健脾清肠方对结直肠腺瘤切除术后复发的影响

摘要

OBJECTIVE To study the effects of Chinese medicine on patients with endoscopic resection of adenomatous colorectal polyps.METHODS 60 adenomatous colorectal polyps patients meeting with the criterion were investigated and randomly divided into two groups,Chinese medicine intervention group and the control group.Same treatments including fasting,anti-inflammation,anti-infection and parenteral nutrition support were performed to all patients after surgery:for 1-3 days.Jianpi Qingchang formula was given to the Chinese medicine intervention group on the 2nd day after surgery,while no more intervention was given to the control group.The recurrence condition of polyps was checked by colonoscopy at 6 months and 12 months after the surgery,respectively.The evaluation criterion was whether there were any new polyps in the original resected sites or other parts.The pathological types were compared and the recurrence rate of the 2 groups were evaluated.RESULTS The bowel evacuation frequency and habit scores of the two groups were compared after 6 months of treatment P＜0.05,P ＜0.01.The number,maximum diameter and average diameter of adenomas of the two groups were compared after 6 months of treatment,P＜0.01.After 6 months of follow-up,the total effective rate of the Chinese medicine intervention group was 93.33％,and that of the control group was after 83.33％,there were significant differences between the two groups.After one year of follow-up,the total effective rates of the Chinese medicine intervention group and the control group were 93.33％ and 80.00％,respectively,there were significant differences between the two groups,P＜0.01.CONCLUSIONS Chinese medicine intervention can reduce the recurrence rate of patients with adenomatous colorectal polys after endoscopic resection surger y.%目的 研究健脾清肠方干预对内镜下摘除腺瘤性大肠息肉复发的影响.方法 纳入符合标准的腺瘤性大肠息肉病人60名,按照随机原则分为中药干预组和对照组.所有患者术后处理相同,均禁饮食,并给予抗炎、抗感染及肠外营养支持治疗1～3 d,中药组患者在术后第2天给予健脾清肠方干预治疗,疗程8周.对照组术后除上述常规西药治疗外不给予中药及其他治疗.分别于切除术后6月、1年行肠镜复查息肉是否复发(原切除部位发现了新生息肉或者其他部位发现了新生息肉).结果 2组治疗半年、1年后的腹痛、大便次数、便血、排便习惯等评分对比,P＜0.05～0.01,2组治疗半年、1年后腺瘤最大直径、平均直径等比较,P＜0.01.随访半年后,中药干预组的总体有效率为93.33％,对照组仅为83.33％,2组比较P＜0.05;随访1年后,中药干预组与对照组的总体有效率分别为93.33％和80.00％,2组比较,P＜0.01.2组复发率比较,P＜0.05.结论 中药干预可以降低内镜下摘除腺瘤性大肠息肉病人的复发率.