大肠癌前病变与中医证型相关性研究OA

Objective To explore the correlation between endoscopic characteristics and Traditional Chinese Medicine(TCM)syndrome types of colorectal precancerous lesions(CPL)with dysplasia based on narrow-band imaging(NBI)electronic chromoendoscopy,providing a reference for the integration of TCM and Western medi-cine in syndrome differentiation and clinical intervention.Methods A total of 100 patients with CPL confirmed by NBI magnifying endoscopy and pathology at the First Affiliated Hospital of Henan University of Science and Technology from January 2023 to January 2025 were selected as the study subjects.Based on the"Diagnostic and Treatment Protocols for 104 Diseases in 24 Specialties"combined with clinical practical experience,the sub-jects were divided into four groups:spleen and kidney yang deficiency syndrome,spleen deficiency and blood stasis syndrome,damp-heat accumulation syndrome,and qi stagnation and blood stasis syndrome.Data on en-doscopic lesion morphology,lesion height,and pathological type were collected,and univariate analysis was per-formed using the x2 test.Logistic regression analysis was used to explore the correlation between TCM syndrome types and endoscopic pathological characteristics.Results(1)Among the 100 patients,50 cases(50％)were diagnosed with damp-heat accumulation syndrome,42 cases(42％)with qi stagnation and blood stasis syn-drome,5 cases(5％)with spleen deficiency and blood stasis syndrome,and 3 cases(3％)with spleen and kidney yang deficiency syndrome;(2)Univariate analysis showed that qi stagnation and blood stasis syndrome was significantly associated with lesion height＜2.5 mm,superficial morphology,and tubular adenoma(all P＜0.05);damp-heat accumulation syndrome was significantly associated with lesion height＞2.5 mm,protruding morphology,villous adenoma,and serrated adenoma(all P＜0.05).(3)Logistic regression analysis showed that protruding morphology(OR=0.15)and lesion height＞2.5 mm(OR=0.09)were negatively correlated with qi stagnation and blood stasis syndrome,and tubular adenoma(OR=5.83)was an independent factor as-sociated with qi stagnation and blood stasis syndrome(all P＜0.05);lesion diameter＞2.5 mm(OR=11.72),protruding morphology(OR=10.98),villous adenoma(OR=7.61),and serrated adenoma(OR=8.58)were independent factors associated with damp-heat accumulation syndrome(P＜0.05);Conclusion The distribution of TCM syndrome types in CPL is primarily characterized by damp-heat accumulation syndrome and qi stagnation with blood stasis syndrome.Significant correlations exist between different syndrome types and the morphological and pathological characteristics of lesions.The damp-heat accumulation syndrome is often as-sociated with larger,protruding lesions that pose higher pathological risks(villous adenoma,serrated adcroma);whereas the qi stagnation with blood stasis syndrome is predominantly linked to smaller,superficial lesions,pri-marily comprising tubular adenomas.This study provides objective endoscopic morphological evidence for TCM syndrome differentiation,facilitating more precise differentiation and integrated Chinese and Western medicine intervention in clinical practice.