CAJ | 학술논문

目的：比较不同中医证型溃疡性结肠炎（ UC）患者癌变危险因素的差异。方法选择UC住院患者71例，按中医辨证分为脾胃气虚证组35例和湿热内蕴证组36例，对2组患者的基本信息、临床症状、肠镜表现及组织病理学改变进行回顾性分析。结果脾胃气虚证组平均病程（69．3个月）较湿热内蕴证组（24．7个月）更长。脾胃气虚证组26％的患者病程超过10 a，与湿热内蕴证组（6％）比较差异有统计学意义（P＝0．019）；发生全结肠炎的患者脾胃气虚证组（7例）较湿热内蕴证组（3例）更多，但差异无统计学意义（ P＝0．905）；湿热内蕴证组患者肠黏膜主要表现为中、重度充血、水肿、质脆（47％），中、重度糜烂（29％）；脾胃气虚证组患者以无明显或呈轻度充血、水肿、质脆为主（86％），糜烂也多呈轻度（91％），2组比较差异有统计学意义（P＝0．001，P＝0．042）。2组发生异型增生的病例均呈低级别异型增生，脾胃气虚证组（8例）多于湿热内蕴证组（3例），但差异无统计学意义（P＝0．065）。结论从病程、病变范围、炎症程度及异型增生的角度，看溃疡性结肠炎脾胃气虚证具有癌变危险因素的患者比例明显高于湿热内蕴证，但脾胃气虚证患者中是否有更多患者发生了癌前病变或癌变，还有待长期的随访研究。
목적：비교불동중의증형궤양성결장염（ UC）환자암변위험인소적차이。방법선택UC주원환자71례，안중의변증분위비위기허증조35례화습열내온증조36례，대2조환자적기본신식、림상증상、장경표현급조직병이학개변진행회고성분석。결과비위기허증조평균병정（69．3개월）교습열내온증조（24．7개월）경장。비위기허증조26％적환자병정초과10 a，여습열내온증조（6％）비교차이유통계학의의（P＝0．019）；발생전결장염적환자비위기허증조（7례）교습열내온증조（3례）경다，단차이무통계학의의（ P＝0．905）；습열내온증조환자장점막주요표현위중、중도충혈、수종、질취（47％），중、중도미란（29％）；비위기허증조환자이무명현혹정경도충혈、수종、질취위주（86％），미란야다정경도（91％），2조비교차이유통계학의의（P＝0．001，P＝0．042）。2조발생이형증생적병례균정저급별이형증생，비위기허증조（8례）다우습열내온증조（3례），단차이무통계학의의（P＝0．065）。결론종병정、병변범위、염증정도급이형증생적각도，간궤양성결장염비위기허증구유암변위험인소적환자비례명현고우습열내온증，단비위기허증환자중시부유경다환자발생료암전병변혹암변，환유대장기적수방연구。
Objective It is to compare the differences in cancer risk factors between different Chinese traditional medical syndromes of ulcerative colitis ( UC) .Methods 71 patients with UC in hospital were divided into two groups according to dif-ferent Chinese medicine syndrome types:spleen Qi and stomach Qi deficiency syndrome(35 cases)and internal accumulation of dampness-heat syndrome(36 cases).The patients'personal data,clinical symptoms,colonoscopy performance and histopatho-logical features were analyzed retrospectively.Results The average duration in spleen Qi and stomach Qi deficiency syndrome group was 69.3 months,which was longer than that was 24.7 months in dampness-heat syndrome group.26% patients had been diagnosed with UC for more than 10 years in spleen Qi and stomach Qi deficiency syndrome group,which was higher than the dampness-heat syndrome group(6%),there was a significant difference between the two groups(P=0.019).Although no significant difference was found,the number of pancolitis in spleen Qi and stomach Qi deficiency syndrome group(7 cases)was higher than that in the another group(3 cases).The extent of intestinal mucosal congestion,edema,crisp(47%)and erosion (29%)in the dampness-heat syndrome group were moderate and severe,which were no or mild in the spleen Qi and stomach Qi deficiency syndrome group(86%and 91%) ,there were statistically significant differences between the two syndrome groups (P=0.001,P=0.042).8 cases in the spleen Qi and stomach Qi deficiency syndrome group and 3 cases in the dampness-heat syndrome(P=0.065)were diagnosed with mucosal dysplasia,and the difference was not significant (P=0.065),all pa-tients with dysplasia were low grade dysplasia.Conclusion From the view of duration, extent, inflammation and dysplasia, the proportion of patients with CAC risk factors in the spleen Qi and stomach Qi deficiency syndrome group was higher than those in the dampness-heat syndrome group.A long-term follow-up survey was still needed to confirm the fact that more patients with the spleen Qi and stomach Qi deficiency syndrome had precancerous or CAC than those with the dampness-heat syndrome.