摘要
[目的]观察结肠息肉内镜下的形态和病理组织学、临床症状与中医证候等特征,探讨结肠息肉发生及生物学特征与中医证型的关系。[方法]2003年1月~2009年12月,电子结肠镜检出的大肠息肉患者1 198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的中医证型特点,性别,年龄,症状,息肉的部位、大小、数目、形态、病理类型及相互关系。[结果]结肠息肉多发年龄为40~88岁（88.6%）,其中,息肉直径〉1.0 cm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%。中医辨证为脾肾阳虚者占息肉发生的44.6%,占直径〉1.0 cm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%、31.2%、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%、5.3%、0%、8.2%）比较差异有统计学意义（P〈0.01）;随年龄增长息肉检出率增高,以〉60岁最为多见,年龄〉60岁者中脾肾阳虚占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,histopathology,symptoms and TCM syndrome features of colonic polyps.and to analyze biological characteristics of colonic polyps and their relationship with TCM syndrome features.[Methods]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.Their clinical data including TCM syndrome features,gender,age,size,location,numbers,growth pattern and pathological characteristics were analyzed.[Results]Most of the colonic polyps occured in those aged 40-88 years（88.6%）,among which,those with size more than 1.0cm were 34.4%,recurrence 25.4%,inflammation 50.6%,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 was significant difference（P0.01）as compared with splenic asthenia with dampness（29.8%,26.7%,27.9%,31.2%,25.6%）,deficiency of spleen-Qi（17.9%,18.9%,8.6%,12.5%,23.1%）,and liver-spleen disharmony（7.6%,2.8%,5.3%,0%,8.1%）.The incidence rate of polyp increased with age.Those more than 60years old showed highest incidence rate,67.4% of whom were deficiency of spleen and kidney yang（P0.01）.[Conclusion]There are high incidence rate,biger size,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 for the important ways of preventing and treating colorectal polyps.
出处
《中国中西医结合消化杂志》
CAS
2011年第2期88-91,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
关键词
结肠息肉
病因
中医辨证
脾肾阳虚
colonic polyps
cause
TCM syndrome features
deficiency of spleen and kidney yang
