大肠息肉患者中医证型分布特点及相关性研究

目的 对大肠息肉流行病学、中医证型及其相关性进行研究。方法 回顾性分析211例以腹泻为主要临床表现的结肠息肉患者的临床资料，分析中医证型分布及其相关性。结果 211例大肠息肉患者中，男女比例约3∶1；年龄为18～83岁，大于40岁患者大肠息肉检出率为88.6%；无蒂息肉占62.1%，多于有蒂息肉；多发性息肉占69.2%，多于单发息肉；直径小于1 cm息肉占75.8%；腺瘤性息肉占82.9%。常见中医证型包括脾胃虚弱证、肝气乘脾证、湿热伤中证、脾虚湿热证，其中脾胃虚弱证所占比例最高。在性别及是否有饮酒史分布上，中医证型差异具有统计学意义(P＜0.05)。以腹泻为主要临床表现的大肠息肉患者中，男性多于女性，有饮酒史患者例数低于无饮酒史患者。在年龄、吸烟史、胆囊切除史方面，中医证型分布差异均无统计学意义(P＞0.05)。在息肉形态、息肉数目、息肉大小、息肉的病理类型上，中医证型分布差异均无统计学意义(P＞0.05)。结论 40岁以上男性患者是大肠息肉的好发人群，腺瘤性息肉较常见，脾胃虚弱证是较常见的中医证型。

Distribution Characteristics and Association of Traditional Chinese Medicine Syndrome Types in Patients with Large Intestinal Polyps

Objective To investigate the epidemiology, traditional Chinese medicine (TCM) syndrome types, and association of large intestinal polyps. Methods A retrospective analysis was performed for the clinical data of 211 patients with colon polyps who had diarrhea as the main clinical manifestation, and TCM syndrome types and their association were analyzed. Results Among the 211 patients with large intestinal polyps, the male/female ratio was about 3∶1, and their age ranged from 18 to 83 years; the detection rate of large intestinal polyps was 88.6% in the patients aged >40 years; sessile polyps accounted for a higher proportion (62.1%) than pedunculated polyps, and multiple polyps accounted for a higher proportion (69.2%) than solitary polyps; the polyps with a diameter of <1 cm accounted for 75.8%, and adenomatous polyps accounted for 82.9%. Common TCM syndrome types included deficiency of the spleen and stomach, syndrome of liver Qi invading the spleen, syndrome of damp-heat in middle energizer, and spleen deficiency and damp-heat syndrome, among which deficiency of the spleen and stomach accounted for the highest proportion. There were significant differences in TCM syndrome types in terms of sex and the presence or absence of drinking history (P<0.05). Among the patients with large intestinal polyps who had diarrhea as the main clinical manifestation, male patients accounted for a higher proportion than female patients, and the patients with drinking history accounted for a lower proportion than those without drinking history. There were no significant differences in TCM syndrome types in terms of age, smoking history, and history of cholecystectomy (P>0.05), and there were also no significant differences in TCM syndrome types in terms of the morphology, number, size, and pathological type of polyps (P>0.05). Conclusion Male individuals aged >40 years are vulnerable to large intestinal polyps, and adenomatous polyps are relatively common. Deficiency of the spleen and stomach is the common TCM syndrome type.