【目的】 探讨大肠息肉患者的流行病学特征、中医证型分布及焦虑抑郁情况。【方法】 选取2022年1月至2023年12月期 间在广州中医药大学东莞医院内镜中心行结肠镜检查或治疗的大肠息肉患者200例（息肉组）和肠道未见异常者100例（非息肉 组），收集2组患者的相关病历资料，对大肠息肉患者进行中医辨证分型，并对其流行病学特征包括性别、年龄、体质量指数 （BMI）、烟酒史等进行问卷调查和记录，同时进行医院焦虑抑郁量表（HAD）评分，以评估其焦虑、抑郁状态。【结果】（1）流 行病学特征方面，息肉组与非息肉组患者的性别、年龄、BMI、吸烟、饮酒等一般情况比较，差异均有统计学意义（P < 0.05 或P < 0.01）。具体表现为，息肉组以男性为主（63.5%），而非息肉组以女性为主（58.0%），说明相比女性患者，男性患者更 易患大肠息肉；年龄方面，息肉组以51 ~ 60岁年龄段为主（36.0%），非息肉组以41 ~ 50岁年龄段为主（38.0%），说明息肉组 的平均年龄较非息肉组大；另外，息肉组的肥胖（BMI ≥ 28.0 kg/m2）、吸烟、饮酒人数占比均较非息肉组高。（2）息肉情况方 面，大肠息肉多发病于左半结肠，占息肉组的53.5%；腺瘤性息肉占所有息肉病理类型的57.0%；肠息肉大小以 < 1.0 cm 为 主，占所有息肉的 81.5%；单发性肠息肉占 45.5%，多发性肠息肉占 54.5%，说明大肠息肉仍以多发为主。（3）中医证型分布 方面，200例大肠息肉患者中，脾虚湿滞证 93例（46.5%），大肠湿热证 59例（29.5%），肝郁气滞证 27例（13.5%），湿瘀阻滞 证 21 例（10.5%）。不同性别、年龄、BMI 和饮酒情况的大肠息肉患者中医证型分布比较，差异均无统计学意义（P > 0.05）； 而不同吸烟情况的大肠息肉患者中医证型分布比较，差异有统计学意义（P < 0.05）。不同发病部位、息肉数目、病理类型的 大肠息肉患者中医证型分布比较，差异均无统计学意义（P > 0.05）；而不同息肉大小的大肠息肉患者中医证型分布比较，差 异有统计学意义（P < 0.05），其中，息肉大小 < 1.0 cm者脾虚湿滞证及大肠湿热证的比例明显高于 ≥ 1.0 cm者，湿瘀阻滞证 的比例明显低于 ≥ 1.0 cm者。（4）焦虑、抑郁状态方面，息肉组患者HAD量表的焦虑、抑郁状态评分均高于非息肉组，差异 均有统计学意义（P < 0.01）。进一步分析发现，对于大肠息肉患者而言，除息肉大小的焦虑状态评分外，不同发病部位、发 病数目、病理类型与焦虑状态、抑郁状态评分以及息肉大小与抑郁状态评分均无关，差异均无统计学意义（P > 0.05）。另外， 不同中医证型的焦虑、抑郁状态评分比较，差异也均无统计学意义（P > 0.05）。【结论】（1）大肠息肉的中医证型分布以脾虚湿 滞证、大肠湿热证为多，其中医证型分布与焦虑抑郁及肠息肉的发病部位、数目、病理类型无关，而与息肉大小具有一定 的相关性；（2）焦虑抑郁可能是大肠息肉发病的危险因素，但大肠息肉的发病部位、发病数目、病理类型与焦虑抑郁无关， 息肉大小可能与焦虑具有一定的相关性。（3）性别、年龄、吸烟、饮酒可能是大肠息肉发病的危险因素。

Objective To investigate the clinical characteristics， distribution of traditional Chinese medicine （TCM）syndrome types，and the anxiety and depression status in patients with colorectal polyps. Methods From January 2022 to December 2023， a total of 200 cases of patients with colorectal polyps（polyp group）and 100 patients without intestinal abnormalities（non-polyp group）under colonoscope who received colonoscopy or treatment at the Endoscopy Center of Dongguan Hospital， Guangzhou University of Chinese Medicine were enrolled. The relevant medical information of the patients in the two groups were collected， and then TCM syndrome differentiation of patients with colorectal polyps were carried out， the general infromation including gender，age，body mass index（BMI），smoking history and alcohol-intake history was recorded，and Hospital Anxiety and Depression Scale（HAD）score was calculated for assessing their anxiety and depression status. Results （1）The investigation of clinical characteristics showed that between the polyp group and the non-polyp group，the differences in the general information of gender， age， BMI， smoking history and alcohol-intake history were statistically significant（P < 0.05 or P < 0.01）. As for the gender，the polyp group was predominated by the male （63.5%），while the non-polyp group was predominated by the female（58.0%），indicating that male patients were more likely to suffer from colorectal polyps. In terms of the age，the age group of 51 - 60 years old accounted for a higher percentage（36.0%）in the polyp group，while the age group of 41 - 50 years old accounted for a higher percentage（38.0%）in the non-polyp group，indicating that the polyp group had an elder average age than the non-polyp group. In addition，the percentages of patients with obesity（BMI ≥ 28.0 kg/m2），smoking history， and alcohol-intake history in the polyp group were higher than those in the non-polyp group.（2）The analysis of features of colorectal polyps showed that the polyps were mostly seen in the left colon，accounting for 53.5% in the polyp group；adenomatous polyps accounted for 57.0% of all polyps；the size of colorectal polyps was usually less than one centimeter， accounting for 81.5% of all polyps； single colorectal polyps accounted for 45.5%， and multiple colorectal polyps accounted for 54.5%，indicating that colorectal polyps were usually multiple.（3）Among the 200 patients with colorectal polyps，there were 93 cases of syndrome of stagnation dampness due to spleen deficiency （46.5%）， 59 cases of dampness-heat in large intestine syndrome （29.5%）， 27 cases of liver depression and qi stagnation syndrome（13.5%），and 21 cases of dampness and blood stasis obstruction syndrome （10.5%）. There were no statistically significant differences in the distribution of TCM syndrome types among colorectal polyp patients with different genders，ages，BMIs and alcohol consumption（P > 0.05）. The difference in the distribution of TCM syndrome types among colorectal polyp patients with or without smoking history was statistically significant（P < 0.05）. No statistically significant differences were shown in the distribution of TCM syndrome types among the colorectal polyp patients with various foci，number of polyps，and pathological types （P > 0.05）. The difference in the distribution of TCM syndrome types in colorectal polyp patients with different polyp sizes was statistically significant（P < 0.05）. In the patients with the polyp size < one centimeter，syndrome of stagnation dampness due to spleen deficiency and dampness-heat in large intestine syndrome accounted for higher percentages， and dampness and blood stasis obstruction syndrome accounted for lower percentage than those in the patiens with polyp size ≥ one centimeter.（4）The anxiety and depression scores evaluated with HAD in the polyp group were higher than those in the non-polyp group，the differences being statistically significant（P < 0.01）. Further analysis revealed that except for the anxiety scores in patients with various polyp sizes， anxiety scores and depression scores had no correlation with the poly foci， number of polyps and pathological types of polyps， and depression scores had no correlation with the polyp size， the differences being not statistically significant（P > 0.05）. In addition，the differences of anxiety scores and depression scores in the patients with various TCM syndrome types were not statistically significant（P > 0.05）. Conclusion（1）The distribution of TCM syndrome types of colorectal polyps is predominated by the syndrome of stagnation dampness due to spleen deficiency and dampness-heat in large intestine syndrome. The distribution of TCM syndrome types has no correlation with anxiety and depression，and the polyp foci，number of polyps，and pathological types of polyps， but has certain correlation with the size of the polyps.（2）Anxiety and depression may be the risk factors for colorectal polyps，but the polyp foci，number of polyps，and pathological types of polyps have no correlation with anxiety and depression， and the size of polyps may have certain correlation with anxiety.（3）Gender， age， smoking history and alcohol-intake history may be the risk factors for colorectal polyps.

R269.569

广东省基础与应用基础研究基金企业联合基金（公共卫生与医药健康领域）项目（编号：2022A1515220059）