【目的】探讨结直肠息肉病例特点、中医证型分布及其与高脂血症等相关危险因素的关联性。【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结直肠息肉患者 （息肉组） 174例和肠道未见 异常者 （非息肉组） 87例，收集其相关病历资料，包括性别、年龄、体质量指数 （BMI） 、糖尿病史、高血压史、血脂情况[包 括总胆固醇 （TC） 、甘油三酯 （TG） 、低密度脂蛋白胆固醇 （LDL-C） 、高密度脂蛋白胆固醇 （HDL-C） 、动脉硬化指数 （AI） ]、是 否有脂肪肝以及肠息肉的发病部位、数量、大小和病理类型等数据，并对息肉组患者进行中医辨证分型，统计并分析结直 肠息肉患者的病例特点、中医证型分布及其与高脂血症的关联性。 【结果】（1） 息肉组和非息肉组患者均以41~60岁年龄段为 主，前者占59.8%，后者占49.4%，2组年龄比较，差异有统计学意义 （P < 0.05） 。 （2） 结直肠息肉发病部位多位于左半结肠， 占63.2%；息肉数量以单发为主，占69.0%；息肉大小以1~10 mm为主，占90.2%；息肉类型以非腺瘤性息肉为主，占 51.1%。 （3） 息肉组患者的中医证型主要为脾虚湿滞证，占44.8%；其次为大肠湿热证，占30.5%。 （4） 不同中医证型的BMI、糖 尿病史分布比较，差异均有统计学意义 （P < 0.05） ，而不同中医证型的性别、年龄、高血压史、脂肪肝史以及息肉发病部位、 数量、大小、病理类型比较，差异均无统计学意义 （P > 0.05） 。 （5） 息肉组患者的高脂血症占比明显高于非息肉组，差异有统计 学意义 （P < 0.01） ；且息肉组的TC、TG、LDL-C及AI水平均明显高于非息肉组，差异均有统计学意义 （P < 0.05或P < 0.01） ， 而2组的HDL-C水平比较，差异无统计学意义 （P > 0.05） 。 （6） 不同发病部位的TC、LDL-C水平及不同中医证型的LDL-C水 平比较，差异均有统计学意义 （P < 0.05或P < 0.01） ，其余不同临床特征 （包括息肉发病部位、数量、息肉大小、病理类型） 及中医证型的血脂情况比较，差异均无统计学意义 （P > 0.05）。 【结论】年龄是结直肠息肉发病的危险因素；结直肠息肉的中 医证型以脾虚湿滞证及大肠湿热证为主，且中医证型分布与BMI及糖尿病有一定的相关性；高脂血症是结直肠息肉发病的 危险因素，且TC、TG、LDL-C及AI的异常与息肉的发生有一定的相关性；TC及LDL-C与结直肠息肉的发病部位有关，且 LDL-C还可能与中医证型分布有关。

Objective To investigate the clinical characteristics and traditional Chinese medicine（TCM）syndrome types of colorectal polyp（CP）and to explore their correlation with hyperlipidemia and other related risk factors. Methods From January 2022 to December 2023， 174 patients with CP（polyp group）and 87 patients without intestinal abnormalities (non-polyp group）who underwent colonoscopy or treatment at the Endoscopy Center of Dongguan Hospital of Guangzhou University of Chinese Medicine were selected. Their data of medical records were collected，including gender，age，body mass index（BMI），history of diabetes mellitus，history of hypertension，blood lipid indicators [total cholesterol（TC），triglycerides（TG），low-density lipoprotein cholesterol（LDL-C）， high-density lipoprotein cholesterol（HDL-C），and arteriosclerosis index（AI）]，the presence offatty liver or not， and the foci，number，size，and pathological types of polyps. Moreover，TCM syndrome differentiation of patients in the polyp group was carried out， and then the clinical characteristics and TCM syndrome types of CP as well as their correlation with hyperlipidemia were statistically analyzed. Results（1）The age group of 41-60 years old accounted for a higher percentage in patients of the polyp group and non-polyp group，59.8% in the polyp group and 49.4% in the non-polyp group， and the comparison of ages between the two groups showed statistically significant difference（P < 0.05）.（2）The polyp foci of CP were mostly located in the left colon，accounting for 63.2%；single polyp was common，accounting for 69.0%；the size of polyps was usually 1-10 mm，accounting for 90.2%； the polyps were predominated by non-adenomatous polyps， accounting for 51.1%.（3）In the polyp group，spleen deficiency and dampness retention syndrome was the predominated syndrome type，accounting for 44.8%，and then followed by syndrome of damp-heat in large intestine，which accounted for 30.5%.（4）Comparison of the distribution of BMI and history of diabetes mellitus among various TCM syndrome types showed statistically significant differences（P < 0.05），while no statistically significant differences were presented in the comparison of gender，age，history of hypertension，and history of fatty liver，as well as the polyp foci，number，size，and pathological types among patients with various TCM syndrome types （P > 0.05）. （5） The percentage of complication of hyperlipidemia in the polyp group was significantly higher than that in the non-polyp group，and the difference was statistically significant（P < 0.01）. The levels of TC，TG，LDL-C，and AI in the polyp group were significantly higher than those in the non-polyp group， the differences being statistically significant（P < 0.05 or P < 0.01）. However， the difference of the HDL-C level between the two groups was not statistically significant（P > 0.05）.（6）Comparison of TC and LDL-C levels among the patients with different polyp foci and LDL-C level among the patients with various TCM syndrome types showed statistically significant differences（P < 0.05 or P < 0.01），while no statistically significant differences of blood lipid indicators were presented among the patients with various foci，number，sizes，and pathological types of the polyp and among the patients with various TCM syndrome types（P > 0.05）. Conclusion Age is a risk factor for CP. CP patients are usually differentiated as the syndrome of spleen deficiency and dampness retention and the syndrome of damp-heat in large intestine，and the distribution of TCM syndrome types exert a certain correlation with BMI and history of diabetes mellitus. Hyperlipidemia is also a risk factor for the onset of CP，and abnormal levels of TC，TG，LDL-C，and AI exert certain correlation with the occurrence of polyps. TC and LDL-C have a certain correlation with the polyp foci，and LDL-C may also be related to the distribution of TCM syndrome types.

R259.574

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） ；董明国广东省名中 医传承工作室建设项目 （编号：粤中医办函 [ 2020 ] 1号）