健脾活血解毒方防治大肠腺瘤性息肉复发疗效观察

发布时间：2018-06-28 19:42

本文选题：大肠腺瘤性息肉 + 健脾活血解毒方　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:本研究通过运用健脾活血解毒方治疗经肠镜切除术后组织病理学诊断为大肠腺瘤性息肉的患者,试验采用随机对照的方法,证明息肉切除术后中医药的干预治疗是否可以降低大肠腺瘤的短期复发率和改善患者临床症状的情况。客观评价大肠腺瘤切除术后用中医药的干预治疗对降低大肠腺瘤短期复发率和改善患者症状的效果,为临床制定预防大肠腺瘤术后复发的有效中医药方案提供依据。方法:采集我院消化内科门诊2016年3月至2017年2月符合纳入标准的62例患者,将患者随机分为中药干预组与对照组各31例。由于试验过程中两组各自然脱落1例,所以实际每组30例。两组患者经肠镜行腺瘤切除术后均常规给予内科止血、抗感染、支持营养等治疗1-3天。对中药干预组大肠腺瘤术后恢复进食起给予健脾活血解毒方治疗8周,对照组术后除上述常规治疗外不给予中药及其他治疗;治疗过程中,如果出现特殊情况及时进行随访或者嘱患者就诊。治疗结束6个月后分别对全部病例作随访,复查肠镜一周前随访患者症状表现,所有患者均要求进行结肠镜检查,发现息肉时立即行镜下切除治疗,并记录复发情况。对两组息肉复发情况与症状改善情况经统计学分析进行比较。结果:临床研究结果显示:(1)单项症状疗效:在腹部疼痛、食少纳呆、大便溏烂及肛门灼热症状的改善上,中药干预组显著优于对照组,差异有统计学意义(P0.05),在体倦乏力和里急后重症状改善上,中药干预组与对照组差异无统计学意义(P0.05);(2)中医证候总疗效:中药干预组总有效率93.33%,对照组总有效率70%,中药干预组显著优于对照组,差异有统计学意义(P0.05);(3)短期复发率:中药干预组总共30例复发3例,复发率为10%,对照组总共30例,复发6例,复发率为20%。中药干预组与对照组差异无统计学意义(P0.05)。结论:中药健脾活血解毒方对大肠腺瘤切除术后患者临床症状改善明显,能显著改善腹部疼痛、食少纳呆、大便溏烂及肛门灼热症状,本药基本无毒副作用,安全性好。在预防腺瘤短期复发上,本方与单纯息肉切除效果差异不明显。
[Abstract]:Objective: to study the effect of Jianpi Huoxue jiedu recipe on patients with colorectal adenomatous polyps diagnosed by histopathology after endoscopy. It is proved that the intervention of TCM after polyposis can reduce the short term recurrence rate of colorectal adenoma and improve the clinical symptoms of the patients. Objective to evaluate the effect of intervention therapy with traditional Chinese medicine (TCM) after resection of colorectal adenoma on reducing the short-term recurrence rate of colorectal adenoma and improving the symptoms of colorectal adenoma, and to provide the basis for clinical establishment of effective Chinese medicine program to prevent recurrence of colorectal adenoma after operation. Methods: from March 2016 to February 2017, 62 patients were selected and randomly divided into Chinese medicine intervention group and control group. There were 30 cases in each group because of the natural shedding of 1 case in each group. Patients in both groups were treated with medical hemostasis, anti-infection and supportive nutrition for 1-3 days after resection of adenoma by endoscopy. The intervention group was treated with Jianpi Huoxue jiedu recipe for 8 weeks from the recovery of food intake after operation, while the control group was not treated with traditional Chinese medicine or other treatment except for the above-mentioned routine treatment. Follow up in time if special circumstances arise or ask the patient to see a doctor. All the patients were followed up 6 months after the treatment, and the symptoms of the patients were followed up one week before the endoscopy. All the patients were required to be examined by colonoscopy, the polyps were immediately resected under the microscope, and the recurrence was recorded. The recurrence of polyps and the improvement of symptoms in the two groups were compared by statistical analysis. Results: the results of clinical study showed that: (1) the curative effect of single symptom: in the abdominal pain, less food intake, loose stool and anal burning symptoms, the Chinese medicine intervention group was significantly better than the control group. The difference was statistically significant (P0.05). There was no significant difference between the Chinese medicine intervention group and the control group (P0.05); (2). The total effective rate of TCM intervention group was 93.33. The total effective rate of the control group was 700.The Chinese medicine intervention group was significantly better than the control group. The difference was statistically significant (P0.05); (3) short-term recurrence rate: a total of 30 cases of recurrence in the Chinese medicine intervention group, the recurrence rate was 10, the control group of 30 cases, recurrence of 6 cases, the recurrence rate was 20. There was no significant difference between the Chinese medicine intervention group and the control group (P0.05). Conclusion: the traditional Chinese medicine Jianpi Huoxue jiedu prescription can obviously improve the clinical symptoms of patients after resection of colorectal adenoma, can significantly improve abdominal pain, food intake, loose stool and anal burning symptoms, basically no toxic side effects, good safety. In the prevention of short-term recurrence of adenoma, there was no significant difference between our prescription and simple polyp resection.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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