溃疡性结肠炎内镜特征与中医证素的相关性研究OA

Objective To provide an objective basis for syndrome differentiation and treatment of ulcerative colitis(UC)from an endoscopic perspective by studying the correlation between endoscopic manifestations and Traditional Chinese Medicine(TCM)syndrome elements in UC patients.Methods A total of 187 UC patients who underwent endoscopic examination at Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from March 2024 to February 2025 were selected as the UC group.Another 30 patients with diarrhea-predominant irritable bowel syndrome(IBS-D)and 30 healthy examinees without gastrointestinal symptoms who visited the same hospital during the same period were selected as the IBS-D group and healthy control group(health group for short),respectively.TCM syndrome element data of all three groups and endoscopic data of UC patients were collected.The TCM syndrome elements and endoscopic features were analyzed to explore the correlation between characteristic TCM nature syndrome elements and endoscopic manifestations in UC patients.Results(1)Among 187 UC patients,a total of 7 nature syndrome elements were involved,including dampness,qi stagnation,blood stasis,toxin,qi deficiency,yang deficiency and yin deficiency.Among them,TCM syndrome elements with significant differences from other groups included dampness,blood stasis,toxin and yang deficiency(P＜0.017),which were the characteristic TCM nature syndrome elements of UC patients.(2)In active UC patients,with the expansion of lesion range,the proportions of dampness,blood stasis and toxin syndrome elements were significantly increased(P＜0.05 or P＜0.01).Further multiple comparisons showed that the proportions of dampness and blood stasis syndrome elements in patients with pancolitis(E3)were higher than those in patients with proctitis(E1)(P＜0.017),and the proportion of toxin syndrome element in E3 patients was higher than that in patients with left-sided colitis(E2)(P＜0.017).(3)Correlation analysis between characteristic TCM nature syndrome elements and UC endoscopic manifestations showed that ulcer formation was correlated with dampness syndrome element[OR=3.008,95%CI(1.230-7.359),P=0.016];mucosal erosion was correlated with blood stasis syndrome element[OR=4.410,95%CI(1.396-13.936),P=0.011];intestinal stricture was correlated with toxin syndrome element[OR=11.295,95%CI(2.176-58.619),P=0.004].Conclusion In UC patients,lesion range is correlated with dampness,blood stasis and toxin;mucosal ulcer is correlated with dampness;mucosal erosion is correlated with blood stasis;intestinal stricture is correlated with toxin.