健脾利湿解毒方对脾虚湿毒型大肠腺瘤内镜术后患者预后的影响OA

Objective It is to evaluate the short-and long-term therapeutic effects of prescription for fortifying spleen,disinhibiting dampness and removing toxin in patients with colorectal adenomas with syndrome of spleen-deficiency and dampness-toxin after endoscopic surgery.Methods Ninety-six patients with colorectal adenomas with syndrome of spleen-deficiency and dampness-toxin after endoscopic surgery treated at Nanjing Hospital of Integrated Traditional and Western Medicine from November 2021 to June 2023 were randomly divided into2 groups.The control group(n=48)received health education and lifestyle/dietary guidance,while the treatment group(n=48)was treated with prescription for fortif-ying spleen,disinhibiting dampness and removing toxin based on the intervention in the control group,both groups were treated for 3 months.The TCM syndrome scores,Gastrointestinal Quality of Life Index(GIQLI)scores,and levels of blood lipid indicators[triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-den-sity lipoprotein cholesterol(LDL-C)]were compared between the two groups before treatment and 3 months after treat-ment,the incidence of adverse reactions and adenoma recurrence at 1 year after treatment were counted in both groups.Re-sults Thirty-eight patients in the treatment group and 42 in the control group finally completed the study.The scores of pri-mary symptoms,total TCM syndrome scores,and the scores of secondary symptoms such as shortness of breath and reluc-tance to speak,body heaviness and limb fatigue,borborygmi,poor appetite,and acne in the treatment group after treat-ment were all significantly lower,while the GIQLI scores and serum level of HDL-C were significantly higher than those be-fore treatment and in the control group after treatment(all P<0.05);the scores of primary symptoms,total TCM syn-drome scores,and the scores of secondary symptoms such as shortness breath and reluctance to speak,body heaviness and limb fatigue in the control group after treatment were all significantly lower,while the GIQLI scores were significantly higher than those before treatment(all P<0.05).The total effective rate in the treatment group was significantly higher than that in the control group[92.11%(35/38)vs50.00%(21/42),P<0.05].No significant adverse reactions were observed in either group during treatment.At one year after treatment,the recurrence rate in the treatment group was significantly lower than that in the control group[28.95%(11/38)vs 54.76%(23/42),P<0.05],and the diameter of recurrent adenomas was significantly smaller than that in the control group(P<0.05);however,there was no statistically significant difference in the pathological subtypes of recurrent adenomas between the two groups(P>0.05).Conclusion Prescription for fortifying spleen,disinhibiting dampness and removing toxin not only can improve clinical symptoms and enhances quali-ty of life,but also can regulate lipid metabolism and reduce the postoperative recurrence rate in the treatment of patients with colorectal adenomas with syndrome of spleen-deficiency and dampness-toxin after endoscopic surgery.