Clinical Observation Of The Effect Of Jiamei Wumei Pill On The Prevention And Treatment Of Colorectal Adenoma After Endoscopic Treatment

Objecitve:The pathogenesis of colorectal adenoma is not very clear in modern medical research that its onset is concealed commonly,most of the patients don’t have obvious clinical symptoms.Colorectal adenoma is currently recognized as a premalignant disease and it has a high risk of recurrence that its prevention and treatment have an important clinical significance.Resection under colonoscopy is the first choice for the treatment of colorectal adenoma in modern clinical practice,and then the patients need to be reviewed by electronic colonoscopy half a year later,and the drug research for the treatment and prevention have not advanced very far.The aim of this study is to observe the effect of addition and subtraction of Wumei pills on the recurrence rate of colorectal adenoma by randomized controlled trial,and provide a feasible therapy for the prevention and treatment of colorectal adenoma.Methods:110 patients who met the inclusion criteria from Dongzhimen Hospital of BUChM(Beijing University of Chinese Medicine)between June 2016 and December 2017 were included in this study.all of which had been resected polyps under colonoscopy.All of the patients were randomly divided into the treatment group(n=55)and the control group(n=55).The patients of treatment group were given the addition and subtraction of Wumei pills for 3months,as the control group without intervention.The recurrence rate of polyps,the improvement of clinical symptoms and the other factors that may affect the recurrence of polyps has been observed after 6months.SPSS22.0 was used for statistical analysis,and t-test,chi-square test and variance analysis has been used according to the d emand and the type of data.Results:There were 55 cases in each of the two groups,and a total of 110 cases were included in this study,Among the 110 cases,62.7%were male and 37.3%were female,13.6%were patients between 30 and 40 years old,while 20%were between 41 and 50,39.1%were between 51 and 60 years old,27.3%were between 61 and 70 years old.The rate of patients with symptom of diarrhea was 34.5%,and abdominal distension was 23.6%,abdominal pain 26.4%,food less than before 10%,constipation6.4%,mucus and blood stool 3.6%,wasting 2%,and no obvious clinical symptoms 31.8%.The types of Bristol stool type were mainly type 4(32.4%),followed by type 5(30.6%)and type 6(18.0%).The numbers of adenomas were 3 mainly single(59.5%),followed by 23.4%of patients with 2 polyps,and 16.2%of patients with more than 2 polyps.The majority of adenomas were 5-10mm for the size of polyps(52.6%),and 31.4%were below 5mm,18.9%were bigger than 10mm.The distribution of adenomas was mainly left hemicolon(70.9%),in which rectum was 21.1%,sigmoid colon was 25.1%,descending colon was 24.6%,and the less was right hemicolon 29.1%,in which transverse colon was 17.7%and ascending colon was 11.4%.Most of the adenomas were tubulovillous adenoma(64.0%),then the tubular adenoma(31.4%)and villous adenoma(4.6%).There was significant difference in the clinical symptoms scores and the rate of recurrence of polyps which was effected by the size of the polyps between the treatment group and the control group(P<0.05).There was no significant difference in the changes of CEA(carcinoembryonic antigen)between the two groups(P>0.05).Conclusion:1.Addition and subtraction of Wumei pills can significantly reduce the recurrence rate of colorectal adenoma.2.Addition and subtraction of Wumei pills can significantly improve the symptoms of diarrhea and abdominal distension of patients with colorectal adenoma.3.The risk factors of colorectal adenoma were male,over 50 years old and the bigger size of polyps.4.The main symptoms of colorectal adenoma were diarrhea,abdominal distension and abdominal pain.5.The types of Bristol stool type were mainly type4 and type5,type2 and type7 were less common,type1 was the last.6.Most patients were with single polyp which were more than patients with 2polyps or more.Most of the colonrectal adenomas were located in left hemicolon,the pathological type were tubulovillous adenoma.7.The addition and subtraction of Wumei pills had no significant effect on the CEA of colorectal adenoma patients.8.There was a positive correlation betweeen the size of polyps and the recurrence rate of polyps.