Study On TCM Syndromes Of Community-acquired Pneumonia In Children And Analysis Of Severe Early Warning Indicators Based On Bayesian Network Technolog

Purpose:To analyze the relationship between TCM symptom type and symptoms of community-acquired pneumonia in children,and to explore the value of laboratory tests in the diagnosis and severity assessment of CAP in children.Meterial and method: A total of 339 patients with community-acquired pneumonia were collected from the outpatient department of the Affiliated Hospital of Liaoning University of Chinese Medicine and the second ward of Shenyang Children’s Hospital from December 2021 to May 2022,including 48 severe patients and 291 mild patients.The clinical features,laboratory tests,and TCM symptoms of children with CAP were collected,and the differences in gender,age,personal history,clinical features,signs,white blood cell count(WBC),neutrophil percentage(NEUT%),ratio of neutrophils to lymphocytes(NLR),ratio of monocytes to lymphocytes(MLR),hemoglobin(HGB),platelets(PLT),C-reactive protein(CRP),procalcitonin(PCT),lactate dehydrogenase(LDH)were compared between the two groups.Bayesian network technology and association rules were used to analyze the relationship between symptoms and symptoms.Results:1.There were 278 cases(95.5%)of fever,210 cases(72.2%)of cough,179 cases(61.5%)of sputum and 147 cases(50.5%)of wheezing,44 cases(91.7%),38 cases(79.2%)of cough,35 cases(72.9%)of sputum and 40 cases(83.3%)of wheezing,among which wheezing was more prominent in the symptom group,and the difference between the two groups was significant.2.Compare the differences in levels of WBC,NEUT%,NLR,MLR,HGB,PLT,CRP,PCT,and LDH between the two groups,among which the results of NEUT%,NLR and LDH are more prominent,and the corresponding AUC is 0.644,0.632,0.727,the sensitivity is 39.6%,70.8%,45.8%,the specificity is 84.2%,51.9%,89.7%,and the Jordon index is 0.238,0.227、0.355。3.Combined with Bayesian network technology and correlation analysis,the symptoms of malignant wind,pharyngeal redness,pulse floating,moss thin yellow,nasal congestion,runny nose,slight sweating,thirst,cough and fever,were calculated,and the contribution to the diagnosis of wind and heat closed lung was 0.93,0.85,0.77,0.74 and 0.44.4.Combined with Bayesian network technology and association analysis,the symptoms group were calculated for pulse slippage,moss yellow greasy,cough,sputum volume,thick sputum,yellow sputum,shortness of breath,wheezing,red tongue,thirst,and the contribution to the diagnosis of sputum fever closed lung was0.94,0.72,0.57,0.51 and 0.40.Comclusion:1.NEUT%,NLR,and LDH have certain early warning value for the diagnosis of severe CAP in children,and the combined diagnostic value of the three is higher.2.We preliminarily established the diagnostic basis for common syndromes of CAP in children according to correlated symptom clusters and their contribution to syndromes,which could provide new thoughts and methods for differentiation standard.