慢性腹泻者结肠息肉发生与中医脾肾阳虚的关系探讨
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摘要
目的:
研究结肠息肉内镜下的形态和病理组织学、临床症状与中医证型的关系,探讨结肠息肉发生的中医学病因。
材料与方法:
在沈阳军区总医院2003年1月至2009年12月,电子结肠镜检出的大肠息肉患者1198例中,筛选并分析630例以慢性腹泻症状就诊,电子结肠镜检出的大肠息肉患者,分析其性别、年龄、症状、息肉的部位、大小、数目、形态、病理类型与中医证型的关系。
结果:
1.结肠息肉多发年龄在40～88岁(88.6%),其中,息肉直径>1.0cm者占34.4%,复发息肉占25.4%;炎性息肉占48.1%,增生性息肉占1.7%,绒毛腺瘤性息肉占14.8%,息肉癌变占2.5%。
2.中医辨证为脾肾阳虚者占息肉发生的44.6%,占直径>1.0cm息肉的51.6%,占绒毛腺瘤性息肉的58.1%,占癌变息肉的56.2%,占复发息肉的43.1%,与脾虚夹湿证(29.8%、26.7%、27.9%、31.3%、25.6%)、脾气虚弱证(17.9%、18.9%、8.6%、12.5%、23.1%)、肝脾不调证(7.6%、2.8%、5.4%、0%、8.2%)比较,差异有统计学意义(P<0.01)。
3.息肉有随年龄增长检出率增高的趋势,以>60岁最为多见,脾肾阳虚在年龄>60岁者中占67.4%,与其他证型比较,差异有统计学意义(P<0.01)。
结论:
脾肾阳虚者息肉发生率高、息肉大、分化差、癌变多,易复发,中医阳虚体质是结肠息肉的重要病因之一,温阳散结为主的治疗,应是结肠息肉的重要防治方法之一。
Objective:
To study the endoscopic morphology of colonic polyps and histopathology,symptoms and TCM syndrome features of clinical features.To analyze biological characteristics of colonic polyps and their relationship with TCM syndrome features.
Method:
The data of colonic polyps cases from the General Hospital of Shenyang Military Region from 2003 to 2009 were analyzed retrospectively. 630 polyp patients with chronic diarrhea were detected from a total of 1198 cases. and their clinical data including the TCM syndrome features, the gender,the age,the size,location,numbers,growth pattern and pathological characteristics were analyzed.
Result:
Most of colonic polyps occur in aged 40-88 years(88.6%),among them, those with size more than 1.0cm are 34.4%, recurrence 25.4%,inflammation 48.1%,hyperplasia 1.75%, the villous adenoma 14.8% and cancer 2.5%.Deficiency of spleen and kidney yang accounted for 44.6% of the polyps, 51.6% of the size more than 1.0cm, 58.1% of the villous adenoma, 56.2% of the cancer, 43.1% of recurrence, there were significant differences (P<0.01) compare with splenic asthenia hold wet(29.8%、26.7%、27.9%、31.3%、25.6%)、deficiency of spleen-Qi(17.9%、18.9%、8.6%、12.5%、23.1%)、and liver-spleen disharmony(7.6%、2.8%、5.4%、0%、8.2%). The incidence rate of polyp increased with age, the most common is To> 60 years of age, it accounted for67.4% of deficiency of spleen and kidney yang(P<0.01).
Conclusion:
There are high incidence rate, biger sise, lower differentiation, more cancerization, easy recurrence of the polyps in the patients with Deficiency of spleen and kidney yang. Yang deficiency is an important cause of colonic polyps. Warming Yang and removing stasis may be one of the important ways of prevention and cure of colorectal polyps.
研究结肠息肉内镜下的形态和病理组织学、临床症状与中医证型的关系,探讨结肠息肉发生的中医学病因。
材料与方法:
在沈阳军区总医院2003年1月至2009年12月,电子结肠镜检出的大肠息肉患者1198例中,筛选并分析630例以慢性腹泻症状就诊,电子结肠镜检出的大肠息肉患者,分析其性别、年龄、症状、息肉的部位、大小、数目、形态、病理类型与中医证型的关系。
结果:
1.结肠息肉多发年龄在40～88岁(88.6%),其中,息肉直径>1.0cm者占34.4%,复发息肉占25.4%;炎性息肉占48.1%,增生性息肉占1.7%,绒毛腺瘤性息肉占14.8%,息肉癌变占2.5%。
2.中医辨证为脾肾阳虚者占息肉发生的44.6%,占直径>1.0cm息肉的51.6%,占绒毛腺瘤性息肉的58.1%,占癌变息肉的56.2%,占复发息肉的43.1%,与脾虚夹湿证(29.8%、26.7%、27.9%、31.3%、25.6%)、脾气虚弱证(17.9%、18.9%、8.6%、12.5%、23.1%)、肝脾不调证(7.6%、2.8%、5.4%、0%、8.2%)比较,差异有统计学意义(P<0.01)。
3.息肉有随年龄增长检出率增高的趋势,以>60岁最为多见,脾肾阳虚在年龄>60岁者中占67.4%,与其他证型比较,差异有统计学意义(P<0.01)。
结论:
脾肾阳虚者息肉发生率高、息肉大、分化差、癌变多,易复发,中医阳虚体质是结肠息肉的重要病因之一,温阳散结为主的治疗,应是结肠息肉的重要防治方法之一。
Objective:
To study the endoscopic morphology of colonic polyps and histopathology,symptoms and TCM syndrome features of clinical features.To analyze biological characteristics of colonic polyps and their relationship with TCM syndrome features.
Method:
The data of colonic polyps cases from the General Hospital of Shenyang Military Region from 2003 to 2009 were analyzed retrospectively. 630 polyp patients with chronic diarrhea were detected from a total of 1198 cases. and their clinical data including the TCM syndrome features, the gender,the age,the size,location,numbers,growth pattern and pathological characteristics were analyzed.
Result:
Most of colonic polyps occur in aged 40-88 years(88.6%),among them, those with size more than 1.0cm are 34.4%, recurrence 25.4%,inflammation 48.1%,hyperplasia 1.75%, the villous adenoma 14.8% and cancer 2.5%.Deficiency of spleen and kidney yang accounted for 44.6% of the polyps, 51.6% of the size more than 1.0cm, 58.1% of the villous adenoma, 56.2% of the cancer, 43.1% of recurrence, there were significant differences (P<0.01) compare with splenic asthenia hold wet(29.8%、26.7%、27.9%、31.3%、25.6%)、deficiency of spleen-Qi(17.9%、18.9%、8.6%、12.5%、23.1%)、and liver-spleen disharmony(7.6%、2.8%、5.4%、0%、8.2%). The incidence rate of polyp increased with age, the most common is To> 60 years of age, it accounted for67.4% of deficiency of spleen and kidney yang(P<0.01).
Conclusion:
There are high incidence rate, biger sise, lower differentiation, more cancerization, easy recurrence of the polyps in the patients with Deficiency of spleen and kidney yang. Yang deficiency is an important cause of colonic polyps. Warming Yang and removing stasis may be one of the important ways of prevention and cure of colorectal polyps.
引文
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