| The paper is divided into three parts:literature review,mentor experience and clinical research.Journals reviewedThe literature review of traditional Chinese medicine(TCM)summarizes the relevant literature for the last 10 years,mainly including the name of the disease,the pathogenesis,the treatment principle,the syndrome differentiation and the selection of drugs.The literature review of Western medicine has systematically summarized the progress of the recent 10 years of clinical research on pediatric occlusive bronchiolitis(BO)from the aspects of etiological pathology,clinical manifestation,auxiliary examination,diagnosis and treatment.summarize experienceUnder the guidance of traditional Chinese medicine theory,we will thoroughly explore the understanding of the etiology,pathogenesis,clinical diagnosis and treatment experience of the disease.clinical researchObjective:To explore the effect of invigorating the lung and invigorating the spleen,eliminating phlegm and removing stasis on the symptoms,signs,lung function and imaging of the children before and after treatment,to evaluate the clinical efficacy and safety of reinforcing the spleen,eliminating phlegm and removing stasis in treating children with bronchiolitis obliterans,and to provide a powerful clinical basis for the treatment of bronchiolitis obliterans of children in traditional Chinese medicine.Data mining and analysis of clinical data were conducted to summarize and verify the medication rules of tutors in the treatment of children with obliterative bronchiolitis.Method:Children with obliterans bronchitis were divided into light,medium and severe type three according to the chest high resolution CT score.Among the 50 children,6 were of severe BO and 44 were light and moderate.44 cases of light and moderate children were divided into group of guardians,22 cases of traditional Chinese medicine group were treated with pure Chinese medicine decoction,and 22 cases in the control group were treated with traditional Chinese medicine decoction combined with western medicine.There were 5 cases of total abscission,including 1 cases of severe BO,2 cases of abscission in Chinese medicine group,and 2 cases in control group.Using the project management platform of "famous doctors and famous doctors" of Chinese Academy of Chinese medicine and the data analysis and mining platform of clinical scientific research information sharing system,the clinical records are converted into data that can be analyzed directly,and the rule of medication for the treatment of children with bronchitis obliterans is arranged and verified.Observation index:Before treatment,3 months after treatment and 6 months after treatment,the total score of clinical observation table and clinical observation of symptom score(cough,wheezing,sputum volume,oxygen saturation)were compared.The lung function(FEV1,FEV1/FVC,MMEF)and chest HRCT score were compared before and 6 months after treatment respectively,so as to determine the difference of curative effect.45 children were collected in the study.According to the HRCT score of the chest,40 cases were divided into Chinese medicine group(traditional Chinese Medicine)and the control group(Western medicine plus traditional Chinese Medicine).The total score of the clinical observation table after treatment and the clinical observation of the symptom score(cough,wheezing,sputum volume,oxygen saturation)and lung function were observed.We can compare(FEV1,FEV1/FVC,MMEF)and chest HRCT scores to determine the efficacy of Chinese medicine in treating BO.Research results:1.1 Data of the subjects:45 cases were observed in this study.①Age distribution:4 to 6 years old,33.33%,6 to 8 years old,35.56%,8 to 10 years old,22.22%,10 years to 12 years.②Sex distribution:male 29,female 16,male and female ratio 1.81:1;the course of disease was 1 months to 20 months,which accounted for 37.78%from January to May,37.78%in June to October,33.33%in October to 15 months,and 11.11%in 16 months to 20 months.③The duration of the disease ranged from 1 months to 20 months,from January to May,accounting for 37.78%,from June to October accounted for 37.78%,and October to 15 accounted for 33.33%,and 16 to 20 months accounted for 11.11%.④he main symptoms and signs before treatment:in 45 cases,45 cases were repeated wheezing(100%),45 cases of recurrent cough(100%),10 cases(22.22%)after exercise and 10 cases of dyspnea(22.22%).Physical examination:pulmonary wheezing in 10 cases(22.22%),lung wet rales in 5 cases(11.11%),peripheral cyanosis in 0 cases(0%),and clubbing in 0 cases(0%);⑤Etiology:39 cases of infantile obliterans bronchiolitis(PIBO),including 18 cases of adenovirus pneumonia(46.15%of PIBO),12 cases of Mycoplasma pneumoniae pneumonia(30.77%of PIBO),6 cases of adenovirus with Mycoplasma pneumoniae pneumonia(15.38%of PIBO),respiratory syncytial virus pneumonia,influenza virus pneumonia,parainfluenza virus There were 1 cases of pneumonia and 1 cases of BO caused by non infectious factors,namely,Steven-Johnson syndrome and 5 cases with unknown etiology.⑥Lung high resolution CT results:45 cases were all diagnosed with high resolution CT,including 40 cases(88.89%),39 cases of glass shadow(86.67%),35 cases of mosaic perfusion syndrome(77.78%),44 cases of lung texture(97.78%),bronchiectasis 15 cases(33.33%),bronchial wall thickening 12 cases(26.67%).Gas retention was found in 6 cases(13.33%),grid shadow in 5 cases(11.11%),consolidation in 14 cases(31.11%),atelectasis in 8 cases(17.78%).;⑦Pulmonary function results:45 cases improved lung function examination,45 cases(100%)had obstructive ventilation dysfunction mainly with small airway involvement,5 cases were severe obstruction,20 cases were moderate obstruction,20 cases were mild obstruction,5 cases(11.11%)were accompanied by restrictive ventilation dysfunction.1.2 Comparison results after treatment:①Total effective rate:45 cases were treated,10 cases were markedly effective,25 cases were effective,10 cases were ineffective,and the total effective rate was 77.78%.②The total score of clinical manifestation,the single symptom(cough,wheezing,sputum,hypoxemia,etc.)was compared.The total score,cough score,wheezing score,phlegm score,and hypoxemia score decreased after the year of June and before the treatment,after the treatment in June and after the treatment in March.The difference was statistically significant(P<0.0083);after March,the total score of clinical manifestation,cough score,wheezing score,phlegm score,and hypoxemia were slightly lower,and the difference was not statistically significant(P>0.0083).Pulmonary function indexes FEV1,FEV1/FVC and MMEF increased at 6 months after treatment,and there was a significant difference compared with that before treatment(P<0.05).The HRCT score of the chest decreased at 6 months,and there was a significant difference between the mild and moderate children(P<0.05),and there was no significant difference between the severe children and the pre treatment(P>0.05).③The total score of clinical manifestation,the single symptom(cough,wheezing,sputum,hypoxemia,etc.)was compared.The total score,cough score,wheezing score,phlegm score,and hypoxemia score decreased after the year of June and before the treatment,after the treatment in June and after the treatment in March.The difference was statistically significant(P<0.0083);after March,the total score of clinical manifestation,cough score,wheezing score,phlegm score,and hypoxemia were slightly lower,and the difference was not statistically significant(P>0.0083).Pulmonary function indexes FEV1,FEV1/FVC and MMEF increased at 6 months after treatment,and there was a significant difference compared with that before treatment(P<0.05).The HRCT score of the chest decreased at 6 months,and there was a significant difference between the mild and moderate children(P<0.05),and there was no significant difference between the severe children and the pre treatment(P>0.05).1.3 45 cases of children were observed in this experiment.Data mining analysis results:the commonly used drugs are Astragalus,tuckahoe,yam,Rhodiola,licorice,Salvia miltiorrhiza,zelia,radix ginseng,honeysuckle,tangerine,Fritillaria thunbergii,dragon,Chinese yam,Platycodon,rhizome,Ligusticum chuanxiong,and Banxia.The most commonly used core drugs are Radix Astragali,Radix et Rhizoma Radix et Rhizoma,Radix Codonopsis pilosula,Poria,yam,citrus peel,Pinellia ternata,earthworm,Rhodiola rosea and Eupatorium adenophorum.research conclusion:The tutor uses the method of invigorating the lung and invigorating the spleen,eliminating phlegm and removing stasis to treat children with bronchiolitis obliterans,which can improve the symptoms,signs,lung function and high resolution CT of the chest,and the curative effect is clear.Through analyzing the clinical data of the children,we have collated and verified the medication rule of the tutor in treating this disease. |
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