| ObjectiveTo explore the endoscopic characteristics,influencing factors and TCM constitution characteristics of colorectal sessile serrated lesions,and combine the holistic view of traditional Chinese medicine with modern microscopic research to provide reference for early screening,early diagnosis and early intervention of colorectal sessile serrated lesions in clinical work.MethodsCase group a total of 70 patients with ssls who met the criteria of nanorow from January 2019 to January 2022 in Shanxi Province Hospital of Chinese medicine,and a control group,140 patients with serrated lesions other than ssls during the same period,were collected to analyze their clinical,endoscopic as well as TCM Constitution in this study.Information was collected by questionnaires,and after inductive summary,a database was established and analyzed with spss25 Statistical analysis was performed using0 software and P<0.05 was considered statistically significant.Results1.General situation:the 70 SSL patients were aged(56.91±10.52)years with an age interval of 30-82 years,including 38 males(54.3%),32 females(45.7%),and a male to female ratio of 1.19:1.The 130 HP patients were aged(58.19±10.88)years with an age interval of 24-87 years,including 66 males(50.8%),64 females(49.2%),and the male to female ratio was 1.03:1.There were no statistically significant differences in age(t=0.80,P=0.424)or gender(χ~2=2.06,P=0.357)between the two groups.2.Endoscopic characteristics:of the 74 SSLs,58(78.4%)were located in the proximal colon and 16(21.6%)in the distal colon and rectum;Median size was 0.8(0.6,1.0)cm;29(39.2%)in ridge type(0-Ⅰp,0-Ⅰs)and 45(60.8%)in superficial type(0-Ⅱa,0-Ⅱb);Surface glandular opening was present in 2(2.7%)of typeⅠ,16(21.6%)of typeⅡ,54(73.0%)of typeⅡ-O,and 2(2.7%)of typeⅢ;56(75.7%)had surface coated"mucinous caps",46(62.2%)had black dot opacities,50(67.6%)had cumulus like appearances,and 42(56.8%)had surface vascular coarsening.Of 146 HPs,75(51.4%)were located in the proximal colon and 71(48.6%)in the distal colon and rectum;Median size was 0.5(0.4,0.6)cm;42(28.8%)in ridge type(0-Ⅰp,0-Ⅰs)and 104(71.3%)in superficial type(0-Ⅱa,0-Ⅱb);Surface glandular opening was present in 9(6.2%)of typeⅠ,124(84.9%)of typeⅡ,7(4.8%)of typeⅡ-O,5(3.4%)of typeⅢ,1(0.7%)of typeⅣ;17(11.6%)had surface coated"mucinous caps",11(7.5%)had black spot shadowing,8(5.5%)had cumulus like appearances,and 7(4.8%)had surface vessel coarsening.However,the superficial type was the predominant morphology between ssls and HP lesions,with no statistical difference between them(P>0.05).In contrast to HP,SSL occur more frequently in the proximal colon,mostly>0.5cm,and the opening of typeⅡ-O glandular duct,"mucous cap",surface black dot shadow,cumulus like appearance,and the proportion of blood vessel thickening were significantly higher than HP,both of which were statistically different(P<0.001).3.Influencing factors:on univariate analysis,byχ~2test,P<0.05,a statistically significant difference was found between the incidences of diabetes in the two groups(χ~2=10.04,P=0.002).The incidences of obesity,smoking,drinking,hypertension,and hyperlipidemia in the case group tended to be higher than those in the control group,but there was no statistical difference between them(P>0.05).Logistic regression equations were constructed by including diabetes mellitus,smoking,hypertension and hyperlipidemia,the results showed that the effects of diabetes mellitus on SSL were statistically significant(OR:2.79,95%CI:1.31-5.92,P=0.008),while the effects of smoking mellitus,hypertension and hyperlipidemia on SSL were not statistically significant(P>0.05).4.TCM Constitution:among the 70 SSL patients,Qi deficiency qualitative 24(34.3%)>dampness heat qualitative 14(20.0%)>Ping He qualitative 9(12.9%)>phlegm dampness qualitative 8(11.4%)>qi depression qualitative 8(11.4%)>Yang deficiency qualitative 4(5.7%)>Yin deficiency qualitative 2(2.9%)>blood stasis qualitative 1(1.4%)>terinbu qualitative 0(0.0%).When Yang deficiency,Qi deficiency and blood stasis were included to construct the logistic regression equation,the results showed that qi deficiency had a statistically significant effect on SSL(OR:4.74,95%CI:2.12-10.58,P<0.001),which was a promoting factor for the occurrence of SSL,and the risk of developing SSL was approximately 3.74 times higher in the Qi deficiency population than in the non Qi deficiency population when other conditions were unchanged.The influence of Yang deficiency quality on SSL was statistically significant(OR:0.28,95%CI:0.09-0.85,P=0.024),which was an impeding factor for the occurrence of SSL.Conclusion1.SSL patients,male to female ratio 1.19:1,with a slightly higher detection rate in males than in females.The age interval was 30-82 years,with a predominance of individuals≥60 years.2.SSLs have a predilection for the proximal colon,are mostly>0.5cm,predominate as superficial type,and the opening of typeⅡ-O glandular duct,"mucinous cap",surface black dot opacities,cumulus like appearance,and coarsening of surface vessels are characteristic findings.3.Diabetes is a risk factor for the development of SSLs.4.Qi deficiency is a dangerous constitution for the occurrence of SSLs. |
