Efficacy and safety evaluation of Weifuchun in preventing recurrence and treating mucosal lesions after endoscopic resection of intestinal polyps: A potential modulation of gut microbiome.

We evaluated Weifuchun tablets (composed of red ginseng, chamomile, and roasted shell) for preventing intestinal polyp recurrence and treating mucosal lesions after endoscopic resection, and to analyze its mechanism via gut microbiome regulation. This study prospectively enrolled 218 patients who underwent endoscopic intestinal polyp resection (April 2022-April 2024). The observation group (n = 109) received routine postoperative care plus oral Weifuchun tablets for three months, while the control group (n = 109) received routine care alone. Propensity score matching (PSM) was used to balance baseline characteristics. Primary outcomes included one-year polyp recurrence, mucosal injury scores, and gut microbiome alterations (16S rDNA sequencing). Safety and independent protective factors for recurrence (multivariate logistic regression) were also assessed. After PSM, the observation group had a significantly lower one-year recurrence rate than the control group (31.00% vs. 42.16%, P = 0.025). Weifuchun significantly reduced intestinal mucosal injury scores (P < 0.001). Crucially, microbiome analysis revealed that Weifuchun markedly increased gut microbial diversity (Sorensen index, P < 0.05) and significantly boosted the relative abundance of beneficial bacteria such as Bifidobacterium and Lactobacillus, while decreasing harmful bacteria including Escherichia coli and Bacteroides (all P < 0.001). Furthermore, Weifuchun significantly reduced postoperative complications (2.00% vs. 8.82%, P = 0.032) and was identified as an independent protective factor against recurrence (OR = 0.456, 95% CI: 0.304-0.683, P < 0.001). Weifuchun effectively prevents polyp recurrence and promotes mucosal repair post-endoscopic resection. Its mechanism is closely linked to beneficial modulation of the gut microbiome, restoring microbial balance and enhancing the intestinal microenvironment, and demonstrates a favorable safety profile.