| Objective1.Through the research of ancient and modern literature,this paper summarizes and discusses professor Xu Youjia’s theory of "Children’s Constitution is Deficiency and Cold ",and demonstrates the innovation and practicability of this theory。2.By using the method of evidence-based medicine system evaluation,this paper analyzes the current situation and existing problems of TCM constitution research in children,summarizes the distribution law of TCM Constitution Types in healthy children,and provides scientific research direction and ideas for the further research of the theory of"Children’s Constitution is Deficiency and Cold ".3.Through prospective non randomized controlled study,to evaluate the effectiveness and safety of the health management plan for children with allergic rhinitis guided by the theory of "Children’s Constitution is Deficiency and Cold",and preliminarily verify the applicability of this theory in children outside the south of the Five Ridges in china.4.To establish a TCM health management plan for children with allergic rhinitis guided by the theory of "Children’s Constitution is Deficiency and Cold",and to provide a new idea for TCM health management mode of allergic rhinitis and other allergic diseases.Methods1.By using the method of literature research and consulting the ancient books about children’s physique,this paper explores and summarizes the origin and characteristics of the academic theory of "Children’s Constitution is Deficiency and Cold ",and analyzes the innovation by comparing with the traditional understanding of children’s physique.2.Taking "Xu Youjia,Er Wei Xu Han" as the key words and subject words,we searched the related literature of "Er Wei Xu Han" theory in CNKI,Wanfang and other databases on the Internet.By summarizing,combing and analyzing these literature,we summarized the current development,application and research of "Er Wei Xu Han" theory in clinical treatment,and further discussed the academic significance of this theory.3.The databases of CNKI,Wanfang and Chongqing VIP were searched.All the literatures on the distribution of TCM Constitution in healthy children from January 1978 to may 2020 were included,including cross-sectional study,case-control study and cohort study.Then we extracted basic characteristics,research results and methodology from each literature for qualitative analysis and systematic evaluation.All the data were analyzed by descriptive statistical methods.Stata15.0 software was used to conduct meta-analysis and graph drawing on the main body mass ratio data of healthy children in the research report that met the inclusion criteria of qualitative research.Subgroup analysis was conducted according to age,gender and region of the research population.Q test was used to evaluate the heterogeneity,and funnel plot was used to evaluate the publication bias.4.In this prospective non randomized controlled study,children with allergic rhinitis who visited the Department of Pediatrics,Affiliated Hospital of Henan Academy of Chinese medicine from February 2018 to June 2019 were selected as the research objects and divided into groups according to the treatment willingness of parents.The control group was treated with standard western medicine,the observation group A was treated with traditional Chinese medicine granules,and the observation group B was treated with traditional Chinese medicine granules combined with traditional Chinese medicine health management scheme.The observation period was 24 weeks,and the patients were followed up every 4 weeks.The rhinitis symptom score and TCM daily performance score were recorded at the time of admission,the 12th week and the 24th week.All the data were entered into the computer and analyzed by spss22.0 software.Results1.Based on the idea of "Chong Yang",the constitution concept of "Er Wei Xu Han" is established.There is no contradiction between the theory of "Children’s Constitution is Deficiency and Cold" and the traditional theory of children’s constitution,which is the inheritance,development and innovation of it.2.Through this search,37 articles about the theory were obtained,including 18 theoretical reviews and literature studies,19 clinical studies and 1 experimental study.In terms of research content,there are 13 researches on respiratory allergic diseases,3 researches on children’s physique and care,7 researches on children’s spleen and stomach diseases,7 researches on other lung diseases,and 4 researches on children’s kidney diseases,involving 10 kinds of diseases,all of which have achieved good curative effect and verified clinical curative effect.3.41 literature were included for qualitative analysis,including 24 cross-sectional studies,15 case-control studies and 2 cohort studies.The main publication types were journal literature(58.5%)and Dissertation(41.5%).The main research design type was cross-sectional study(58.5%),followed by case-control study(36.6%).After 2009,the number of published literature showed an obvious upward trend,with South China as the largest research area(61.0%).Universities and hospitals are the main body to carry out the research on the physical distribution of healthy children.In terms of methodology,Wang Qi’s nine point constitution method or improved constitution standard is used directly in TCM constitution classification standard,and scale evaluation method is mainly used to measure and judge children’s constitution.The overall quality evaluation of methods is medium,and there is a certain risk of bias.26 studies were included in the meta-analysis,including 16 cross-sectional studies,9 case-control studies and 1 cohort study,involving a total sample size of 15080 cases.The results showed that the highest proportion of Chinese medicine constitution type in healthy children was mild constitution,accounting for 41%(30%-53%),and the rest were Yin deficiency(16%),Qi deficiency(14%),Yang excess(11%),phlegm dampness(7.35%),Yang deficiency(7.03%),etc.Results of age subgroup analysis showed that the proportions of qi deficiency(21.93%),Yang deficiency(10.93%)and Yang excess(17.84%)in children aged 0-6 were significantly higher than those in children aged 7-14(6.83%),Yang deficiency(2.75%)and Yang excess(3.4%).Meanwhile,the proportion of children aged 7-14(52.34%)was significantly higher than that of children aged 0-6(26.96%).The results of regional subgroup analysis showed that the proportion of mild and yang deficiency in the South was significantly lower than that in the north,while the proportion of yin deficiency,Qi deficiency,Yang excess and phlegm dampness in the South was higher than that in the north.The proportion of hot and humid mass in the south is higher than that in the north.Methods quality evaluation:the quality evaluation of 16 cross-sectional studies was moderate,and there was a certain risk of bias.The methodological quality evaluation of 9 case-control studies is generally low,and there is a high risk of bias.4.Clinical researchA total of 105 cases were included in this study,including 35 cases in the control group.35 cases in the treatment group A and 35 cases in the control group B.But among them,8 cases fell off and 9 cases were eliminated.Finally,88 cases completed the study,including 29 cases in the control group,31 cases in the treatment group A and 28 cases in the treatment group B.The baseline demographic data and experimental analysis data of the three groups were comparable(P>0.05).(1)Distribution of TCM ConstitutionAmong the 88 cases included,the number of each type of constitution from more to less was Qi deficiency,phlegm dampness,Yang deficiency,Yang excess,yin deficiency and peace.Among them,the number of Qi deficiency constitution was the most,followed by phlegm dampness and yang deficiency.(2)Symptom score of allergic rhinitisWeek 12 and before treatment:intra group comparison showed that the total score of rhinitis symptoms and four specific scores of the three groups at 12 weeks were lower than those before treatment(P<0.05).Inter group comparison showed that there were statistically significant differences in the total score of symptoms and the number of daily blowing nose among the three groups(P<0.05).Further multiple comparison results between the three groups showed that the observation group B and the observation group A were better than the control group(P<0.05),but there was no significant difference between the observation group B and the observation group A(P>0.05).week 24 and week 12:intra group comparison showed that there was no significant difference in the symptom score and total score of observation group B(P>0.05).For the control group in the total score of rhinitis symptoms,the number of continuous sneezing,the number of nasal congestion,and the observation group A in the total score of rhinitis symptoms,the number of daily blowing nose,nasal congestion,the differences between before and after were statistically significant(P<0.05);the comparison between groups(the difference between week 24 and week 12)showed that there were no significant difference among the three groups(P>0.05).Week 24 and before treatment:intra group comparison showed that there were no significant difference in the number of continuous sneezing and nasal itching in the control group(P>0.05),but there was significant difference in daily blowing times,nasal congestion and total score(P<0.05);the total score of rhinitis symptoms and four specific scores in observation group A and B were lower than before,and the differences were statistically significant(P<0.05).The comparison between the three groups(the difference between week 24 and before treatment)showed that there were significant differences in the total score,the number of continuous sneezing,the number of daily blowing nose.nasal congestion between the observation group B and the control group(P<0.05),and there were significant differences in the total score,the number of daily blowing nose between the observation group B and the treatment group A(P<0.05),and there were significant differences in the nasal congestion between the observation group A and the control group(P<0.05)。(3)Evaluation of the overall efficacy of allergic rhinitisAt week 12,there was no significant difference in the total effective rate among the three groups(P>0.05);at week 24,there was no significant difference in the total effective rate between the treatment group A and the control group(P>0.05),the total effective rate of the treatment group B was better than that of the control group,and the difference was statistically significant(P<0.05);there was no significant difference between the treatment group A and the treatment group B.(4)Daily physiological performance score(Week 12 and before treatment)Intra group comparison showed that:the control group had no significant difference in the total score of daily physiology and 11 specific scores except energy(P>0.05);the observation group A had significant difference in the total score of daily physiology and 11 specific scores except skin,while the observation group B had significant difference in the total score of daily physiology and all 12 specific scores(P<0.05).The comparison between the groups showed that:the difference between the three groups in the total score of daily physiology and 11 specific scores except for tongue coating was statistically significant(P<0.05);the multiple comparison between the groups showed that the observation group B was better than the control group in the total score and 11 specific scores except for tongue coating(P<0.05),in the total score and complexion,defecation,breath and illness Compared with the observation group A(P<0.05).(5)General evaluation of TCM Constitution improvement effectIn terms of the total effective rate of TCM Constitution improvement,there were significant differences between treatment group B and control group,treatment group A and control group,treatment group B and treatment group A(P<0.05)。Conclusion1.The constitution theory of "Children’s Constitution is Deficiency and Cold " is an innovative theory about the physiological and pathological characteristics of children’s constitution,which is put forward by Professor Xu Youjia.It inherits,develops and innovates the traditional theory of children’s constitution.It has been applied to the diagnosis and treatment of various diseases in pediatrics,the study of constitution in traditional Chinese medicine,and the study of children’s health care.It has achieved remarkable clinical effects and has been verified by researches.2.At present,the research on the physical distribution of healthy children is still in the early stage of development,and there is a lack of large sample and high-quality epidemiological investigation of TCM Constitution.How to define the age stage,determine the type of constitution in different age stages,the development of TCM children’s body mass scale,the development of scale or questionnaire and scientific evaluation,etc.,are controversial,which are the problems that need to be solved urgently in the research of children’s constitution,and the research of children’s constitution still needs to be further developed.The results of meta-analysis showed that mild constitution,yin deficiency constitution and Qi deficiency constitution were the main types of TCM Constitution in healthy children.With the increase of age,the proportion of qi deficiency constitution,Yang deficiency constitution,Yang excess constitution and yin deficiency constitution in healthy children decreased significantly,while the proportion of mild constitution increased significantly;the proportion of Yang excess constitution and yin deficiency constitution in healthy children in the South was higher than that in the north,while the proportion of mild constitution and yin deficiency constitution in healthy children in the South was higher than that in the north Qi deficiency quality,the north is higher than the south.However,limited by the quality of original literature and other factors,the results of this study may have obvious bias,which needs to be further verified by more high-quality and large sample healthy children’s TCM constitution investigation.3.It has a definite clinical effect to guide the treatment of children’s allergic rhinitis in Zhengzhou area with the physical concept of "Children’s Constitution is Deficiency and Cold".The TCM health management scheme of allergic rhinitis established under the guidance of this theory can still effectively alleviate the condition of allergic rhinitis,reduce the recurrence,improve the continuity of the curative effect of TCM scheme,and improve the final curative effect.At the same time,the program can also effectively regulate and improve the spleen and stomach function of children,and then improve the physique,and may ultimately achieve the purpose of reducing disease attacks through the improvement of physique,which provides a new idea for the construction of Chinese medicine health management mode of children with allergic rhinitis,and is a new research direction.However,due to the small sample size and other factors,there is no significant difference in some results,which still needs further research. |
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