| Objective: Through a retrospective study of the case data of children snoring who received tonsillar pecking therapy or tonsillar cauterization therapy in the department of otolaryngology of the affiliated hospital of Shandong University of Traditional Chinese Medicine in the past two years,the advantages and disadvantages of the two traditional Chinese medicine characteristic therapies in the treatment of children snoring caused by tonsillar hypertrophy were comprehensively compared and analyzed.Methods: Retrospective comparative analysis was used.The data of snoring cases in children who were treated by simple tonsil cauterization or pecking in the Department of Otolaryngology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine from October 2020 to October 2022 were collected.On the basis of different treatment schemes,case data were divided into cauterization treatment group and pecking treatment group.On the basis of the inclusion and exclusion criteria,32 cases in the cauterization treatment group and 67 cases in the pecking treatment group were collected from the selfbuilt information database for the treatment of snoring in children caused by tonsillar hypertrophy.A total of 99 cases were collected.In order to reduce the influence of various factors and confounding factors on the bias of the results in the study,this study uses the Propensity Score Matching(PSM)to balance the non-research factors of different research groups.Taking cauterization group as matching benchmark,clamp matching was carried out,and the clamp value was set to 0.1.A total of30 groups of 60 patients were successfully matched.Compare and analyze the differences between the baseline data of the two groups before and after matching,such as the patient’s sex,age,body mass index(BMI),symptoms and signs score.After matching,the disappearance rate of snoring symptoms,the changes of single symptom score and single physical sign score,the overall curative effect,the effective time of snoring,the total treatment time,the time of single medical treatment,the adverse side effects and the occurrence of dangerous events of the two groups were compared,and the respective advantages of the two treatments in the treatment of children’s snoring caused by hypertrophic tonsils were comprehensively compared and analyzed.Results: Before matching,the age data of children in the two groups were compared.The age of children in the cauterization group was higher than that in the pecking group,with significant statistical difference(P<0.05),There was no statistically significant difference between the two groups in terms of gender,course of disease,body mass index and symptom and sign score(P>0.05),Because the baseline data of the two groups before matching are significantly different,the case data of the two groups are not comparable.Using the propensity score matching method,taking the baseline of age,sex,body mass index,course of disease,and symptoms and signs as variables,and the cauterization group as the baseline group,clamp matching was performed in 30 cases.After matching,the baseline data of the two groups were not significantly different(P>0.05),so they were comparable.After the end of treatment,the rate of snoring disappearance in the soldering group was higher than that in the pecking group,and the difference was statistically significant(P<0.05).The statistical analysis of individual scores of symptoms and signs showed that the scores of sleep snoring,sleep breath holding,mouth breathing,restlessness,apnea,lethargy,attention deficit and tonsillar hypertrophy were significantly reduced(P<0.05)after treatment(P0.05),and the scores of sleep snoring,sleep breathing,mouth breathing and tonsil hypertrophy were more significant in the treatment group(P<0.01).The score of symptoms and signs in the cauterization group after treatment was significantly different from that before therapy(P<0.05).After treatment,the score of cauterization group was lower than that of pecking group(P<0.05).Compared with the difference between the two groups before and after treatment,the difference between the cauterization group was higher,with a significant difference(P<0.05).Compared with the overall efficacy evaluation of the two groups,the cauterization group significantly improved in 18 cases,slightly improved in 18 cases,and no improvement in 0 case;In the pecking treatment group,there were significant improvement in 7 cases,slight improvement in 23 cases,and no improvement in 0 case.The curative effect of cauterization group is better,and there is significant difference between the two groups.The onset time of snoring symptoms in cauterization group was shorter than that in pecking group,the total duration of treatment in the cauterization group was shorter than that in the pecking group,and the single treatment time was longer than that in the pecking group,with an obvious difference(P<0.05).There were no serious adverse reactions and safety events in both groups.Only one child was exposed to uvula during cauterization,resulting in local ulcer of uvula.In general,both cauterization and pecking are safe methods to treat snoring in children.Conclusion: As commonly used TCM external treatment techniques for the treatment of childhood snoring caused by tonsil hypertrophy,tonsil soldering treatment and pecking treatment have the characteristics of simplicity,flexibility and safety.Both tonsil soldering and pecking treatments significantly improved symptoms and signs such as sleep snoring,sleep breathing,mouth breathing,restlessness,apnea,lethargy,attention deficit,and tonsil hypertrophy.Compared with the two treatments,tonsil soldering treatment has more advantages in reducing the size of tonsils,eliminating snoring symptoms,improving sleep and breathing,and opening mouth breathing,but the operation is relatively complicated,the single treatment time is longer,the applicable age range is narrow,and it is difficult for young children to cooperate.The tonsil pecking method is relatively simple,the single treatment time is short,the applicable age range is wider,and the degree of cooperation of children is higher,but it is relatively weak in the ability to improve the symptoms of snoring in children and quickly reduce the volume of tonsils.Clinicians can choose the appropriate treatment according to the characteristics of the two therapies and the actual clinical situation of the child. |
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