The Clinical Observation Of "Xiao Xun Tang"on Colorectal Polyps

Objective:Description of present situation of the TCM and modern medicine’s current understandings and treatments on colorectal polyps; tevaluate the efficacy of "Xiao Xun Tang" which is an empirical prescription of professor Shuxin Zhang treated CRP;investigate the curative effect differences of the prescription in different clinical symptoms,distribution sites and pathological classifications of CRP. We have a meta-analysis for literatures of non-stcroidal anti-inflammatory drugs to prevent the colorectal polyps in about50years;judge the efficacy that cured colorectal polyps with "Xiao Xun Tang" for3months with chi-square test and variance analysis;discuss the different efficacy for different clinical symptoms,distribution sites and pathological classifications that cured colorectal polypswith "Xiao Xun Tang’ with multifactorial rank sum test;We offered the core pathogenesis and syndrome groups of CRP based on professor Shuxin Zhang’s prolific clinical experiencesMethods:(1) The standard literature retrieval were ready and have made the inclusive and exclusive criteria. With the database such as PubMed, CNKI and CBM, the medical literature which is about CRP in English and Chinese from1960(or1978) to2013were chosen. After the choose,we had a meta-analysis of RCT to assess that if the Non-Steroidal Anti-Inflammatory Drugs might to be prevent the CRP.(2) Patients (research objects) who are been diagnosed suffering from CRP in January1,2012to January31,2013used the "Xiao Xun Tang" continually in3months,then to determine the efficacy with collected their clinical symptoms,distribution sites and pathological classifications and chi-square test and variance analysis.(3) Discuss the different efficacy for different clinical symptoms,distribution sites and pathological classifications that cured colorectal polyps with "Xiao Xun Tang" with multifactorial rank sum test,to comparative difference between themselves and describe the prescription’s better using aspects.(4) We offered the core pathogenesis and syndrome groups of CRP based on professor Shuxin Zhang’s prolific clinical experiences,and introducing his dialectical thinking and medical features.Results:(1) Meta analysis’ results shows that OR-0.68,95%CI(0.46,1.00) and the overall effect test demonstrates that Z=1.95,P=0.05, it illustrated that the Non-Steroidal Anti-Inflammatory Drugs might to be prevent the CRP in comparing with placebo group.(2)50patients,28males and22females;aged20-89years old,Average aged60.25±10.05years old. Pathological types:8cases of inflammatory polyps,12cases of tubular adenoma,3cases of villous adenoma,15cases of tubular villous adenoma,1cases of benign lymphoid polyp,11cases of hyperplastic polyp. Amount:29cases of single polyps and21cases of multiple polyps,about16cases of patients,their colorectal polyps was distributed across two or more sites.(3) Changes in clinical symptoms after treatment:14cases of cured,31cases of a significant effect,2cases of curative,3cases of null;the polyps was evaluated with colonoscopy:21cases of cured,23cases of a sign i f icant effect,3cases of curative,3cases of null.(4) In7cases of patients who were evaluated as "curative" or "null"(5cases of changes in clinical symptoms after treatment,6cases of the polyps was evaluated with colonoscopy,both of them where there is1cases of coincidence),there were1cases of hyperplastic polyps,2cases of villous adenoma,4cases of tubular villous adenoma;the polyps was evaluated with colonoscopy had cured was20cases (12cases of single polyps and8cases of multiple polyps),3cases on ascending colon,6cases on transverse colon,2cases on descending colon,8cases on sigmoid,I cases on rectal;27cases of patients with polyps reduced (16cases of single polyps and11cases of multiple polyps),1cases on ileocecal,4cases on ascending colon,8cases on transverse colon,4cases on descending colon,9cases on sigmoid,1cases on rectal;9cases of patients with polyps ranges reduced,1cases on ascending colon,2cases on transverse colon,3cases on descending colon,3cases on sigmoid;multiple polyps decrease in the number of patients was9,5cases on transverse colon,1cases on descending colon,2cases on sigmoid,1cases on rectal.Conclusions:(1) NSAIDs was of effective for the prevention of colorectal adenomas.(2) The results of an investigation of50cases of colonoscopy and biopsy results in patients with colorectal polyps show that the total efficiency of clinical symptoms improving was about94%,comparative results show t=7.060, P＜0.01, there were significant differences. So patients with clinical symptoms after treatment than before treatment has improved markedly.(3) The polyps was evaluated with colonoscopy show that the total efficiency of clinical symptoms improving was about88%. The polyps comparison before and after treatment in patients with colonoscopy show that t=7.060, P＜0.01; there were significant differences. So after treatment, patients electronic colonoscopy see the various polyps indicators have a significantly reduced than before treatment.(4)"Xiao Xun Tang" has a poor efficacy for the polyps which located on the ileocecal and rectal than distributed on other parts, show that P<0.01, there were significant differences."Xiao Xun Tang" has a poor efficacy for the polyps which were villous adenoma and tubular villous adenoma, show that P＜0.01, there were significant differences.(5)"Xiao Xun Tang" has a good efficacy for the polyps which manifested as poor appetite,tcnesmus, change in bowel habits and stool shape change symptoms than belching,dry mouth.hematochezia,and worst of abdominal pain, bloating, mucous stool efficacy,show that P＜0.01, there were significant differences.(6) Professor Shuxin Zhang thinks in the treatment of colorectal polyps that adequacy syndromes is hot and humid bet;and deficiency syndromes is lack of temper spleen qi,the major prescription would be "Xiao Xun Tang".There were3accompanied syndrome types: lack of Intestinal jin, the stagnation of intestinal qi and intestinal wind with hematoehezia. With the basic idea,subtraction with the disease.we would achieve satisfactory outcomes in the clinical treatment of colorectal polyps.