1030例结直肠癌流行病学及中医证型特征分析

Epidemiology of 1030 Cases of Colorectal Cancer and Analysis of TCM Symptom Characteristics

目的:探究湖南省局部地区结直肠癌患者流行病学及中医证型特征。方法:以2012年01月01日—2022年12月31日于湖南中医药大学第一附属医院就诊且经组织病理学确诊为结直肠癌的患者为研究对象,对患者基本信息、初次就诊主诉、临床病理结果以及中医证型进行统计学分析。结果:结直肠癌患者男616例,女414例,男发病率大于女;患病率高的年龄50~69岁,不同年龄段结直肠癌患者就诊率差异有统计学意义;首发症状以腹痛、排便习惯改变、便血常见;直肠癌462例,结肠癌568例;组织学分型以管状腺癌为主,病变分化程度以中分化为主;血清癌胚抗原(CEA)联合糖类抗原199(CA199)检测阳性检出率大于单项阳性检出率;中医证型以瘀毒内阻证最为多见,各证型分布差异具有统计学意义,且证型分布与患者年龄相关。结论:近年来,结直肠癌发病就诊人数整体呈现上升趋势,且男性多于女性,发病人群年龄以50~60岁以上多见,以管状腺癌、中分化为主,中医证型以瘀毒内阻证多见。因此,应逐步完善结直肠癌三级预防措施,采取联合筛查方式,提高早诊率,降低病死率。

Objective:To explore the epidemiology and TCM syndrome characteristics of colorectal cancer patients in local areas of Hunan Province.Methods:Patients diagnosed with colorectal cancer by histopathology in the First Af-filiated Hospital of Hunan University of Chinese Medicine from January 1,2012 to December 31,2022 were selected as the research subjects.The basic information of the patients,the main complaint of the first visit,the clinical pathologi-cal results and TCM syndrome types were statistically analyzed.Results:There were 616 males and 414 females with colorectal cancer,and the incidence rate of males was higher than that of females.The age with the highest incidence was 50-69 years old,and the difference in the consultation rate of colorectal cancer patients of different age groups was statistically significant.The first symptoms were abdominal pain,change in bowel habits,and blood in stool.There were 462 cases of rectal cancer and 568 cases of colon cancer.The histological type was mainly tubular adenocarcinoma,and the degree of differentiation of lesions was mainly moderate differentiation.The positive detection rate of serum carcinoembryonic antigen(CEA)combined with carbohydrate antigen 199(CA199)was higher than the positive detec-tion rate of single item.The most common syndrome type in traditional Chinese medicine was internal obstruction of stasis and toxicity,and the distribution of each syndrome type was statistically significant,and the distribution of syn-drome type was related to the age of patients.Conclusion:In recent years,the number of patients with colorectal can-cer has shown an overall upward trend,and more men than women,the age of the patients is more than 50 to 60 years old,mainly tubular adenocarcinoma and moderate differentiation,and the TCM syndrome is mainly stasis and internal obstruction.Therefore,the three-level prevention measures for colorectal cancer should be gradually improved,and a joint screening method should be adopted to increase the early diagnosis rate and reduce the mortality rate.