency and cold coagulation type of 14.63%,intestinal dampness and heat type of 14.63%,Qi stagnation and blood stasis type of 11.59%,liver stagnation and spleen deficiency type of 5.49%,blood deficiency and intestinal dryness type of 3.66%,in addition,no syndrome type patients accounted for 21.34%.The proportion of males in phlegm-dampness constitution type,Yang-deficiency constitution type,damp-heat constitution type,blood-stasis constitution type,Yin deficiency constitution type and harmony constitution type was higher than that of females,while the proportion of females in Qi-deficiency constitution type and Qi-stagnation constitution type was higher than that of males,the difference was statistically significant [χ~2=17.412,P=0.014(<0.05)].All types of constitution were lower in young patients,and the seven constitution types of phlegmdampness,Yang-deficiency,damp-heat,Qi-stagnation,blood-stasis,Yin-deficiency and harmony constitution in middle age were higher than those in young and old age,and the Qi-deficiency constitution type in old age was higher than that in young and middle-aged age,the difference was with statistical significant [χ~2=31.484,P=0.005(<0.05)].Conclusion:The constitution of patients with large intestine polyps is affected by many factors such as age and gender etc.,and there is a certain corresponding relationship between the constitution type and the syndrome type,especially the phlegm-dampness constitution type and Qi-deficiency constitution type have obvious correlation with TCM syndrome type of large intestine polyps,and the theory of TCM constitution can be referred to prevent and treat large intestine polyps.