A Real World Study Of Integrated Traditional Chinese And Western Medicine In The Treatment Of Wind-heat Closed Lung Syndrome In Children With Community Acquired Pneumonia

Objective:Based on real-world research methods,the characteristics of TCM symptoms,laboratory examinations,pathogen diagnosis,and treatment of TCM in children with community-acquired pneumonia(CAP)wind and heat closure lung syndrome are analyzed,which provides a reference for the formulation of community-acquired pneumonia programs for the treatment of children with integrated TCM and Western medicine.Methods:A total of 441 cases of pneumonia from the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Shandong Provincial Hospital,Qilu Hospital of Shandong University,Qilu Children’s Hospital of Shandong University,Jinan Maternal and Child Health Hospital,and The First People’s Hospital of Jining City met the diagnostic criteria of "Children’s Community Acquired Pneumonia Diagnosis and Treatment Specification(2019Edition)",a total of 441 cases were collected.The information is screened,sorted,counted and summarized to obtain the basic information,medical history information,clinical symptom observation,laboratory examination results,pathogenic examination,adverse events,integrated traditional Chinese and Western medicine treatment of children with community-acquired pneumonia,wind fever and lung closure in the real world,and is divided into conventional Western medicine treatment group and integrated traditional Chinese and Western medicine treatment group according to the different medication conditions,and the SPSS26.0 statistical software is used for analysis and discussion.Results:1.The incidence of wind-heat closed lung syndrome of community-acquired pneumonia in children was more male(60.8%)than female(39.2%),and the onset age was early school age(51.0%).The proportion of height and weight below the standard was 56.4% and 42.0%,respectively.The most common season was winter(37.2%).The most common initial symptom was cough(97.3%).About 80.7%of the children had a history of pre-hospitalization diagnosis and treatment,and antibiotics(62.1%)were used for treatment than traditional Chinese medicine(29.0%).2.In western medicine,bronchopneumonia(89.1%),asthmatic pneumonia(5.0%),lobar pneumonia(4.3%)and severe pneumonia(1.6%)ranked in the order of diagnosis.After admission,the main clinical symptoms and signs were cough(98.4%),pharyngeal swelling(90.9%),expectoration(86.2%),fever(46.3%),runny nose(43.3%),sweating(42.9%).The tongue quality is red,moss yellow or thin yellow,pulse is more common with floating number of pulse,fingerprint is mostly floating purple in fengguan.In physical examination,the common respiratory sounds were thick(95.7%)and lymphadenopathy(50.8%).Lung rales were mainly phlegm sounds(23.0%)and blister sounds(20.0%).3.The abnormal results of laboratory test mainly included increased WBC(38.6%),increased absolute value of neutral granule(25.3%),decreased percentage of neutral granule(32.2%),increased absolute value of lymph(45.3%),increased percentage of lymph(27.0%),decreased percentage of eosinophilic acid(40.8%),increased C-reactive protein(22.9%),and blood Elevation of sedimentation(49.2%)was the main factor.The imaging reports showed that the double lung texture increased and the fuzzy suggestion was more common.Etiological examination indicated that viral infection(47.5%)was the most common,followed by mycoplasma pneumoniae(37.2%),bacterial infection(7.6%),and co-infection accounted for 9.8%.4.The number of patients treated with integrated traditional Chinese and Western medicine(52.6%)was more than that treated with pure western medicine(47.4%).The main herbal prescriptions were Maxing Shigan Decoction(88.6%)and Wendan Decoction(35.2%).The antibiotics used were macrolides(55.3%),cephalosporins(49.7%)and penicillins(29.0%).5.The complication of wind-heat closed lung syndrome of community-acquired pneumonia in children was relatively rare,accounting for8.2%.The most common diseases were myocardial damage(3.9%),gastrointestinal disease(3.4%)and liver function damage(1.6%).6.The mean course of disease was 5.58 days in the western medicine group and 6.43 days in the integrated Chinese and Western medicine group.The average cost of western medicine treatment group was 5824.05 yuan,and that of integrated Chinese and Western medicine treatment group was 5149.48 yuan.Conclusion:1.441 cases of wind-heat closed lung syndrome of community-acquired pneumonia in children had a higher incidence rate in boys than in girls,most of which occurred before 7 years old.The main season of the disease is winter.Antibiotics are commonly used in outpatient clinics.2.441 cases of wind-heat closed lung syndrome of community-acquired pneumonia in children showed the main clinical manifestations of cough,expectoration,fever and wheezing.3.441 cases of community-acquired pneumonia in children with wind-heat closed lung syndrome were mostly infected by virus,followed by mycoplasma infection,and co-infection was rare.4.Western medicine is mainly anti-inflammation and anti-virus;Traditional Chinese medicine decoction to clear lung heat,phlegm relieving cough and asthma;Proprietary Chinese medicine to heat and detoxification,phlegm relieving cough.5.The average course of disease in the western medicine treatment group was shorter than that in the integrated Chinese and Western medicine treatment group,and the average cost was higher than that in the integrated Chinese and Western medicine treatment group.