本文選題：大腸息肉 + 窄帶成像內(nèi)鏡(NBI)��； 參考：《廣西中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:探討基于窄帶成像內(nèi)鏡(Narrow-band Imaging,NBI)技術(shù)的大腸息肉(Colorectal polyp)鏡下表現(xiàn),中醫(yī)證型的分布特點,病理學(xué)特征及三者之間的關(guān)系,將內(nèi)鏡表現(xiàn)延伸作為中醫(yī)診療資料,為臨床應(yīng)用辨證論治提供客觀依據(jù)。方法:以2014年9月至2015年9月在我院脾胃病科住院及門診就診,符合納入和診斷標(biāo)準(zhǔn)的病例,對經(jīng)NBI內(nèi)鏡白光模式及病理確診入組的100例大腸息肉患者進(jìn)行中醫(yī)辨證分型,觀察NBI內(nèi)鏡下的表現(xiàn),并分析其與各中醫(yī)證型、病理類型之間的關(guān)系。結(jié)果:(1)大腸息肉患者中男性56例(占56%),女性44例(占44%),男女之比為1.27:l。發(fā)生部位以乙狀結(jié)腸最多(發(fā)生率32%),直腸次之(發(fā)生率29%),回盲部最少(發(fā)生率3%)。臨床表現(xiàn)以腹瀉、便秘為多見。(2)NBI模式下大腸息肉以pit-Ⅰ型、pit-Ⅱ型、pit-Ⅲ型腺管開口為主;根據(jù)山田分型四種形態(tài)均有出現(xiàn),山田Ⅰ型、山田Ⅱ型、山田Ⅲ型較多出現(xiàn)。pit-Ⅰ型腺管開口多見于山田Ⅰ型、Ⅱ型息肉;pit-Ⅱ型腺管開口多見于山田Ⅱ型、Ⅰ型息肉;pit-Ⅲ型腺管開口多見于山田Ⅲ型、Ⅱ型息肉;pit-Ⅳ型腺管開口多見于山田Ⅲ型、Ⅳ型息肉。病理分型炎性息肉與管狀腺瘤為主。(3)大腸息肉腺管開口分型與性別無相關(guān)性。(4)大腸息肉的中醫(yī)證候分型主要有四類:脾虛夾瘀型(占37%)、濕熱瘀阻型(占34%)、氣郁痰凝型(占15%)、脾腎陽虛型(占14%)。(5)大腸息肉中醫(yī)舌脈診特點,舌形以胖大舌、嫩舌為主,舌苔分布中白苔占多數(shù),舌色以淡白舌、淡紅舌為主,脈象分布主要以緩脈,沉脈為主。(6)中醫(yī)證候分型與性別、息肉大小無顯著差異(P0.05),與不同年齡段有顯著相關(guān)性。40~49歲及50~59歲的患者以濕熱瘀阻型為主,60歲以上的患者以脾虛夾瘀型為主,70歲以上的患者以脾腎陽虛證為主。(7)NBI模式下大腸息肉腺管開口分型與中醫(yī)證候分型呈正相關(guān)(P0.05)。(8)中醫(yī)證候與病理類型之間的關(guān)系:炎性息肉、增生性息肉、幼年性息肉多見于濕熱瘀阻證,管狀腺瘤多見于脾虛夾瘀證,管狀絨毛狀腺瘤與絨毛狀腺瘤多見于脾腎陽虛證。結(jié)論:本研究提示:(1)本病患病率男性高于女性,好發(fā)部位為直腸和乙狀結(jié)腸。(2)舌脈象提示大腸息肉病患者的中醫(yī)病性為本虛為主,虛實夾雜,主要病理產(chǎn)物為濕、痰、熱及瘀。(3)本病的主要中醫(yī)證型分布趨勢為:脾虛夾瘀型濕熱瘀阻型氣郁痰凝型脾腎陽虛型。(4)病理診斷與腺管開口分型之間具有高度一致性。(5)NBI模式下大腸息肉腺管開口分型與中醫(yī)證候分型呈正相關(guān),豐富中醫(yī)辨證的信息量,為中醫(yī)辨證論治提供參考依據(jù)。
[Abstract]:Objective: to study the features of colorectal polypypypypypypypy of large intestine polyp under narrow band imaging (NBI) technique, the distribution characteristics of TCM syndromes, pathological characteristics and the relationship among them, and to extend the endoscopic manifestations as the data of diagnosis and treatment of traditional Chinese medicine (TCM). To provide objective basis for clinical application of syndrome differentiation and treatment. Methods: from September 2014 to September 2015, 100 cases of colonic polyps diagnosed by endoscopy and pathology in our hospital were divided into two groups according to the criteria of inclusion and diagnosis. To observe the endoscopic manifestations of NBI and to analyze the relationship between NBI and TCM syndromes and pathological types. Results among the patients with colorectal polyps, 56 cases were male (56%) and 44 cases were female (44%). The ratio of male to female was 1.27: l. The most common sites were sigmoid colon (32%), rectum (29%) and ileocecal part (3 cases). The clinical manifestations were diarrhea and constipation. In the pattern of constipation, the large intestine polyps were mainly pit- 鈪，

本文編號：2033955