基于'治未病'理论的腺瘤性大肠息肉的中药干预研究

摘要

Objective To explore the effects of TCM intervention on patients with adenomatous colonic polyps ( ACP ) under the guide of " preventive treatment of diseases " . Methods One hundred and forty ACP patients were divided, according to syndrome differentiation, into groups A ( spleen wet stasis group ), B ( dampness and hotness obstruction group ), C ( Qi depression to blood stasis ). Group A were subdivided into groups Al ( TCM group ) and A0 ( non - TCM ), group B into Bl ( TCM group ) and BO ( non - TCM ), group C into Cl ( TCM group ) and CO ( non - TCM ). The treatment lasted 6 months. Colonoscopy review performed after one year. Results Symptoms improved in TCM groups, the total average symptom score was ( 3. 00 ± 0. 96 ) before treatment and ( 0. 87 ± 0. 62 ) after, the difference was significant ( t = 13. 07 , P < 0. 05 ). Spearman correction analysis showed that number of ACP was positively correlated with relapse rate ( r =0. 191, P <0. 05 ). Relapse rates of 6 subgroups were, from low to high, Cl ( 9. 1% ) < Al ( 12. 5% ) < Bl ( 18. 2% ) < A0 ( 30. 6% ) < B0 ( 60. 9% ) < CO ( 87. 5% ), lowest in group A, highest in group C. The relapse rates lower in subgroups TCM than subgroups non -TCM, the difference was significant ( x2A1:A0 =3. 72, x2B1:B0=8.54, x2c1:c0 = 11.68 , P<0.05). Conclusion Under the guide of theory " preventive treatment of diseases " , TCM intervention can improve effectively clinical symptoms of ACP patients, reduce the relapse rate after endoscopic removal.%目的 探讨"治未病"理论指导下,中药干预对内镜下摘除腺瘤性大肠息肉患者的影响.方法 选择符合标准的腺瘤性大肠息肉患者140例,根据辨证分型将患者分为脾虚湿瘀组(A组)、湿热瘀阻组(B组)和气滞血瘀组(C组),每组再根据服不服用中药分为两个亚组:中药治疗组(A1组)和非中药治疗组(A0组)、中药治疗组(B1组)和非中药治疗组(B0组)、中药治疗组(C1组)和非中药治疗组(C0组),治疗周期为6个月,1年后复查肠镜.结果 A1组患者经治疗后症状明显改善,治疗前总平均症状积分为(3.00±0.96)分,治疗后为(0.87±0.62)分,差异有统计学意义(t=13.07,P＜0.05＝.Spearman相关分析显示,腺瘤性大肠息肉个数与复发率呈正相关(r=0.191,P＜0.05＝.6个亚组复发率由低到高的顺序为:C1(9.1%)＜A1(12.5%)＜B1(18.2%)＜A0(30.6%)＜B0(60.9%)＜C0(87.5%),以脾虚湿瘀证患者复发率最低,气滞血瘀证患者复发率最高;各中药治疗亚组复发率均低于其相对的非中药治疗亚组,差异均有统计学意义(χ2A1:A0=3.72,χ2B1:B0=8.54,χ2C1:C0=11.68,P＜0.05＝.本组140例患者中有1例患者发生癌变,经中药治疗后管状腺瘤、绒毛状腺瘤及混合型腺瘤患者例数均减少.结论 在"治未病"理论指导下,中药干预能有效改善腺瘤性大肠息肉患者临床症状,有效降低内镜下摘除腺瘤性大肠息肉患者的复发率.