【目的】 基于五运六气理论探讨结直肠癌（CRC）术后息肉再发患者的先天运气禀赋特点，为临床息肉再发预测以及肿 瘤预后寻找新的切入点，完善治未病策略。【方法】 对2019—2023年在南京中医药大学附属南京中医院（南京市中医院）行结 直肠癌切除术，完成术后1年电子结肠镜检查的229例CRC患者（包括息肉再发组59例和无息肉再发的对照组170例）的一般 资料及出生时运气分布进行统计分析。【结果】（1）岁运、主气、客气、主运、客运、司天之气/在泉之气以及运气同化对结直 肠癌术后息肉再发无明显影响，差异均无统计学意义（P＞0.05）；而结直肠癌术后息肉再发与运气异化中的天刑年以及后天 因素中的吸烟史、饮酒史存在相关性，差异均有统计学意义（P＜0.01）。（2）将上述影响因素纳入多因素Logistic回归分析，结 果显示：吸烟史、饮酒史和天刑年均为结直肠癌术后息肉再发的独立影响因素（P＜0.01）。在影响程度上，天刑年（OR=5.83， 95%CI：1.69～20.04）＞吸烟史（OR=3.00，95%CI：1.49～6.07）＞饮酒史（OR＝2.85，95%CI：1.40～5.80）。【结论】 结直肠癌 术后息肉再发与气候变化剧烈及后天烟酒暴露密切相关，为运气学说指导息肉再发防治以及改善癌症预后提供了有力证据。

Objective To investigate the characteristics of congenital circuit-qi endowment in patients with polyp recurrence after colorectal cancer （CRC） resection based on the theory of five circuits and six qi，aiming to identify new entry points for predicting polyp recurrence and evaluating tumor prognosis， thereby refining preventive treatment strategies. Methods A statistical analysis was conducted on the general data and birthdate circuit-qi distributions of 229 CRC patients who underwent colorectal cancer resection at Nanjing Hospital of Chinese Medicine Affilaited to Nanjing University of Chinese Medicine from 2019 to 2023 and completed colonoscopy within the first postoperative year. The cohort included 59 patients with polyp recurrence and 170 controls without polyp recurrence. Results（1） Yearly circuit，dominant qi，guest qi，dominant circuit，guest circuit，celestial control qi and terrestrial effect qi，and assimilation of circuit qi showed no significant association with postoperative polyp recurrence in colorectal cancer （P＞0.05）. However， statistically significant differences were observed for celestial restriction year under abnormal transformation of circuit qi，as well as for smoking history and drinking history among acquired factors （P＜0.01）. （2） Multivariate Logistic regression analysis incorporating these influencing factors revealed that smoking history， drinking history， and celestial restriction year were all independent risk factors for postoperative polyp recurrence in colorectal cancer （P＜0.01）. And the factor of celestial restriction year （OR = 5.83， 95%CI： 1.69-20.04） had the strongest influence， followed by smoking history （OR = 3.00，95%CI：1.49-6.07） and drinking history （OR = 2.85，95%CI：1.40-5.80）. Conclusion Postoperative polyp recurrence in CRC is closely associated with years of intense climatic variation and acquired exposures to smoking and alcohol. This study provides robust evidence supporting the application of the five circuits and six qi theory in guiding the prevention of polyp recurrence and improving cancer prognosis.

R273.353

国家自然科学基金项目（编号：82004365）；江苏省科技计划专项资金重点研发计划社会发展面上项目（编号：BE2022674）