本文選題：烏梅丸加減　切入點(diǎn)：結(jié)腸腺瘤術(shù)后　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的:以烏梅丸為基礎(chǔ),探討結(jié)腸腺瘤術(shù)后復(fù)發(fā)及癌變的中醫(yī)認(rèn)識(shí)、相關(guān)因素等,并用烏梅丸加減觀察其對(duì)預(yù)防結(jié)腸腺瘤術(shù)后復(fù)發(fā)及癌變的臨床療效,以及類胰島素生長(zhǎng)因子-l(IGF-l)和血清C肽在治療前后水平的變化,為預(yù)防結(jié)腸腺瘤術(shù)后的復(fù)發(fā)及癌變提供治療依據(jù)。研究方法:1.本研究的對(duì)象為2016年2月-2017年2月在南京中醫(yī)藥大學(xué)附屬江蘇省中醫(yī)院消化內(nèi)鏡中心的所有住院及門診治療的結(jié)腸腺瘤術(shù)后患者60例,按隨機(jī)分組法分為2組,其中治療組30例,對(duì)照組30例。2.治療組患者采用烏梅丸化裁加減治療;對(duì)照組患者不作任何處理。3.對(duì)兩組患者的療效進(jìn)行觀察,主要有一般資料分析,包括患者性別、年齡比較,臨床癥狀,腺瘤術(shù)后總體復(fù)發(fā)率比較,同時(shí)觀察比較治療前后的IGF-1和血清C肽水平的變化。研究結(jié)果:隨訪6個(gè)月后,60例患者中復(fù)發(fā)28例,總復(fù)發(fā)率為46.7%。其中對(duì)照組復(fù)發(fā)18例,復(fù)發(fā)率為60%,治療組復(fù)發(fā)10例,復(fù)發(fā)率為33%,經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn),兩組患者術(shù)后復(fù)發(fā)率存在差異(p0.05)。對(duì)結(jié)腸腺瘤術(shù)后患者隨訪6個(gè)月,治療組中醫(yī)證候積分(除里急后重)與治療前相比,p0.05,具有統(tǒng)計(jì)學(xué)意義,對(duì)照組中醫(yī)證候積分與治療前相比,p0.05,差異無統(tǒng)計(jì)學(xué)意義。治療前,兩組IGF-1、C肽差異不明顯,無統(tǒng)計(jì)學(xué)意義。治療后,治療組IGF-1、C肽明顯低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,治療組IGF-1、C肽較治療前明顯降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05);對(duì)照組IGF-1、C肽較治療前降低,但差異尚不具有統(tǒng)計(jì)學(xué)意義。研究結(jié)論:烏梅丸加減對(duì)預(yù)防結(jié)腸腺瘤術(shù)后復(fù)發(fā)及癌變療效顯著,可在一定程度上降低了結(jié)腸腺瘤的術(shù)后復(fù)發(fā)率,促進(jìn)患者癥狀的恢復(fù),可有效降低IGF-1,血清C肽表達(dá),適宜在臨床中推廣應(yīng)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.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R273

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 鐘玲玲;舒鵬;;烏梅丸加減治療多發(fā)性大腸息肉經(jīng)驗(yàn)談[J];環(huán)球中醫(yī)藥;2017年02期

2 張凌云;郭士杰;韓樹堂;;內(nèi)鏡結(jié)合中醫(yī)藥治療大腸息肉研究概述[J];遼寧中醫(yī)藥大學(xué)學(xué)報(bào);2016年11期

3 陳雪芳;;328例老年人結(jié)腸息肉臨床及病理特點(diǎn)分析[J];黑龍江醫(yī)藥;2016年04期

4 唐蓉珠;尚靜娟;董躍濱;;非酒精性肝病與結(jié)腸腺瘤性息肉的相關(guān)性分析[J];中國(guó)婦幼健康研究;2016年S1期

5 孟憲紅;劉鐵夫;劉平;許鵬;劉勇;;結(jié)腸癌與結(jié)腸腺瘤患者常見腸道菌群數(shù)量比較[J];山東醫(yī)藥;2016年13期

6 李玉嬋;安彥軍;;大腸腺瘤的研究進(jìn)展[J];世界最新醫(yī)學(xué)信息文摘;2016年26期

7 Wanqing Chen;Rongshou Zheng;Hongmei Zeng;Siwei Zhang;;The updated incidences and mortalities of major cancers in China, 2011[J];Chinese Journal of Cancer;2015年11期

8 鄧婉婷;管淑玉;李瑤;李將;陳磊;羅蘭;;烏梅總有機(jī)酸的提取優(yōu)化工藝及其抗氧化活性研究[J];廣東藥學(xué)院學(xué)報(bào);2015年02期

9 王瓊;劉沈林;嚴(yán)士海;王海丹;符蕊;張迪;金瑩;朱萱萱;;烏梅黃連復(fù)方對(duì)人結(jié)腸癌細(xì)胞HT29增殖和遷移的影響[J];南京中醫(yī)藥大學(xué)學(xué)報(bào);2014年06期

10 陸寶鈿;崔西玉;李兆滔;黃輝文;劉瀏;程燦昌;;年齡對(duì)大腸腺瘤臨床流行病學(xué)特征的影響[J];廣東醫(yī)學(xué);2014年08期

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