| Objective:As a disease peculiar to children, Adenoidal Hypertrophy(AH) can cause a variety of symptoms and complications, in which obstructive sleep apnea syndrome(OSA)is the most common complication. The morbidity of AH in Asia among primary and secondary school students is high to 7.9%. The symptoms of AH includes snoring, nocturnal hypoxemia, leading to effects on the growth and development of children as well as various diseases of nervous system, cardiovascular system, endocrine system and so on. At present the main treatment to AH is surgery, but there is not an accurate age internationally accepted for surgery, neither a specific operation indication. Whether the immune function will be affected by surgery has not reached a consensus. Owing to the surgery to potential trauma, such as postoperative complications and recurrence, more and more parents prefer conservative treatments. As an important part of those conservative treatments, Chinese Medicine is widely applied in clinical. Professor Sun Shuchen built "Rhinopathy Sequential Therapy of Chinese Medicine, (RSTCM)" with Chinese characteristics basing on his several years'clinical experience and researches on herbs used on nasal diseases in Traditional Chinese Medicine. The RSTCM can be divided into three steps, steam fumigation, distillate nose dripping and the fried decoction drinking. That method aims at buffering patients'pain as well as improving their compliancy and clinical efficacy by mainly using external treatment. The RSTCM provides a new way to deal with AH with making full use of Traditional Chinese Medicine at the same time.In present domestic researches on AH's drug treatment, clinical evaluation indicators are mostly quantitative score of the symptoms and quality of life assessment (OSA-18) comparative scores, both are symptom scores. Those indicators cause the lack of objective indicators such as the comparison of size of the front and after treatment endoscopic adenoids.Methods:This study includes 30 cases diagnosed as AH among children 2 to 6 years old by nasal endoscope. Endoscopic observations of patients'Adenoids were taken to diagnose the patients'syndrome type. Compare the endoscopic posterior nares'size and morphology as well as the surface discharge and its relationship with pharyngeal opening of auditory tube before and after "RSTCM to provide an objective evaluation of the efficacy of treatment in children AH.Results:1. Before treated there are 17 cases of adenoid degree III and 20 cases of degree IVwithin the 30 patients with AH. After treatment, there is 0 case of degree IV,13 cases of II (P<0.01); 2. After the treatment,13 cases has a normal size adenoid, and in anther 15 cases the size of adenoid has reduced, but not yet reached the 1/2 or below.2 cases have no significant changes in the size of the adenoids; 3. Adenoid size changes have no difference (P> 0.05) in terms of gender.Conclusion:1. The RSTCM can shrink the adenoid tissue and alleviate posterior nares' clog by nasal endoscopy before and after treatment; 2. Adenoid size changes have no difference in terms of gender; 3. The changes of adenoids are not affected by original size, but relate to the TCM Syndromes; 4. The RSTCM can improve the surface condition of the adenoids with shrinking the adenoid tissue at the same time. |
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