结肠管状腺瘤与中医体质相关性研究
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摘要
目的:通过对结肠管状腺瘤患者中医体质的流行病学调查,探讨结肠管状腺瘤患者中医体质分布规律,辨识易发体质类型。方法:选取2016年6月至2017年12月哈尔滨医科大学附属第一医院收治的结肠管状腺瘤患者449例进行中医体质调查问卷,同时统计被调查者的临床资料,分析结肠管状腺瘤患者的中医体质分布规律。结果:结肠管状腺瘤患者中,男性发病率明显高于女性,管状腺瘤检出发病年龄高峰段在51～60岁,占36. 75%,男女在结肠管状腺瘤检出年龄上差异无统计学意义(P> 0. 05);阳虚体质为结肠管状腺瘤患者易患体质类型,其次为湿热质、痰湿质,不同年龄调查对象的阳虚质分布差异有统计学意义(P <0. 05);不同性别调查对象在湿热质、痰湿质、血瘀质和气郁质上的差异有统计学意义(P <0. 05);吸烟与不吸烟结肠管状腺瘤患者在气虚质、阴虚质、湿热质以及气郁质发病差异有统计学意义(P <0. 05)。结论:阳虚质、湿热质、痰湿质是结肠管状腺瘤的易患体质类型。
Objective: To investigate the distribution of traditional Chinese medicine (TCM) constitution,and to identify the type of constitution by the epidemiological investigation of TCM constitution in patients with colorectal tubular adenomas. Methods: A total of 449 patients with colorectal tubular adenomas admitted to the First Affiliated Hospital of Harbin Medical University from June 2016 to July 2017 were randomly selected to complete the TCM constitution questionnaire. The clinical data of the surveyed individuals were also collected to analyze the distribution of TCM constitution in patients with colorectal tubular adenoma. Results:In the patients with colorectal tubular adenoma,the incidence rate of males was significantly higher than that of females,and the peak age of tubular adenomas was 51-60 years old,accounting for 36. 75%. There was no significant difference in the age of male and female colorectal tubular adenoma (P > 0. 05). The yang deficiency constitution is a type of constitutional susceptibility in patients with colorectal tubular adenomas,followed by damp-heat and phlegm-dampness constitution. The distribution of yang deficiency in the subjects of different ages was statistically significant. There was a statistically significant difference in constitutions of damp-heat,phlegm-dampness,blood-stasis and speciality between different genders (P < 0. 05). There was statistical significance in constitutions of qi deficiency,yin deficiency,damp-heat and qi-stagnation among smoking and non-smoking patients with colorectal tubular adenoma. Conclusion: People with constitutions of yang deficiency,damp-heat,phlegm-dampness are more susceptible to have colorectal tubular adenoma.
Objective: To investigate the distribution of traditional Chinese medicine (TCM) constitution,and to identify the type of constitution by the epidemiological investigation of TCM constitution in patients with colorectal tubular adenomas. Methods: A total of 449 patients with colorectal tubular adenomas admitted to the First Affiliated Hospital of Harbin Medical University from June 2016 to July 2017 were randomly selected to complete the TCM constitution questionnaire. The clinical data of the surveyed individuals were also collected to analyze the distribution of TCM constitution in patients with colorectal tubular adenoma. Results:In the patients with colorectal tubular adenoma,the incidence rate of males was significantly higher than that of females,and the peak age of tubular adenomas was 51-60 years old,accounting for 36. 75%. There was no significant difference in the age of male and female colorectal tubular adenoma (P > 0. 05). The yang deficiency constitution is a type of constitutional susceptibility in patients with colorectal tubular adenomas,followed by damp-heat and phlegm-dampness constitution. The distribution of yang deficiency in the subjects of different ages was statistically significant. There was a statistically significant difference in constitutions of damp-heat,phlegm-dampness,blood-stasis and speciality between different genders (P < 0. 05). There was statistical significance in constitutions of qi deficiency,yin deficiency,damp-heat and qi-stagnation among smoking and non-smoking patients with colorectal tubular adenoma. Conclusion: People with constitutions of yang deficiency,damp-heat,phlegm-dampness are more susceptible to have colorectal tubular adenoma.
引文
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[3]Sakamoto T,Mitsuzaki K,Utsunomiya D,et al.Detection of flat colorectal polyps at screening CT colonography in comparison with conventional polypoid lesions[J].Acta Radiol,2012,53(7):714-719.
[4]Hong YS,Jung EJ,Ryu CG,et al.Incidence and Multiplicities of Adenomatous Polyps in TNM Stage I Colorectal Cancer in Korea[J].JKorean Soc Coloproctol,2012,28(4):213-218.
[5]Cui G,Yang H,Zhao J,et al.Elevated proinflammatory cytokine IL-17A in the adjacent tissues along the adenoma-carcinoma sequence[J].Pathol Oncol Res,2015,21(1):139-146.
[6]张永,徐敏,朱艺艺.结肠镜在结直肠早癌防治中的作用[J].医学信息,2014,31(1):246-246.
[7]Wang Q,Yao S.Molecular basis for cold-intolerant yang-deficient constitution of traditional Chinese medicine[J].Am J Chin Med,2008,36(5):827-34.
[8]王琦.9种基本中医体质类型的分类及其诊断表述依据[J].北京中医药大学学报,2005,28(4):1-8.
[9]张彩兰,韩军平,董亮,等.结直肠癌干细胞及靶向治疗研究进展[J].现代肿瘤医学,2012,20(10):2184-2187.
[10]Cappell MS.From colonic polyps to colon cancer:pathophysiology,clinical presentation,screening and colonoscopic therapy[J].Minerva Gastroenterol Dietol,2007,53(4):351-373.
[11]张北平,赵喜颖,刘刚.基于“治未病”理论的腺瘤性大肠息肉的中药干预研究[J].中西医结合研究,2012,12(8):2718-2720.
[12]王洪图,赵明山,邱幸凡.内经讲文[M].北京:人民卫生出版社,2002:29-212.
[13]陈超,周灵运,张佳琪,等.中医体质学研究述评[J].中国医药导报,2017,14(33):151-153,160.