Efficacy of Jianpi formulas in reducing the recurrence of colorectal adenoma after polypectomy: a systematic review and Meta-analysis.

Abstract

Objectives: To systematically review the efficacy and safety of Jianpi formulas in reducing the recurrence of colorectal adenoma (CRA) after poly-pectomy.

Methods: Randomized controlled trials (RCTs) investigating Jianpi formulas for CRA post-polypectomy were systematically retrieved from eight electronic databases. The quality of the methodology was assessed using the Cochrane collaboration tool. The Grades of Recommendations Assessment Development and Evaluation (GRADE) approach was employed for evidence assessment. Statistical analyses were conducted using Statistics and Data Analysis (STATA) 17 (StataCorp (College Station, TX, USA) and Review Manager (RevMan) 5.4 (The Cochrane Collaboration (London, UK).

Results: The Meta-analysis, encompassing 18 RCTs with 1838 patients, revealed that Jianpi formulas significantly outperformed postoperative routine treatment. It demonstrated a reduction in the half-year recurrence rate [relative risk (RR) = 0.41, 95% confidence interval (CI) = 0.33-0.49, Z = 9.08, P < 0.000 01], the one-year recurrence rate [RR = 0.58, 95% CI= 0.49-0.69, Z= 6.12, P < 0.000 01], and an enhancement in the clinical effective rate [RR = 1.27, 95% CI = 1.19-1.36, Z= 7.06, P < 0.000 01]. The half-year recurrence rate and the clinical effective rate were medium-quality evidence. The one-year recurrence rate was low-quality evidence. Additionally, Jianpi formulas appear to be safe and do not increase adverse reactions compared to postoperative routine treatment alone.

Conclusion: Jianpi formulas exhibit efficacy in reducing postoperative half-year and one-year recurrence rates while improving the clinical effective rate after polypectomy for CRA.