摘要
目的:通过分析复发性大肠息肉患者证素及证型的分布规律探讨复发性大肠息肉的“既病防变”治疗策略。方法:收集合肥医科大学附属医院多次住院行肠镜检查及治疗的大肠息肉患者的临床资料,判断患者的病位和病性证素,并采用聚类分析及因子分析获得证素组合规律,同时按照中医证候采集量表判断患者的证型,对比证型与证素组合规律之间的关系。结果:共提取到病位证素10个、病性证素15个,其中高频病位证素依次为脾、大肠、肾、胃、肝,高频病性证素依次为湿、瘀、痰、气虚、气滞、热、阳虚,高频证素聚类结果有4个类型:肾、阳虚、寒、气虚,胃、气滞、肝,大肠、热,脾、湿、痰、血瘀。4个因子分析结果:脾、肾、气虚、阳虚、寒,肝、胃、气滞,大肠、热,湿、痰、血瘀。中医临床证型占比由高到低分别为脾虚夹湿、阳虚寒凝、肠道湿热、气滞血瘀、肝郁脾虚、肠燥津亏。结论:证型辨证基本上涵盖了复发性大肠息肉病的辨证论治要点,而证素辨证可以发现更多潜在的病理变化,提示将要受到波及的脏腑及可能出现的病机变化,在临床针对证型进行论治的同时可参考证素辨证对脾、肾、湿、痰、瘀等多个证素进行治疗,体现了中医“既病防变”的治疗原则。
Objective:By analyzing the distribution patterns of syndrome elements and syndrome types in patients with recurrent colorectal polyps,the strategy of“preventing disease from exacerbating”for recurrent colorectal polyps was explored.Methods:Relevant clinical information of patients with colorectal polyps who were hospitalized multiple times and undergone colonoscopy examination and treatment in the Affiliated Hospital of Zunyi Medical University were collected to clarify the disease location and pathological syndrome elements,and cluster analysis and factor analysis were performed to obtain the combination pattern of syndrome elements.At the same time,the patients’syndrome type was clarified according to the traditional Chinese medicine(TCM)syndrome type collection scale,and the relationship between the syndrome type and the combination rules of syndrome elements was compared.Results:A total of 10 disease location elements and 15 pathological syndrome elements were extracted,among which the high-frequency disease location syndrome elements were as follows in order:spleen,large intestine,kidney,stomach and liver.The high-frequency pathogenic syndrome elements were as follows in order:dampness,stasis,phlegm,Qi(气)deficiency,Qi stagnation,heatness and Yang(阳)deficiency.The clustering results of high-frequency syndrome elements were divided into four types:kidney,Yang deficiency,cold,Qi deficiency.Stomach,Qi stagnation,liver.Large intestine,heat.Spleen,dampness,phlegm,and blood stasis.There were four factor analysis results as follows in order:spleen,kidney,Qi deficiency,Yang deficiency,cold.Liver,stomach,Qi stagnation.Large intestine,heat.Dampness,phlegm,and blood stasis.The TCM clinical syndrome types from high to low were spleen deficiency with dampness,Yang deficiency with cold coagulation,intestinal dampness and heat,Qi stagnation and blood stasis,liver depression with spleen deficiency,and intestinal dryness and fluid deficiency.Conclusion:TCM syndrome type-based differentiation essentially covers the key points of syndrome differentiation and treatment for recurrent colorectal polyps.Meanwhile,syndrome element-based differentiation can reveal more underlying pathological changes,indicating the organs that likely to be affected and potential shifts in pathogenesis.While conducting treatment based on syndrome types in clinical practice,one can also refer to syndrome element to address multiple syndrome elements such as spleen,kidney,dampness,phlegm,and stasis,which reflects the TCM therapeutic principle of“preventing disease from exacerbating”.
出处
《中医临床研究》
2025年第28期102-106,共5页
Clinical Journal Of Chinese Medicine
基金
贵州省合肥市科技与大数据局资助科研课题(遵市科合HZ字〔2022〕364号)。
关键词
复发性大肠息肉
既病防变
证素
证型
Recurrent colorectal polyp
Preventing disease from exacerbating
Syndrome element
Syndrome type
