Clinical Observation On Prevention Of Recurrence Of Colorectal Adenoma By Retention Enema Combined With Oral Traditional Chinese Medicine

ObjectiveColorectal polyp refers to any benign protuberant lesion originating from the epithelium of the large intestine mucosa and protruding to the intestinal cavity.According to its pathological type,it can be divided into adenomatous polyps and non-adenomatous polyps.Adenomatous polyps are benign neoplastic polyps,including tubular adenomas,villous adenomas,mixed tubular villous adenomas and serrated adenomas.At present,a large number of evidence-based medicine and long-term clinical epidemiological studies have confirmed that adenomatous polyps are precancerous lesions of colorectal cancer.The malignant rate varies from 5%to 40%according to the specific pathological types.Adenoma resection and prophylactic colonoscopy can effectively reduce the incidence and mortality of colorectal cancer.However,resection of adenomas under colonoscopy is not a once-in-a-lifetime event.According to relevant research and development,the recurrence rate within 3-5 years after polypectomy is 28.9%-58.1%.Due to the high recurrence rate and high canceration rate of adenomatous polyps,most western developed countries adopt regular colonoscopy and timely removal of pre-cancerous lesions in the budding stage.However,such large-scale monitoring and follow-up not only increase the financial burden of patients,increase unnecessary pain and complications of patients,but also cause great waste of medical resources.Chinese medicine is broad and profound,with mature overall thinking and syndrome differentiation and treatment system.Relevant studies have shown that retention enema with traditional Chinese medicine can directly or indirectly affect local wound tissue after polypectomy,significantly promote the repair of intestinal mucosa and prevent and control postoperative complications.Combined with clinical experience,most of the patients with adenomatous polyps belong to the type of spleen deficiency and dampness and blood stasis.Under the guidance of traditional Chinese medicine theory,the combination of internal and external therapies can be used to explore the feasibility of"Preventing recurrence after recovery " after endoscopic resection of adenomatous polyps.Therefore,this study observes the clinical efficacy of oral Chinese herbal decoction combined with retention enema in preventing recurrence of colorectal adenoma of spleen deficiency and dampness-stasis type after polypectomy,and provides new ideas and new methods for the prevention of recurrence of intestinal polyps after operation.MethodsFrom January 2017 to August 2018,60 patients with intestinal adenomatous polyps were selected from the endoscopy department of Shenzhen Traditional Chinese Medicine Hospital.Patients were divided into experimental group and control group according to random number table method.The experimental group was treated with retention enema of Chinese herbs for 4 days after polypectomy,and the traditional Chinese medicine decoction of invigorating spleen and removing blood stasis was given orally for 3 months.The control group was a blank control group.The clinical symptom scores of the two groups before and after polypectomy were compared.Six months later,the two groups were re-examined by electronic colonoscopy to record the number,size and pathological results of polyps recurrence,and to evaluate the curative effect.ResultsBefore treatment,comparing the basic data(including sex,age)and adenoma status(including adenoma number,size,pathological type)of the oral Chinese medicine decoction combined with retention enema group and the control group,there was no significant difference between the two groups(P>0.05),which was comparable.After 3 months of treatment,there was a significant difference in the scores of clinical symptoms between the two groups(P<0.05).The effective rate of improving symptoms in the experimental group was as high as 100%,and that in the control group was 25.9%.The difference was statistically significant(P<0.05).The recurrence rate of adenoma was 10.7%in the oral Chinese medicine combined with retention enema group and 24.1%in the control group after 6 months of observation.There was no significant difference between the two groups(P>0.05).There was no significant difference in the scores of recurrent adenomas between the two groups(P>0.05).ConclusionOral Chinese herbal decoction combined with retention enema can significantly improve the clinical symptoms of patients with adenomatous intestinal polyps of spleen deficiency and dampness-stasis type after operation.However,short-term observation(6 months)did not show significant advantages in preventing recurrence of adenomatous polyps and improving the degree of adenomatous lesions after recurrence.