Clinical Observation On The Effect Of Daoxie Tongchang Decoction Combined With Polyethylene Glycol-Electrolyte Solutions In Precolonoscopic Intestinal Preparation

ObjectiveBy observing the effect of traditional Chinese medicine Daoxie Tongchang decoction combined with Polyethylene glycol-electrolyte solutions（PEG-ELS）in colonoscopy,this subject evaluates the intestinal preparation,intestinal cleanliness,adenoma detection rate and adverse reactions of this scheme,in order to provide a safe and effective intestinal preparation method.Methods1.Grouping methods:from September 2021 to December 2021,80 patients who underwent electronic colonoscopy in the digestive endoscopy center of Guanggu Hospital of Hubei traditional Chinese medicine hospital were randomly divided into observation group and control group,with 40 cases in each group.2.Research methods:single blind method was used,that is,the colonoscopy operator did not know the patient’s intestinal preparation plan.All operators in this study were doctors with at least 500 cases of enteroscopy experience.Observation group:1.The day before the examination:（1）9 a.m.,dissolve a package of traditional Chinese medicine preparation in 200ml warmed water and take it at one time;3 pm,dissolve a package of traditional Chinese medicine preparation in 200ml warmed water and take it at one time.（2）8 pm,disperse 1 bag of compound polyethylene glycol electrolyte and dissolve it in 1000ml warmed water.Drink 250ml every 10-15minutes and finish it within 1 hour.2.The day of examination:6a.m.,dissolve 1 bag of compound polyethylene glycol electrolyte in 1000ml warmed water,drink 250ml every 10-15 minutes and finish it within 1 hour.Control group:1.One day before the examination:8 p.m.,disperse a bag of compound polyethylene glycol electrolyte,dissolve it in 1000ml warmed water,drink 250ml every 10-15 minutes and finish it within 1 hour.2.Inspection day:5 am,dissolve 2bags of compound polyethylene glycol electrolyte in 2000ml warmed water,drink 250ml every 10-15 minutes and finish it within 2 hours.The patients in the two groups were instructed to eat low residue and low fiber diet one day before colonoscopy,and fast after 6 pm.The colonoscopy was completed before 11:30 am on the same day.3.Outcome measures:basic data of patients undergoing colonoscopy（age,sex,body mass index,etc.）;Intestinal cleanliness score,detection rate of intestinal adenoma,endoscopy time,patient tolerance and adverse reactions in intestinal preparation.4.Statistical method:Counting data:Chi square test or Fisher’s exact test were used for independent sample comparison,and rank sum test was used for grade data;Measurement data:conform to the normal distribution,described by^—x±s,using t-test;Rank sum test is used when it does not conform to normal distribution or uneven variance.The data were analyzed by spss24.0 statistical software,P<0.05 indicates that the difference is statistically significant.ResultsThere was no significant difference between the observation group and the control group in basic data such as body mass index（BMI）,age,Bristol stool classification,gender,weekly defecation times,history of abdominal surgery and causes of colonoscopy（P>0.05）.1.Comparison of intestinal cleanliness:the average scores of ascending colon and cecum（RC）cleanliness and OBPS in the observation group（1.85±0.48,5.77±1.20）were better than those in the control group（2.10±0.59,6.35±1.09）,and the difference did not reach statistical significance（P<0.05）;There was no significant difference in the qualified rate of intestinal preparation,transverse colon and descending colon cleanliness score（TC）,sigmoid colon and rectum cleanliness score（LC）and total colonic fluid volume between the two groups（P>0.05）.2.Comparison of adenoma detection rate:the detection rate of adenoma in the observation group was 20.0%and that in the control group was 32.5%,the difference was not statistically significant（P>0.05）.3.Comparison of lens entry time:the average lens entry time in the observation group was（5.65±3.20）min and that in the control group was（5.60±2.69）min,the difference was not statistically significant（P>0.05）.4.Comparison of patient tolerance and adverse reactions:the incidence of discomfort in the observation group（52.5%）was lower than that in the control group（55.0%）,and the average score of discomfort in the observation group（2.90±1.33）was lower than that in the control group（3.64±1.91）,but the difference did not reach statistical significance（P>0.05）.The incidence of abdominal distension in the observation group（50.0%）was lower than that in the control group（72.5%）,the difference was statistically significant（P<0.05）,but there was no significant difference in the average score of abdominal distension between the two groups（P>0.05）;There was no significant difference in the incidence and average score of abdominal pain in observation group and control group（P>0.05）;Comparing with the observation group and control group,the incidence of first group of nausea and vomiting（42.5%,12.5%）was lower than that in the second group（45.0%,22.5%）,but the difference did not reach statistical significance（P>0.05）.ConclusionDouxie Tongchang decoction combined with compound polyethylene glycol electrolyte powder has good cleaning effect in intestinal preparation before colonoscopy,and will not increase adverse reactions.It is well tolerated by patients.It is worthy of clinical application.