Data Analysis Of The Regularity Of Traditional Chinese Medicine In Infectious Mononucleosis With Children And Study On Risk Factors Of IM Combined With Respiratory Tract Bacterial Infection

Objective:This study aims to retrospectively analyze the effective cases of infectious mononucleosis in children in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,and summarize TCM prescriptions by data mining analysis,so as to provide reference for TCM syndrome differentiation in the future;In addition,this study investigates the risk factors of this disease combined with respiratory bacterial infection,and make a beneficial exploration for the rational clinical use of antibiotic.Methods:A total of 120 children who were diagnosed with IM and hospitalized in our hospital from January 2017 to January 2022,of which 116 had complete medical records,were selected for summary and analysis.Test one Study on the rule of IM TCM prescriptionAmong the 116 medical records,the treatment method was selected as simple Chinese medicine or combined with intravenous traditional Chinese medicine preparations,and 70 intravenous or oral anti-infective drugs or hormones were not used.The database was established to include the effective TCM prescriptions during hospitalization,extract and sort out the data,create a TCM database,summarize its frequency,taste,meridian and efficacy,and SPSS Modeler 18.0 was used for association rule analysis,SPSS Statistics 24.0 was used for frequency analysis and cluster analysis,and summarize the formation rules of TCM treatment of IM.Test two Investigation of risk factors for IM combined with respiratory bacterial infectionThe 116 medical records collected were grouped according to the diagnostic criteria of respiratory bacterial infection,among which the diagnostic criteria of respiratory bacterial infection were met.The effective cases of antibiotic treatment were the group of combined respiratory bacterial infection and the infection group,a total of 23 cases.In the cases that did not meet the diagnostic criteria for respiratory bacterial infection,they were matched by sex as a factor,and selected 69 cases,the group without combined respiratory bacterial infection,or the non-infected group.By consulting domestic and foreign literature and expert opinions,the general data include sex,age,preadmission course,hospital day;clinical symptoms include heat course,lymph node tenderness,early cough;clinical symptoms include tonsil enlargement,tonsil secretion,lung sounds;laboratory indicators including white blood cell count(WBC),neutrophil percentage(N%),C reactive protein(CRP),procalcitonin(PCT),lactate dehydrogenase(LDH),throat swab culture,sputum culture,blood culture,Mycoplasma pneumoniae antibody.The electronic statistical table was designed,and the medical records of the two groups were extracted respectively.Correlation analysis using SPSS Statistics 24.0 statistical software was used to identify risk factors for IM combined with respiratory bacterial infection.Results:Test one study on the rule of IM TCM prescription(1)The most commonly used drugs for IM treatment of TCM are huangqin,lianqiao,jinyinhua,gancao,mudanpi,chaihu,xuanshen,banlangen,shigao,chishao,jiegeng,zhizi;(2)Most drugs for treatment of IM are heat clearing,surface clearing and clearing hot phlegm;(3)Four qi in drugs of IM is mainly cold,five flavors are mainly bitter,sweet,and spicy,to the lung meridian,heart meridian,gastric meridian,liver meridian of drugs in the majority;(4)Association rule analysis showed that the common secondary drugs lianqiao and jinyinhua,huangqin and chaihu,lianqiao and zhizi,etc;Triple drugs: lianqiao and jinyinhua and huangqin,huangqin and zhizi and lianqiao,lianqiao and banlangen and huangqin etc;(5)Cluster analysis introduced the new prescription drugs combination of banlangen,pugongying,jinyinhua,lianqiao,bohe,niubangzi,gancao;jiegeng,jiangcan,huangqin,chaihu;shigao,zhimu,lugen;zhizi,dahuang;mudanpi,xiakucao,xuanshen,dihaung;zicao,danshen,danggui.Test two Investigation of risk factors for IM combined with respiratory bacterial infection(1)The single factor analysis showed,the occurrence of IM with respiratory bacterial infections was not associated with age,sex,tonsil hypertrophy,WBC,N%,CRP,LDH,was significantly associated with course of disease before admission,heat range,lymph node tenderness,early disease cough,tonsil secretion,and PCT.(2)Multivariate logistic regression analysis showed that early cough(OR=6.556,95%CI=1.121～38.345,P=0.037<0.05),the course of disease before admission≥8.5 days(OR=14.936,95%CI=1.975～112.949,P=0.009<0.05),the tonsil has a secretion(OR=15.298,95%CI=2.057～113.797,P=0.008<0.05)and PCT≥0.245ng/ml(OR=29.370,95%CI=4.444～194.125,P=0.000<0.05)is an independent risk factor for IM combined with respiratory bacterial infections.Conclusion:(1)Chinese medicine treatment IM mainly heat clearing drugs,with table,diarrhea class,hot phlegm,promoting blood circulation and stasis,drug compatibility combination summarized in this study can be used as the basic party or combined syndrome for clinicians to treat the disease.(2)Children with IM had early cough,8.5 days before admission course,tonsil secretions,and PCT ≥ 0.245ng/ml is an independent risk factors for combined respiratory bacterial infections.