Clinical Efficacy Observation Of Spleen-strengthening And Damp-removing Prescription Plus Or Minus On Preventing Recurrence Of Colorectal Adenoma After Treatment By Endoscope

Objective:On the basic of clinical experience for many years,Professor Gu Yunfei has formulated the spleen-strengthening and damp-removing prescription.In this subject,this prescription is used to treat patients with colorectal adenoma after treatment by endoscope,and the random control method is adopted.To observe the efficacy of the prescription in preventing recurrence of colorectal adenoma after resection by endoscope and to improvement situations of the symptoms of patients,and to analyze the influence factors of recurrence after colorectal adenoma.Therefore,to effectively prevent the recurrence of colorectal adenoma after treatment by endoscope and to improve the clinical efficacy,it provides a theoretical basis for using Chinese medicine to prevent recurrence of colorectal adenoma after treatment by endoscope and improve clinical symptoms of patients.Methods:Sixty patients who met the inclusion criteria for colorectal adenoma in our hospital were selected.Randomly divided into control group and treatment group 30 cases.After high-frequency electrocoagulation(HFEC)or Endoscpic mucosal resection(EMR)or Endoscpic submucosal dissection(ESD),they were given Conventional antibiotics for intravenous antibiotics for three days to prevent postoperative infection,nutritional support and other treatment.In the treatment group,the traditional Chinese medicine decoction(Lanceolata 15g,Raw Radix Astragali 30g,Poria 10g,Dark Plum 30g,Fried Atractylodes 10g,Fried Radix Astragali 10g,Radix Scutellariae 10g,Yam 15g,Coix Seed 15g,Fire-dried Fructus Crataegi 15g,Scorch-fried medicated leaven 15g,Tangerine Peel 5g,Licorice 3g).For people with too much damp,uncomfortable stools,and exquisite tongue coating,10g of Perrin was added;For people with yang deficiency and cold limbs,6g of nutmeg was added;For people with gas block and poor stools,10g of Citrus Aurantium was added.According to the above dosage,400ml decoction was taken at a moderate temperature in the morning and evening for twice,and the course of treatment was three months.In the control group,no any treatment was performed.At sixth month after the operation,the colonoscopy was reviewed,the recurrence was observed,and the clinical symptom score was performed.Relevant factors affecting recurrence were analyzed,such as the patient's age,gender,adenoma size,number,location,pathological type,and degree of neoplasia.Results:Statistics 6 months after the follow-up showed that 22 cases relapsed in the 60 patients,with a total recurrence rate of 36.7%.The recurrence rates were 50%and 23.3%,respectively,in the control group(15 cases)and the treatment group(7 cases)..After statistical examination,there was a significant difference in postoperative recurrence rates between the two groups of patients(p<0.05).Patients with recurrence after surgery were analyzed.Age,number of adenomas,adenoma size,adenoma type,and degree of neoplasia of patients were compared,p<0.05,all of which were statistically significant.The sex and adenoma locations of patients were compared,p>0.05,there was no statistical significance.Before treatment by endoscope,the symptom scores of mucus,bloody stool,abdominal pain,bloating,constipation,diarrhea,bitter mouth,and tenesmus were compared between the two groups of patients,and there was no significant difference(P>0.05).At sixth month after operation,compared with that before treatment,the Chinese medicine clinical symptom score of the treatment group was P<0.05,there was statistical significance;The Chinese medicine clinical symptom score of the control group(except for mucus and bloody stools)was P>0.05 compared with that before treatment.There was no statistical significance.Conclusion:The spleen-strengthening and damp-removing prescription plus or minus is used to treat patients with colorectal adenoma after treatment by endoscope,which can reduce the recurrence rate of colorectal adenoma after surgery and effectively improve patients' mucus,bloody stool,abdominal pain,bloating,constipation,diarrhea,bitter mouth,tenesmus,other symptoms and signs,without adverse reactions.Through clinical analysis of patients with recurrence after surgery,it is found that the recurrence situations is related to the patient's age,the number of adenoma,the adenoma size,the adenoma type,and the degree of neoplasia,and there is no significant correlation with the patient's gender and adenoma location.