| Objective: To retrospectively analyze the medical records of patients with colorectal polyps,to explore the distribution of TCM syndromes,onset features and related factors of colorectal polyps,for purpose of offer reference for clinical prevention and treatment of colorectal polyps and TCM syndrome differentiation in the future.Methods: A total of 235 patients who were hospitalized in the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from December 2021 to December 2022 and met the inclusion criteria were selected.The personal information,major symptoms,past history,TCM syndrome types and colonoscopy data of the patients were recorded and sorted out.Excel was used to gather and manage the contents,and SPSS 25.0was used for statistical analysis.Results:(1)Of 235 patients with colorectal polyps,the male to female ratio was 1:1.94.Patients ranged in age from 19 to 95,with an average age(55.34 ±13.132).The peak age of onset was concentrated among seniors over 59 years of age.There were 139 patients with normal BMI,106 patients with dyslipidemia,51 smokers and 33 drinkers.(2)Among 235 patients,171 had single lesion and 64 had multiple lesions.The most common site of polyps was rectum(92,31.1%),followed by transverse colon(61,20.6%),sigmoid colon(59,19.9%),ascending colon(47,15.9%),descending colon(35,11.8%)and ileocecum(2,0.7%).Under the colonoscopy,there were 154 polyps smaller than 0.5cm,accounting for the largest proportion,followed by polyps between 0.5cm and 1.0cm(117polyps)and larger than 1.0cm polyps(25 polyps).There was no statistical significance between the size of polyps and lesion locations(P=0.148),but between the size of polyps and the distribution of the number of polyps have significant difference(P=0.000).The larger the polyps,the more likely the patients to have multiple polyps.There were 177 non-adenomatous polyps(59.9%),including 138 inflammatory polyps and 39 hyperplastic polyps.There were 119 adenomatous polyps(40.1%),including 112 tubular adenomas,1 villous adenoma,3 tubulo-villous adenoma and 3 serrated adenoma.(3)The most typical clinical manifestations of colorectal polyps were abdominal distension(11.13%),followed by abdominal pain(7.91%),loose stool(4.98%),acid reflux(4.54%),diarrhea(4.39%)and constipation(3.51%).Tongue texture was most common in light tongue(106 times),tongue coating was most common in thin white tongue(35.3%),white tongue(20.4%),yellow greasy tongue(20.4%).The main pulse manifestations were weak pulse(27.7%),string pulse(23.4%),heavy thin pulse(15.3%),slippery pulse(11.1%),and string slippery pulse(10.2%).(4)The TCM syndrome types of patients with colorectal polyps in order were spleen deficiency and dampness accumulation syndrome(71,30.2%)、 intestinal damp-heat syndrome(65,27.7%)> liver depression and qi stagnation syndrome(64,27.2%)> spleen and kidney Yang deficiency syndrome(23,9.8%)> stasis and internal stasis syndrome(12,5.1%),and the largest proportion of spleen deficiency and dampness accumulation syndrome.There was a significant difference in TCM syndrome type and gender distribution of CRP patients(P=0.018).Male patients were more likely to suffer from intestinal damp-heat syndrome,while female patients were mainly suffering from liver depression and qi stagnation syndrome.When the TCM syndrome types were compared with the age distribution,the spleen-kidney Yang deficiency syndrome to more common in the elderly patients over 59 years old(P=0.035).The distribution of different serum lipids in TCM syndromes of CRP patients is significantly different(P=0.008).And there was a crystal clear difference between TCM syndrome types and pathological distribution of polyps(P=0.001).Non-adenomatous polyps were more frequent in patients with intestinal damp-heat syndrome and liver depression and qi stagnation syndrome.Adenomatous polyps were more common in stasis syndrome and spleen-kidney Yang deficiency syndrome.There was no significant difference in the distribution of TCM syndrome types and BMI,polyp size,polyp number and polyp location in CRP patients(P > 0.05).(5)Analysis of the incidence of adenomatous polyps and correlative factors indicated that the risk of adenomatous polyps was higher in males than in females(P=0.001).As far as age is concerned,elderly patients were more likely to have adenomatous polyps(P=0.000),and tubular adenomas were more common.Patients with a history of gastric polyps had a higher risk of adenomatous polyps(P=0.003).There was a significant difference between the onset of adenoma and the size distribution of polyps(P=0.000).Using multivariate logistic regression,it was determined that gender(OR: 2.195,P=0.022,95%CI: 1.120-4.299),age(OR: 1.051,P=0.000,95%CI: 1.025-1.077),polyp size(OR: 8.44,P=0.00,OR: 15.588,P=0.00)could increase the risk of adenomatous polyps.Conclusion:(1)The male to female ratio of colorectal polyps was 1:1.94,and the peak age was concentrated in the elderly over 59.(2)The number of polyps was mainly single,the rectum was the most common site of polyps,the size of polyps was mainly less than 0.5cm under the microscope,the pathological type was mostly non-adenomatous polyps,and the concentration was mainly inflammatory polyps.(3)Clinical symptoms are abdominal distension most,TCM syndrome is light tongue,thin white moss and weak pulse.(4)Spleen deficiency and damp accumulation predominate when it comes to TCM syndrome,followed by intestinal damp-heat syndrome > liver depression and qi stagnation syndrome > spleen and kidney Yang deficiency syndrome > blood stasis syndrome.The distribution of syndrome types is related to gender,age,blood lipids and pathological types of polyps.The occurrence of colorectal polyps is based on spleen deficiency,and dampness is the most important factor.(5)The incidence of adenomatous polyps is related to gender,age,history of gastric polyps,polyp size and other factors.Multivariate logistic regression analysis showed that gender,age and polyp size could increase the risk of adenomatous polyps. |
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