Correlation Between Chinese Medical Evidence And Pathological Types And Clinical Indices Of Colonic Polyps

Objective:To study the distribution pattern of TCM patterns of colon polyps and to investigate the correlation between TCM patterns and pathological types and pathogenetic factors,in order to provide an objective basis for clinical identification and TCM prevention and treatment of colon polyps.Method:A retrospective study was conducted to collect clinical data of 503 patients with colon polyps who were hospitalized at Shandong Provincial Hospital of Traditional Chinese Medicine from October 2018 to January 2021 and met the inclusion criteria.A colon polyp clinical data collection form and a TCM evidence distribution questionnaire were developed to identify and classify patients according to TCM diagnostic criteria,and to record the patients’general data,laboratory indices,pathological diagnosis and colonoscopy findings,including gender,age,body mass index(BMI),dietary habits,emotional factors,smoking and alcohol consumption,gastrointestinal symptoms,Helicobacter pylori(Hp)infection,triglycerides(TG),total cholesterol(TC),high-density lipoprotein(HDL),low-density lipoprotein(LDL),polyp pathology type and number,diameter,morphology,and location,and to analyze the correlation between TCM evidence and pathology type and pathogenesis factors.Results:1.The distribution pattern of TCM evidence types:from high to low,the evidence of damp-heat in large intestine(39.5%),the evidence of liver depression and qi stagnation(25.2%),the evidence of spleen and stomach weakness(20.0%),the evidence of internal stagnation of blood stasis(9.1%),and the evidence of internal obstruction of cold dampness(5.9%).2.The incidence of colon polyps was mainly in patients aged≥60 years;the ratio of men to women was 1.29:1;patients with BMI≥24 kg/m~2accounted for 45.53%;dietary habits in descending order were fatty,sweet and thick(41.4%),spicy and stimulating(22.5%),cold diet(18.5%),light diet(15.3%),and other diets(2.4%);abnormal emotions accounted for 57.1%;alcohol drinkers accounted for 27%;and smokers accounted for46.1%.3.Relationship between TCM patterns and general data:gender:the gender distribution of different patterns differed(P<0.05),with Damp-Heat in the Large Intestine,Weakness in the Spleen and Stasis in the Blood being more common in males and Liver Stagnation and Cold-Dampness Blockage in females.Age:The age distribution differed among the different types(P<0.05),with Damp-Heat in the large intestine common in45-60 years old(middle-aged)and the remaining types common in≥60 years old(elderly).Dietary habits:The distribution of dietary habits differed among the different types(P<0.01),with fatty,sweet,thick and spicy diets predominating in large intestine damp-heat evidence,light diets and other diets predominating in liver depression and qi stagnation evidence,and raw and cold diets predominating in spleen and stomach weakness evidence.Alcohol consumption:The distribution of alcohol consumption differed among different types(P<0.05),with moderate alcohol consumption predominating in the large intestine damp-heat evidence and light alcohol consumption predominating in the remaining types.There was no difference in the distribution of BMI,emotional factors,and smoking volume among different evidence types(P>0.05).4.Relationship between TCM evidence types and GI symptoms:the distribution of GI symptoms differed among different evidence types(P<0.05),abdominal distension was more common in the evidence of damp-heat in the large intestine,abdominal pain was more common in the evidence of liver depression and qi stagnation and internal stasis of blood stasis,diarrhea was more common in the evidence of spleen and stomach weakness,and abdominal pain and distension were more common in the evidence of cold-damp internal obstruction.5.Relationship between TCM evidence and laboratory indexes:the distribution of high TGemia differed among different evidence types(P<0.05),and was more common in large intestine damp-heat evidence.There was no difference in the distribution of Hp infection,high TCemia,high LDLemia and low HLDemia among different evidence types(P>0.05).6.Relationship between TCM evidence and pathological types:the distribution of different evidence and pathological types had differences(P<0.05).Tubular adenoma,tubular villous adenoma,villous adenoma,and inflammatory polyp were predominantly characterized by damp-heat evidence in the large intestine,and hyperplastic polyp was predominantly characterized by liver-depression and qi-stagnation evidence.The distribution of low-grade intraepithelial neoplasia differed among different types of adenomatous polyps(P<0.01),with tubular adenoma and tubular villous adenoma being predominantly caused by damp-heat in the large intestine,and villous adenoma being predominantly caused by internal stasis of blood.There was no difference in the distribution of high-grade intraepithelial neoplasia between different types of evidence(P>0.05).7.Relationship between TCM evidence and morphological characteristics of polyps:number:the distribution of polyps differed among different evidence types(P<0.01),with multiple polyps being more common.Diameter:The diameter distribution of polyps differed among different types(P<0.05),with polyps≤5 mm in diameter being the most common.There was no difference in the distribution of polyp morphology among different types(P>0.05).8.Relationship between pathological types and gender,age and BMI:There was no difference in the distribution of different pathological types and gender(P>0.05).There was a difference in the distribution of different pathological types and age of onset(P<0.01).Non-adenomatous polyps were more common in<45 years old,and adenomatous polyps were more common in other age groups.The distribution of different pathological types with BMI was different(P<0.01),and all of them were more common with BMI18.5-24.0 kg/m~2.9.Relationship between pathological types and morphological characteristics of polyps:number:the distribution of the number of polyps differed among pathological types(P<0.01),with non-adenomatous polyps predominating in singles and adenomatous polyps in multiples.Diameter:The diameter distribution of polyps differed among different pathological types(P<0.01),with non-adenomatous polyps predominating in polyps≤5 mm in diameter and adenomatous polyps predominating in the rest of polyps.Morphology:The distribution of polyp morphology differed among different pathological types(P<0.01),with non-adenomatous polyps being common in Yamada type I and adenomatous polyps being common in the rest of the polyps.Conclusion:1.The five main types of TCM evidence of colon polyps are large intestine damp-heat evidence,liver depression and qi stagnation evidence,spleen and stomach weakness evidence,blood stasis evidence,and cold and damp internal obstruction evidence.The different types were correlated with gender,age,dietary habits,alcohol consumption,gastrointestinal symptoms,high TGemia,polyp pathology type and number and diameter.2.Different pathological types were correlated with age,BMI,number and diameter of polyps,and morphology.3.The pathological types and pathogenetic factors can be used as reference for the identification and typing of colon polyps.This study provides objective basis for the identification of colon polyps in Chinese medicine,and also provides new ideas for the prevention and treatment of colon polyps in Chinese medicine.