Upper gastrointestinal submucosal lesions: Endoscopic ultrasonographic features and endoscopic curative effects

Correlation of endoscopic morphological characteristics and pathological types with traditional Chinese medicine syndrome types of colorectal polyps

BACKGROUND

Colorectal polyp (CRP) is a common clinical disease whose therapy relies on endoscopic resection. However, it is prone to relapse after surgery. There are few reports about the clinical application of conservative treatment for CRP, and the therapeutic effect is not satisfactory. This study investigated the traditional Chinese medicine (TCM) syndrome types of CRP based on the four diagnostic methods of TCM and endoscopic polyp morphology characteristics, and explored the correlation of TCM syndrome types with pathological types and endoscopic polyp morphology characteristics, with the hope of preventing the recurrence of CRP and reducing their malignant transformation.

AIM

To explore the correlation of morphological characteristics and pathological types with TCM syndrome types of CRP.

METHODS

Clinical data of 300 patients with CRP were collected for investigation. Information such as the size, shape, number, and lesion site under endoscopy was recorded. The four diagnostic methods of TCM were used to determine the TCM syndromes. The correlation of TCM syndromes with morphological characteristics and pathological types of CRP was then analyzed.

RESULTS

The pathological classification of CRP in the 300 patients was dominated by adenomatous polyps, and the incidence of adenomatous polyps was significantly related to gender, occupation, age group, polyp size, number, location of disease, and Yamada classification (P < 0.05). In CRP associated with the TCM syndromes of dampness accumulation of spleen deficiency, dampness and heat of large intestine, and block syndrome of cold dampness, polyps were mostly less than 1 cm in diameter and smooth, without a pedicle or sub-pedicle. In CRP associated with the syndrome of qi stagnation and blood stasis, syndrome of blood deficiency and intestinal bath, and syndrome of liver stagnation and qi stagnation, polyps were mostly 1-2 cm in diameter, single, granular, and pedicled. There were statistically significant differences in the number and morphology of polyps among the TCM syndromes (P < 0.05). The pathological types of dampness accumulation syndrome of spleen deficiency, dampness heat syndrome of large intestine, block syndrome of cold dampness, and liver-qi stagnation syndrome were mostly tubular adenoma and hyperplastic polyp, while those of the other syndromes were mainly hyperplastic polyp. There was a statistically significant difference in the distribution of TCM syndromes between adenomatous polyps and non-adenomatous polyps (P < 0.05).

CONCLUSION

Different TCM syndromes are related to the number and morphological changes of CRP, but do not affect the size and location of polyps. TCM syndromes and pathological types are correlated to a certain extent. In clinical practice, TCM constitution can be used to regulate the incidence and recurrence rate of CRP, thus providing a new idea for the prevention and treatment of CRP.