世界中医药

目的:针对高发病率结肠息肉在病理类型明确的情况下进行中医辨证分型分布规律调查,以期在辨证分型基础上指导其治疗和预防复发。方法:选取2016年6月至2017年12月在哈尔滨医科大学附属第一医院经电子肠镜检查和有明确病理活检结果的患者606例进行发病率统计,选择其中97例炎性息肉患者作为研究对象,对患者的一般资料、临床表现及中医四诊资料进行辨证分析,总结中医证型分布规律。结果:结肠息肉患者的病理类型分布依次为管状腺瘤(62.38%)>炎性息肉(16%)>绒毛状腺瘤(13.87%)>增生性息肉(4.95%)>锯齿状腺瘤(2.81%)。炎性息肉发病率男性(61.86%)>女性(38.14%);其中男性青年、中年、老年的发病率依次为20%、33.33%、46.67%;女性青年、中年、老年的发病率依次为13.51%、27.03%、59.46%。炎性息肉患者的中医证型分布依次为湿热瘀阻证(38.96%)>脾肾阳虚证(31.17%)>脾虚夹瘀证(19.48%)>肝郁气滞证(10.39%)。湿热瘀阻证结肠炎性息肉患者的发病率男性(54.77%)>女性(45.23%),其中男性青年、中年、老年的发病率依次为39.13%、43.48%、17.39%,女性青年、中年、老年的发病率依次为36.84%、34.78%、21.05%。脾肾阳虚证结肠炎性息肉患者的发病率男性(61.11%)>女性(38.89%),其中男性青年、中年、老年的发病率依次为13.67%、30.43%、56.52%,女性青年、中年、老年的发病率依次为14.29%、35.71%、50%。结论:结肠炎性息肉的发病以老年人为主,男性高于女性,同一年龄段发病率男性大于女性,中医证型以湿热瘀阻证和脾肾阳虚证为主。湿热瘀阻型结肠炎性息肉的发病率呈现出男性大于女性,中青年大于老年的趋势。脾肾阳虚型炎性息肉的发病率呈现出男性大于女性,老年大于中青年的趋势。

English Summary:

To investigate the distribution law of traditional Chinese medicine (TCM) syndrome differentiation in the case of clear pathological type of colon polyps with high incidence for the guidance further treatment and prevention of recurrence on the basis of syndrome differentiation. Methods:A total of 606 patients with electronic colonoscopy and clear pathological biopsy treated in the First Affiliated Hospital of Harbin Medical University from June 2016 to December 2017 were selected for morbidity statistics，and a total of 97 cases of inflammatory polyps were selected as the research objects. The general data，clinical manifestations and TCM four diagnosis data were analyzed，and the pattern of TCM syndrome distribution was summarized. Results:The pathological types of patients with colonic polyps were tubular adenoma (62.38%)>inflammatory polyps (16%)>villous adenoma (13.87%)>proliferative polyp (4.95%)>serrated adenoma (2.81%). The rate of inflammatory polyps in male (61.86%)>in female (38.14%)，and the rate of young，middle-aged and elderly men was 20%，33.33% and 46.67%，and the rate of young，middle-aged and elderly women was 13.51%，27.03% and 59.46%. The distribution of TCM syndromes in patients with inflammatory polyps was damp and heat stasis syndrome (38.96%)>spleen and kidney yang deficiency syndrome (31.17%)>spleen qi stagnation syndrome (19.48%)>stagnation of liver qi stagnation (10.39%). The rate of inflammatory polyps in the patients with damp and heat stasis syndrome in male (54.77%) was larger than in female (45.23%). The incidence rate of young，middle-aged and old men was 39.13%，43.48% and 17.39%. The incidence rate of young，middle-aged and elderly women was 36.84%，34.78% and 21.05%. The incidence rate of inflammatory polyps in spleen and kidney yang deficiency syndrome in male (61.11%) was larger than in female (38.89%). The incidence rate of young，middle-aged and old men was 13.67%，30.43% and 56.52%. The rate of young，middle-aged and elderly women was 14.29%，35.71% and 50% in turn. Conclusion:The incidence of inflammatory polyps of the colon is mainly in the elderly，males are higher than females，and the incidence of males in the same age group is greater than that of females. The syndromes of TCM are mainly caused by dampness and heat stasis syndrome and spleen and kidney yang deficiency syndrome. The incidence of colitis polyps with damp and heat stasis syndrome appears higher in men than in women，and higher in the elder than in the young. The incidence of inflammatory polyps of spleen and kidney yang deficiency syndrome is higher in men than that in women，and higher in the elder than in the young.The incidence of inflammatory polyps is mainly in the elderly，the male is higher than the female and the male rate of the same age group is greater than that of the female. The TCM syndrome type is mainly with damp heat stasis syndrome and spleen kidney yang deficiency syndrome. The incidence of inflammatory polyps in damp heat stasis type shows a trend that male is greater than female and youth were higher than those of old age. The incidence of inflammatory polyp in spleen and kidney yang deficiency shows a trend that male is greater than female and older is higher than youth.

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