Distribution regularity of clinical characteristics, traditional Chinese medicine syndromes, and influencing factors in 480 patients with colorectal adenomas

To analyze the characteristics of colorectal adenoma onset, traditional Chinese medicine (TCM) syndromes, and factors influencing advanced colorectal adenoma.

A cross-sectional study was conducted to retrospectively analyze the data of 480 patients with colorectal adenoma admitted to the Department of Gastroenterology of Wangjing Hospital, China Academy of Chinese Medical Sciences, between January 2024 and January 2025 who met the inclusion and exclusion criteria. The hospital case system was used to collect demographic information, basic medical history, general conditions associated with colorectal adenoma, and records of TCM syndrome types, which were compiled into a clinical information Excel spreadsheet. Descriptive statistics were calculated to determine the distribution of demographic information, basic medical history, and TCM syndrome types. The chi-square test or Monte Carlo simulation method was used to analyze the differences in the number, size, pathological type and location of colorectal adenomas, as well as the distribution of TCM syndrome types. Univariate chi-square test was used to analyze the related factors of patients with advanced colorectal adenoma, and the statistically significant variables were included in the multivariate logistic regression analysis to analyze the influencing factors of advanced colorectal adenoma.

Among the 480 patients with colorectal adenoma, 296 were male with an onset age of (60.51±11.17) years, and 184 were female with age of (61.65±11.87) years. There were 233 patients (46.46%) aged 45 to 64. There were 269 cases (56.04%) of overweight individuals. Adenomas smaller than 1 cm accounted for 73.33% (352/480). Among the number of adenomas, single adenomas accounted for 66.46% (319/480). Among the pathological types, tubular adenoma accounted for 86.67% (416/480). The left colon accounted for 80.0% (384/480) of the affected sites. The main clinical manifestations included abdominal distension (20.63%, 99/480), abdominal pain (16.25%, 78/480), diarrhea (9.79%, 47/480), among others. The main syndrome types in traditional Chinese medicine are damp-heat syndrome of the large intestine (25.83%, 124/480) and spleen deficiency with excessive dampness syndrome (22.94%, 110/480). There was a statistically significant difference in the distribution of TCM syndrome types among patients of different age groups (P =0.010). Multitype adenoma (OR =4.504, 95%CI: 2.819~7.198, P < 0.001) and the right colon site (OR =2.166, 95%CI: 1.146~4.092, P < 0.05) are independent risk factors for advanced colorectal adenoma.

Colorectal adenomas are more common in men and tend to occur in middle-aged people. Adenomas under 1 cm are the most common. Single adenomas and tubular adenomas are more common. The left half of the colon is a common site of occurrence. Common clinical symptoms include abdominal distension, abdominal pain, diarrhea, etc. Damp-heat syndrome of the large intestine is the most common type of syndrome in traditional Chinese medicine. The number of multiple adenomas and the location of the right colon are independent risk factors for advanced colorectal adenomas