“乌梅丸”加减预防结肠腺瘤术后复发及癌变的临床疗效观察

发布时间：2018-03-08 05:32

本文选题：乌梅丸加减　切入点：结肠腺瘤术后　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的:以乌梅丸为基础,探讨结肠腺瘤术后复发及癌变的中医认识、相关因素等,并用乌梅丸加减观察其对预防结肠腺瘤术后复发及癌变的临床疗效,以及类胰岛素生长因子-l(IGF-l)和血清C肽在治疗前后水平的变化,为预防结肠腺瘤术后的复发及癌变提供治疗依据。研究方法:1.本研究的对象为2016年2月-2017年2月在南京中医药大学附属江苏省中医院消化内镜中心的所有住院及门诊治疗的结肠腺瘤术后患者60例,按随机分组法分为2组,其中治疗组30例,对照组30例。2.治疗组患者采用乌梅丸化裁加减治疗;对照组患者不作任何处理。3.对两组患者的疗效进行观察,主要有一般资料分析,包括患者性别、年龄比较,临床症状,腺瘤术后总体复发率比较,同时观察比较治疗前后的IGF-1和血清C肽水平的变化。研究结果:随访6个月后,60例患者中复发28例,总复发率为46.7%。其中对照组复发18例,复发率为60%,治疗组复发10例,复发率为33%,经统计学检验,两组患者术后复发率存在差异(p0.05)。对结肠腺瘤术后患者随访6个月,治疗组中医证候积分(除里急后重)与治疗前相比,p0.05,具有统计学意义,对照组中医证候积分与治疗前相比,p0.05,差异无统计学意义。治疗前,两组IGF-1、C肽差异不明显,无统计学意义。治疗后,治疗组IGF-1、C肽明显低于对照组,差异有统计学意义(P0.05)。治疗后,治疗组IGF-1、C肽较治疗前明显降低,差异有统计学意义(P0.05);对照组IGF-1、C肽较治疗前降低,但差异尚不具有统计学意义。研究结论:乌梅丸加减对预防结肠腺瘤术后复发及癌变疗效显著,可在一定程度上降低了结肠腺瘤的术后复发率,促进患者症状的恢复,可有效降低IGF-1,血清C肽表达,适宜在临床中推广应用。
[Abstract]:Objective: based on Wumei Pill, to explore the TCM knowledge and related factors of recurrence and canceration of colon adenoma, and to observe the clinical effect of Wumei Pill on preventing recurrence and canceration of colon adenoma after operation. And the changes of IGF-l-like insulin-like growth factor (IGF-l) and serum C-peptide before and after treatment, To provide treatment basis for preventing recurrence and canceration of colon adenoma after operation. Methods: 1. The subjects of this study were all the inpatients in the digestive endoscopy center of Jiangsu Provincial Hospital of traditional Chinese Medicine affiliated to Nanjing University of traditional Chinese Medicine from February 2016 to February 2017; and. There were 60 patients with colonic adenoma treated in outpatient department. There were 30 cases in the treatment group and 30 cases in the control group. The patients in the treatment group were treated with Wumei pill plus or minus, and the patients in the control group were not treated with any treatment .3.The curative effect of the two groups was observed and the general data were analyzed. Including sex, age, clinical symptoms, overall recurrence rate after adenoma, and the changes of IGF-1 and serum C-peptide levels before and after treatment. Results: 28 out of 60 patients were followed up for 6 months. The total recurrence rate was 46.7% in the control group (n = 18) and in the treatment group (n = 10) with a recurrence rate of 60,10 cases and a recurrence rate of 33 cases. There was a significant difference in the postoperative recurrence rate between the two groups (P 0.05). The patients with colonic adenoma were followed up for 6 months. The scores of TCM syndromes in the treatment group were significantly higher than those before treatment (P 0.05), but in the control group, there was no significant difference in the scores of TCM syndromes compared with that before treatment. Before treatment, there was no significant difference in IGF-1C peptide between the two groups. After treatment, the IGF-1C peptide in the treatment group was significantly lower than that in the control group (P 0.05). After treatment, the IGF-1C peptide in the treatment group was significantly lower than that in the pre-treatment group (P 0.05), and the IGF-1C peptide in the control group was lower than that in the control group. But the difference is not statistically significant. Conclusion: the addition and subtraction of Wumei pill has a significant effect on the prevention of postoperative recurrence and canceration of colon adenoma, which can reduce the postoperative recurrence rate of colon adenoma to some extent and promote the recovery of patients' symptoms. It can effectively reduce the expression of IGF-1 and serum C-peptide, and is suitable for clinical application.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R273

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