本文選題：大腸腺瘤性息肉 + 健脾活血解毒方　； 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本研究通過(guò)運(yùn)用健脾活血解毒方治療經(jīng)腸鏡切除術(shù)后組織病理學(xué)診斷為大腸腺瘤性息肉的患者,試驗(yàn)采用隨機(jī)對(duì)照的方法,證明息肉切除術(shù)后中醫(yī)藥的干預(yù)治療是否可以降低大腸腺瘤的短期復(fù)發(fā)率和改善患者臨床癥狀的情況�？陀^評(píng)價(jià)大腸腺瘤切除術(shù)后用中醫(yī)藥的干預(yù)治療對(duì)降低大腸腺瘤短期復(fù)發(fā)率和改善患者癥狀的效果,為臨床制定預(yù)防大腸腺瘤術(shù)后復(fù)發(fā)的有效中醫(yī)藥方案提供依據(jù)。方法:采集我院消化內(nèi)科門(mén)診2016年3月至2017年2月符合納入標(biāo)準(zhǔn)的62例患者,將患者隨機(jī)分為中藥干預(yù)組與對(duì)照組各31例。由于試驗(yàn)過(guò)程中兩組各自然脫落1例,所以實(shí)際每組30例。兩組患者經(jīng)腸鏡行腺瘤切除術(shù)后均常規(guī)給予內(nèi)科止血、抗感染、支持營(yíng)養(yǎng)等治療1-3天。對(duì)中藥干預(yù)組大腸腺瘤術(shù)后恢復(fù)進(jìn)食起給予健脾活血解毒方治療8周,對(duì)照組術(shù)后除上述常規(guī)治療外不給予中藥及其他治療;治療過(guò)程中,如果出現(xiàn)特殊情況及時(shí)進(jìn)行隨訪或者囑患者就診。治療結(jié)束6個(gè)月后分別對(duì)全部病例作隨訪,復(fù)查腸鏡一周前隨訪患者癥狀表現(xiàn),所有患者均要求進(jìn)行結(jié)腸鏡檢查,發(fā)現(xiàn)息肉時(shí)立即行鏡下切除治療,并記錄復(fù)發(fā)情況。對(duì)兩組息肉復(fù)發(fā)情況與癥狀改善情況經(jīng)統(tǒng)計(jì)學(xué)分析進(jìn)行比較。結(jié)果:臨床研究結(jié)果顯示:(1)單項(xiàng)癥狀療效:在腹部疼痛、食少納呆、大便溏爛及肛門(mén)灼熱癥狀的改善上,中藥干預(yù)組顯著優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),在體倦乏力和里急后重癥狀改善上,中藥干預(yù)組與對(duì)照組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);(2)中醫(yī)證候總療效:中藥干預(yù)組總有效率93.33%,對(duì)照組總有效率70%,中藥干預(yù)組顯著優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);(3)短期復(fù)發(fā)率:中藥干預(yù)組總共30例復(fù)發(fā)3例,復(fù)發(fā)率為10%,對(duì)照組總共30例,復(fù)發(fā)6例,復(fù)發(fā)率為20%。中藥干預(yù)組與對(duì)照組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:中藥健脾活血解毒方對(duì)大腸腺瘤切除術(shù)后患者臨床癥狀改善明顯,能顯著改善腹部疼痛、食少納呆、大便溏爛及肛門(mén)灼熱癥狀,本藥基本無(wú)毒副作用,安全性好。在預(yù)防腺瘤短期復(fù)發(fā)上,本方與單純息肉切除效果差異不明顯。
[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.
【學(xué)位授予單位】：廣西中醫(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)】：R259

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