| Purpose: The first part: to explore the clinical efficacy of Huahe Xiaoguan Decoction on children with adenoid hypertrophy(phlegm-heat syndrome);the second part: to explore the correlation between allergen exposure and adenoid hypertrophy in children.Methods: The first part: a single-center observational comparative study of efficacy.The main research objects were retrospectively taken from the children’s adenoid hypertrophy database built by the research group.Taking intervention measures as exposure factors,they were divided into traditional Chinese medicine group and montelukast sodium group.A total of 35 cases in the montelukast sodium group were collected from the database according to the criteria of the nano-exhaustion,and 78 cases in the traditional Chinese medicine group were included in a ratio of 1:2 taking into account the factors of matching failure.A total of113 cases were collected in the two groups.In this trial,the propensity score matching method was used to control the bias of confounding factors on the results.The montelukast sodium group was used as the reference group for caliper matching.The caliper value was set to 0.03,and 30 groups were successfully matched with 60 children.Comparing the matched two groups of children’s nasopharyngeal lateral X-ray adenoid A/N efficacy,snoring onset time,snoring disappearance time,single main symptoms(nasal congestion,snoring,mouth breathing,apnea)symptom disappearance rate,nose Lateral X-ray of pharynx adenoids A/N curative effect,disease curative effect,curative effect of TCM syndromes,evaluate the curative effect of Huahe Xiaotian Decoction,and compare the traditional Chinese medicine group with and without allergic history of nasopharyngeal lateral X-ray The curative effect of adenoid A/N,observe whether the history of allergies has any influence on the curative effect of Huahe Xiaoguan Decoction in the treatment of adenoid hypertrophy in children;Part II: Using a case-control study,it is planned to include children diagnosed with adenoid hypertrophy in children.54 children with seroallergen test were included in the study group.At the same time,non-adenomatous hypertrophy matching the height,weight,age,and sex of the patients in the pediatric ward were included in the study group,allergic diseases were excluded,and seroallergen was treated.54 children were tested as the control group.Single factor analysis was applied to gender,age,height,weight,inhalation,ingestion,total allergen,and multivariate logistic regression analysis was performed on statistically significant factors to explore the correlation between allergen exposure and adenoid hypertrophy in children.Results: Part 1:(1)Comparison of height,weight,gender,age,course of disease,baseline A/N ratio score of nasopharyngeal lateral X-ray film,disease score and baseline,TCM syndrome score and baseline in the first two groups Except for the difference in height and weight between the two groups,which were statistically significant(p<0.05),the other baseline differences were not statistically significant.In order to better control confounding factors,caliper matching was performed with age,gender,height,weight,course of disease,and baseline lateral adenoid(A/N)score of the nasopharynx as variables.A total of 30 pairs and 60 cases were successfully matched.Children.After matching,there was no significant difference in height and body weight between the two groups of children(p>0.05).(2)The curative effect of lateral adenoids(A/N)of nasopharyngeal area: after 8 weeks of treatment,the total effective rate,recovery rate,and effective rate of the two groups were 86.7%,53.4%,and 33.3% in the traditional Chinese medicine group;montelus The special sodium group was 63.4%,13.4%,and 50.0%.The differences between the two groups were statistically significant(p<0.05).The total effective rate of lateral X-ray adenoids(A/N)of nasopharyngeal adenoids(A/N)in children with adenoid hypertrophy and history of allergy was 91.7%,and the recovery rate was 66.6%;the total effective rate of children without history of allergy was 83.4 %,the recovery rate was 38.8%,the difference was not statistically significant(p>0.05).(3)Onset time and disappearance time of snoring: the onset time of snoring in the Chinese medicine group was 2(2)weeks,the disappearance time of snoring was 6(6)weeks,and the onset time of snoring in the montelukast sodium group was 4(4)weeks and disappeared The time was 8(8)weeks,and the difference was statistically significant(p<0.05).(4)The disappearance rate of single main symptoms: After 8 weeks of treatment,the disappearance rates of single main symptoms of snoring,nasal congestion,mouth breathing,and apnea were 83.3%,76.7%,83.3%,and 94.4% in the traditional Chinese medicine group,and 40.0%,6.7%,40.0%,100%,in the montelukast sodium groupthe difference between the two groups in the disappearance rate of snoring and mouth breathing was statistically significant(p<0.05).There was no significant difference in the disappearance rate of nasal congestion and apnea after 8 weeks of treatment(p>0.05).(5)Efficacy of disease: After 8 weeks of treatment,the cure rate of the Chinese medicine group was 90.0%,and the cure rate of the montelukast sodium group was 40.0%.The difference between the two groups was statistically significant(p<0.05).(6)The curative effect of TCM syndromes: after 8 weeks of treatment,the recovery rates of TCM syndromes in the TCM group and the montelukast sodium group were 56.7% and 13.3%,respectively.The difference between the two groups was statistically significant(p<0.05).Part 2: Both groups included 54 children.The results of univariate analysis showed that there were no statistically significant differences in height,weight,age,and gender between the groups(p>0.05).There were statistically significant differences between the inhalation,ingestion,and total allergen groups(p<0.05).The inhalation,ingestion,and total allergens were analyzed by binary logistic regression analysis.After analysis,the inhalation,ingestion and total allergens were positive as independent risk factors for adenoid hypertrophy.Ingested allergen OR=7.437,95%CI(1.440-38.410),total allergen OR=5.519,95%CI(1.064-28.638),p<0.05.And the OR value of ingested allergens is larger than that of total allergens.In the study group,the positive rate of inhaled allergens accounted for the largest proportion of molds(40%),and the proportion of ingested allergen milk was the largest(28.6%).The difference between the groups was statistically significant(p<0.05).Comparing the allergen-positive age stratification showed that the study group 4≤age≤6 years old allergen positive rate accounted for the highest57.2%,1≤age≤3 years old and 7≤age≤11 years old allergen positive rate accounted for21.4%.The control group had the highest allergen-positive rate of 46.1% in7≤age≤11 years old,and the allergen-positive rates of the two age groups 1≤age≤3years old and 4≤age≤6 years old were 23.1% and 30.8%,respectively.There were no positive cases in the two groups at ≥12 years old.There was no statistically significant difference between the two groups(p>0.05).Conclusion:(1)The curative effect of Huahe Xiaoguan Decoction on children with adenoid hypertrophy(phlegm-heat syndrome)is significantly better than montelukast sodium,and it is safe in clinical application.(2)There is a certain correlation between adenoid hypertrophy and positive food allergen. |
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