基于四象学说探讨结肠腺瘤性息肉与体质的关系

发布时间：2018-08-09 09:52

【摘要】：研究目的探讨结肠腺瘤性息肉与四象体质之间、结肠腺瘤性息肉与中医体质之间的相关关系,以期发现结肠腺瘤性息肉在四象体质中的发病倾向体质,探索四象医学与中医体质之间的相关关系,为本病的预防及治疗上提供有价值的参考。研究方法收集2015年4月至2017年3月在北京中医药大学第三附属医院脾胃科就诊的193例内镜及病理诊断为结肠腺瘤性息肉的患者,收集其结肠组织病理诊断结果,通过对其体型体态、心理状态、摄生嗜好等一系列方面进行资料收集,填写《四象体质辨识量表(QSCCII)》及《中医体质辨识计算表》,根据收集的资料进行四象体质、中医体质归类,对收集的数据运用SPSS21.0进行统计学分析,P0.05时有统计学意义。研究结果1.本次研究的193例结肠腺瘤性息肉患者中,男性109例,女性84例,男女比率为1.3:1,发病的性别与疾病存在相关性,男性发病多于女性。结肠腺瘤性息肉患者检出的平均年龄在59.81 ±1.47岁,最小28岁,最大的83岁。检出发病年龄高峰段在51-60岁,其次在61-70岁,41-80岁年龄段检出发病人群占纳入总人数的94.8%,男女在腺瘤性息肉检出发病年龄上无明显差异,年龄与疾病发病存在相关性。2.结直肠腺瘤性息肉患者中,患者性别与年龄没有显著相关性。3.结直肠腺瘤性息肉大小与性别之间存在相关性。直径在0.5-0.9cm的息肉更容易出现在男性患者,而直径在1.0cm及以上的息肉,更多出现在女性患者身上。4.结直肠腺瘤性息肉的好发部位依次为左半结肠右半结肠全结肠,以左半结肠为主。5.四象体质辨识方面,研究中各体质类型所占比例由大到小依次为太阴人少阴人少阳人太阳人,以太阴人为主。6.结直肠腺瘤性息肉的病理分型与四象体质存在相关关系,混合型腺瘤多发于太阴人,四种体质均以管状腺瘤发生率较高。7.中医体质辨识方面,研究中各体质类型所占比例由大到小依次为阳虚质痰湿质气虚质血瘀质湿热质气郁质阴虚质平和质特禀质,以阳虚质为主,其次为痰湿质。8.四象体质中太阴人与中医体质辨识中阳虚质、痰湿质存在一定相关关系;四象体质中少阴人与中医体质辨识中阳虚质以及气虚质存在一定相关关系。结论结肠腺瘤性息肉好发于男性,年龄集中在40岁以后多发,好发部位为左半结肠。结肠腺瘤性息肉多见于太阴人中,混合型腺瘤多发于太阴人,考虑不除外太阴人在人群中所占比例较高有关。中医体质中,腺瘤性息肉多见于阳虚质、痰湿质人群,考虑与他们的饮食及生活方式有很大相关性。四象体质中太阴人与中医体质辨识中阳虚质、痰湿质存在一定相关关系,而少阴人与气虚质、阳虚质可能存在一定相关性。
[Abstract]:Objective to investigate the relationship between colon adenomatous polyps and four-image constitution, and between colon adenomatous polyps and TCM constitution, in order to find out the incidence tendency of colon adenomatous polyps in four-image constitution. In order to provide valuable reference for the prevention and treatment of the disease, the relationship between the four signs medicine and the constitution of traditional Chinese medicine is explored. Methods 193 patients with colonic adenomatous polyps diagnosed by endoscopy and pathology were collected from April 2015 to March 2017 in the Department of spleen and stomach, third affiliated Hospital of Beijing University of traditional Chinese Medicine, and the results of pathological diagnosis of colonic tissue were collected. A series of data were collected on their physique, mental state and habit of taking birth, filling out (QSCCII) and calculating form of physique identification of traditional Chinese medicine, and classifying the constitution of traditional Chinese medicine according to the data collected. The data collected were statistically analyzed by SPSS21.0 (P0.05). Results 1. In 193 patients with adenomatous polyps of colon, there were 109 males and 84 females, the ratio of males to females was 1.3: 1. The incidence of colonic adenomatous polyps was correlated with the incidence of adenomatous polyps in males than in females. The average age of colonic adenomatous polyps was 59.81 卤1.47 years old, the youngest was 28 years, and the oldest was 83 years old. The peak age of onset was 51-60 years old, and the next was 41-80 years old. There was no significant difference between male and female in detecting adenomatous polyps, and there was a correlation between age and disease. There was no significant correlation between sex and age in patients with colorectal adenomatous polyps. There was a correlation between the size of colorectal adenomatous polyps and sex. Polyps with diameters of 0.5-0.9cm were more likely to appear in male patients, while polyps with diameters of 1.0cm and above were more common in female patients. The most common sites of colorectal adenomatous polyps were left hemicolon, right hemicolon, and left hemicolon. In the aspect of physique identification, the proportion of different constitution types in the study is Taiyin people, Taiyin people and Taiyin people. The pathological classification of colorectal adenomatous polyps was correlated with the four-image constitution. The mixed adenoma was mostly in Taiyin people. The incidence of the four types of adenoma was higher than that of the tubular adenoma. In the aspect of physique identification of traditional Chinese medicine, the proportion of constitution types in the study was from large to small in the order of Yang deficiency, phlegm, dampness, qi, blood stasis, dampness, heat, stagnation, yin deficiency and nature, Yang deficiency, and phlegm dampness, followed by phlegm dampness. There is a certain correlation between Taiyin people and TCM physique identification of deficiency of Yang and phlegm dampness. Conclusion Adenomatous polyps of colon are more common in males than 40 years old, and the most common sites are left hemicolon. Adenomatous polyps of colon are more common in Taiyin people, and mixed adenomas are more common in Taiyin people. In traditional Chinese medicine, adenomatous polyps are more common in Yang deficiency and phlegm dampness groups, which are closely related to their diet and lifestyle. There is a certain correlation between Taiyin people and TCM physique identification of deficiency of Yang, phlegm and dampness, while that of less yin and deficiency of qi and yang may be related.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R273

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