Analysis Of Related Influencing Factors And TCM Syndromes Of Tic Disorder In Children

Objective:To investigate and study the distribution of factors related to the development of tic disorders in children and the distribution of TCM symptoms,to further analyze the relationship between related factors and TCM symptoms,and to provide an objective basis for the TCM diagnosis and treatment of tic disorders in children and the prevention and treatment from the perspective of the development factors.Method:A cross-sectional study was conducted to collect general information,factors associated with the onset of the disorder,and information on the four Chinese medicine consultations from 270 children who met the inclusion criteria for tic disorder and were seen in the outpatient clinic and inpatient pediatric department of the First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine between November 2021 and January 2023 by questionnaire.The data were analyzed by statistical methods such as frequency analysis,cluster analysis,non-parametric Kruskal-Wallis H test and Pearson test using SPSS 26.0 software to investigate the factors associated with the onset of tic disorder in children,the distribution pattern of TCM symptoms and the correlation between them.Rerults:1.Factors associated with the development of tic disorders in children are: mode of delivery,history of perinatal abnormalities(e.g.,premature rupture of amniotic fluid,amniotic fluid aspiration,asphyxia,umbilical cerclage,intrauterine distress,placental abruption,convulsions,neonatal jaundice,severe infections,ischemic-hypoxic encephalopathy),family genetic history(family history of tic disorders,history of neuropsychiatric disorders,history of allergic disorders),previous personal medical history(febrile convulsions,asthma,allergic rhinitis,recurrent upper respiratory tract infections,pharyngitis,otitis media,adenoid hypertrophy,chronic tonsillitis,enuresis,eczema,urticaria,mesenteric lymphadenitis,allergic conjunctivitis,cough variant asthma),poor dietary habits,prolonged use of electronic devices,academic pressure,harsh discipline,exposure to second-hand smoke,poor maternal mood during pregnancy,poor dietary habits during pregnancy,and other factors.Of these,scolding and chastisement and exposure to second-hand smoke were statistically significant.2.Common aggravating factors: external sensation,emotional stimulation,study tension,lack of sleep,scolding and physical punishment,sports exertion,poor diet,environmental changes,seasonal changes,use of electronic products,etc.,among which external sensation,emotional stimulation and use of electronic products are the top three aggravating factors.3.The TCM symptoms of the 270 study subjects were grouped into five categories,in order of frequency: spleen deficiency and liver exuberance(76 cases,28.15%),external wind induced(54 cases,20.00%),hyperliver and wind induced(51 cases,18.89%),phlegm-heat disturbed(50 cases,18.52%),and yin deficiency and wind induced(39 cases,14.44%).Among them,the evidence of spleen deficiency and liver vigor accounted for the highest percentage.4.There was a statistically significant correlation between the distribution of TCM symptoms and individual medical history,co-morbidities,duration of illness,severity of illness,and academic stress(P < 0.05).The two two results showed that previous allergic rhinitis,allergic conjunctivitis,recurrent respiratory tract infections,cough variant asthma,and mesenteric lymphadenitis were mostly seen as external wind induced evidence.The co-morbidities of attention deficit hyperactivity disorder(ADHD)were most often seen in the evidence of phlegm-heat disturbance;sleep disorders were most often seen in the evidence of external wind-triggering.Spleen deficiency and liver hyperactivity have a longer course.The symptoms of liver hyperactivity,yin deficiency and liver deficiency are less severe than those of external wind.Children with high academic stress are more likely to suffer from hyperlipidemic wind-activated symptoms than external wind-activated symptoms.Conclusion:1.mode of delivery,history of perinatal abnormalities(e.g.,premature rupture of amniotic fluid,amniotic fluid aspiration,asphyxia,umbilical cerclage,intrauterine distress,placental abruption,convulsions,neonatal jaundice,severe infection,ischemic-hypoxic encephalopathy),family genetic history(family history of tic disorders,neuropsychiatric history,history of allergic diseases),previous personal medical history(febrile convulsions,asthma,allergic rhinitis,recurrent upper respiratory tract infections,pharyngitis,otitis media,adenoid hypertrophy,chronic tonsillitis,enuresis,eczema,urticaria,mesenteric lymphadenitis,allergic conjunctivitis,cough variant asthma),poor dietary habits,prolonged use of electronic devices,academic stress,harsh discipline,scolding and punishment,frequent parental quarrels,exposure to secondhand smoke,and maternal adverse mood during pregnancy may be risk factors for the development of tic disorders in children.2.Common aggravating factors include external sensation,emotional stimulation,academic stress,lack of sleep,scolding and punishment,sports exertion,poor diet,environmental changes,seasonal changes,and viewing of electronic products.3.The common TCM symptoms in children with tic disorder are: spleen deficiency and liver exuberance,external wind induced,liver hyperactivity and wind movement,phlegm-heat disturbance,and yin deficiency and wind movement.4.The distribution of TCM symptoms may be related to individual medical history,co-morbidities,disease duration,severity of the disease,and academic stress.