Clinical Study On Treating Colorectal Adenoma With Jiawei Zisheng Granules And Endoscopic Mucosal Resection Therapy

Objective: To observe the curative effect and prognosis of recurrence with combining Jiawei Zisheng granules and endoscopic mucosal resection(EMR)in treating colorectal adenoma with a prospective,randomized,control study.Methods: A total of 126 cases met the criteria for inclusion were divided into two groups randomly,63 in treatment group,63 in control group.Both groups underwent EMR received fasting,hemostasis,antiinfection,and nutritional support for one to three days.And in the treatment group,patients took Jiawei Zisheng granules for 3 months since the patients could took food after EMR.However,those in the control group were just given EMR.In addition to the regular medical treatment,the control group would not be given with Chinese traditional medicine and other treatments.Both groups were asked to recheck colonoscope in the 6th month and one year later,and the data of two times colonoscope was collected.And all patients in both groups were followed up regularly to observe the change of their clinical manifestations and adenoma recurrence,and collected those data about Symptoms integral in before the treatment,after treatment of the 3th,6th,12 th months.Results:(1)Symptoms score comparison before and after treatment:the symptoms integral comparison before and after treatment in the3 th,6th,12 thmonths of both group,with a statistically difference(P<0.05);Compared with the control group,the decrease of the symptom score difference in the treatment group,with a statistically difference(P<0.05).(2)Treatment group in a single symptoms such as fatigue,then empress not great ease,compared with the control group,there was no statistically significant difference(P>0.05).But the two groups in improving abdominal distension/abdominal pain,anorexia,defecate pond compared rotten,defecate frequency,etc,the difference was statistically significant(P<0.05).(3)Comprehensive comparative effectiveness:Total effective rate in treatment group after treatment was 86.21%,the control group was68.33%,with a statistically difference(P<0.05).(4)Compared the relapse rate of adenoma: It was 8.62% in the treatment group,but 11.67% in the control group,with reviewing the enteroscope of the 6th month later,here was no statistically significant difference(P>0.05).It was 12.06%in the treatment group,but 22.67% in the control group,with reviewing the enteroscope of one year later,with a statistically difference(P<0.05).(5)Correlation analyses of recurrent colorectal adenoma: Colorectal adenomas recurrence occurs in the sigmoid colon and rectum,distribution of two groups of adenoma recurrence compared with before treatment there was no significant difference(P>0.05).The number and tmaximum diameter of colorectal adenoma were positively correlated with its recurrent,the larger number the maximum diameter of adenoma,the higher proportion of recurrent,and there was statistically difference(P<0.05).There were no statistical significances in amean diameter,and recurrent in two groups(P>0.05).Conclusion:(1)After treatment,the symptom scores in two groups were significantly lower,Jiawei Zisheng granules and EMR in treating colorectal adenoma can significantly improve the clinical symptoms.Im-proved the symptom scores,and the clinical comprehensive curative effect were superior to only with under the treatment of EMR to treat adenoma.(2)In the prevention of adenoma postoperative recurrence,post operative review after the 6th months,the recurrence rate of the two groups are similar,the curative effect does not exist differences;In the12 th months review,the treatment group recurrence rate is lower than the controlgroup.(3)Colorectal adenomas occurs in the sigmoid colon and rectum easyly,the number and tmaximum diameter of colorectal adenoma werepositively correlated with its recurrent,the larger number the maximumdiameter of adenoma,the higher proportion of recurrent.It has nothing to do with the average diameter.(4)Combining Jiawei Zi sheng granules and EMR in treating colorectal adenoma,there were curative effect and can reduce the recurrence rate.That is why integrate d Chinese medicine and western medicine therapy can be used for the treatment of colorectal adenoma.