| Objective : To observe the clinical manifestations and TCM syndrome characteristics of novel coronavirus infection in children in the fever clinic of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,and to explore the etiology,pathogenesis and syndrome distribution characteristics of novel coronavirus infection in children in this area.Provide the basis for further multi-center,large-scale cross-sectional study.Methods : According to the inclusion and exclusion criteria,191 children diagnosed with novel coronavirus infection in the children’s fever clinic of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from December 1,2022 to December 31,2022 were selected.The information of the children was collected and summarized to form a database.SPSS26.0software was used to describe the general situation and epidemio logical characteristics of the children.The four diagnostic information of traditional Chinese medicine was analyzed by cluster analysis according to the duration of the disease,and the correlation between vaccination and TCM syndrome distribution was analyzed.Results :1.Epidemiological characteristics : Among the 191 children with COVID-19,there were 108 males(56.54 %)and 83 females(43.46%),with an average age of 7.6 years.According to age,school-age children(60,31.4 %)had the highest incidence.According to the statistics of school age,primary school students(58,49.1 %)had the largest number of cases.The number of patients showed a trend of increasing first and then decreasing.The vaccination rate of children aged 3-14 years was 91.7 %.Family clustering(125,65 %)is one of the characteristics of this disease.2.Clinical characteristics : All children had fever symptoms,the heat peak was concentrated in 39.1 °C ~ 41 °C,and the duration of fever before diagnosis was 1 ~ 6 days.Complications occurred in 36cases(18.85 %),including 11 cases of febrile convulsion(5.8 %)and 2 cases of purpura(1 %).According to the severity of the disease,mild(167,87.4 %)and common(24,12.6 %)were more common,and no severe and critical cases were found.The treatment methods recommended by doctors were mainly home isolation and oral drugs(157,82.2 %).The western medicines with the highest frequency of use before treatment were ibuprofen suspension(131,52.61 %)and ibuprofen tablets(40,16.06 %).The Chinese patent medicines were Pudilan Oral Liquid(39,27.46 %)and Lianhua Qingwen Granules(24,16.90 %).The average duration of nucleic acid positive was11.02 ± 0.366 days.Most of the children(146,76.44 %)had no new post-coronal symptoms after the nucleic acid turned negative.The remaining children still had symptoms within one month after the nucleic acid turned negative,including cough(29,15.18 %),anorexia(7,3.66 %),fatigue(6,3.14 %),nasal congestion(2,1.05 %),and chest tightness(1,0.52 %).3.TCM syndromes : The four diagnostic information of 191 children were collected and summarized.A total of 52 symptoms and signs appeared.The top ten symptoms were fever(191,100 %),cough(137,71.73 %),runny nose(40,24.84%),sore throat(36,18.85%),anorexia(33,17.28%),nasal congestion(24,12.57%),vomiting(23,12.04%),expectoration(17,8.90%),fatigue(16,8.38%)and diarrhea(12,6.28%).The top ten signs were tongue pink(95,49.74%),red tongue(61,31.94%),thin yellow fur(47,24.61%),yellow greasy fur(43,22.51%),floating pulse(40,20.94%),purple fingerprint(39,20.42%),slippery pulse(38,19.90%),white greasy fur(33,17.28%),thin white fur(23,12.04%),yellow fur(23,12.04%).Cluster analysis was performed on the symptoms and signs of children with different onset time.The results showed that the syndrome characteristics of children with several hours to 1 day of onset could be summarized as wind-cold-dampness-toxin invading lung-wei,dampness-toxin stagnation on muscle surface,wind-heat-dampness-toxin invading lung-wei,disturbing heart and liver.The syndrome characteristics of children with 2 to 3 days of onset can be summarized as wet poison invading lung,wet poison into the heat,wet poison invading the spleen and stomach;the syndrome characteristics of children with 4 to 5 days of onset can be summarized as excess heat,damp-heat toxin,and damp toxin invading lung and spleen;the syndrome characteristics of children with 6 to 7days of onset can be summarized as heat toxicity heavier than wet toxicity,wet toxicity heavier than heat toxicity and excess heat.There are three main types of TCM syndromes : wind-heat damp-toxin syndrome(119,62.3%),wind-cold damp-toxin syndrome(58,30.4%),damp-toxin intrinsic syndrome(14,7.3 %).4.Correlation analysis : The correlation between vaccination and symptoms of children was analyzed.There was no correlation between fever peak,fever duration,nucleic acid positive duration,clinical classification of western medicine,new coronary symptoms and vaccination(P>0.05).There may be a correlation between the presence or absence of complications and whether the child is vaccinated(P<0.05).The correlation between TCM syndromes and baseline data of children was analyzed.The results showed that there was no correlation between TCM syndromes and gender,age,vaccination and fever peak(P>0.05).There was a correlation between different duration of fever and TCM syndromes(P<0.05).The children with fever duration of 1-3 days were mostly wind-heat-dampness-toxin syndrome(110 cases)and wind-cold-dampness-toxin syndrome(55 cases).The children with fever duration of 4-6 days were mostly dampness-toxin intrinsic syndrome(11 cases).There was a correlation between the presence or absence of complications and the TCM syndromes of children(P<0.05).The children with complications were more common in wind-heat-dampness-toxin syndrome(13 cases).There was a correlation between the clinical classification of Western medicine and the TCM syndromes of children(P<0.05).Mild children were more common with wind-heat-dampness-toxin syndrome(110 cases)and wind-cold-dampness-toxin syndrome(55 cases).Common children were more common with dampness-toxin syndrome(12cases).Conclusion :1.Clinical characteristics : There was no significant difference in gender of COVID-19 in children.The incidence was more common in school-age children,and it showed the characteristics of family aggregation.The clinical symptoms were mainly fever,cough,sore throat and other upper respiratory symptoms,and fever was more common.The duration of nucleic acid continuous positive is short and there are fewer new corona symptoms left after turning negative.The vaccination rate of children is high,and vaccination may reduce the incidence of complications.2.TCM syndrome characteristics : The disease is located in the lung,involving the spleen,stomach,heart,liver and so on.The key pathogenesis is the disharmony of defensive exterior,lung qi descending,spleen failing to transport,heart and liver being disturbed.3.TCM syndrome types : TCM syndrome types can be divided into wind-heat-dampness-toxin syndrome,wind-cold-dampness-toxin syndrome,and dampness-toxin syndrome.Patients with longer fever time,common clinical classification of western medicine,and new post-coronal symptoms are more likely to identify damp-toxin syndrome,while children with wind-heat damp-toxin syndrome are more likely to have complications. |
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