Systematic Evaluation And Individual In-depth Interviews Were Used To Study The Quality Of Life And TCM Prevention And Treatment Needs Of Children With Allergic Rhinitis

Background and ObjectiveAllergic rhinitis is a non-infectious chronic inflammatory disease of the nasal mucosa mainly mediated by IgE after exposure of the body to allergens.Typical symptoms include sneezing,runny nose,nasal itching,and nasal congestion.Eye symptoms such as itchy eyes,tearing,red eyes,and burning sensations can also be caused.In recent years,due to changes in social development and the environment,epidemiological surveys at domestic and foreign have shown a significant increase in the prevalence of allergic rhinitis.There are many causes of allergic rhinitis.Genetics and the environment are important factors.At the same time,there are many kinds of allergens.These factors make the disease appear repeatedly and it is difficult to cure.The incidence of allergic rhinitis in children is also rising,which seriously affects children's growth and development.Health-related quality of life refers to the determination of health status and subjective satisfaction associated with personal life events under the influence of diseases,accidental injuries and medical interventions.Health-related quality of life is a new medical evaluation technique that comprehensively evaluates the impact of disease and treatment on patients'physiological,psychological and social life.It has been widely used in many chronic disease evaluation systems in China.The assessment method is mainly a scale method,interview method,etc.It is a subjective evaluation index evaluated by the subject himself.This feature is consistent with the characteristics of allergic rhinitis characterized by subjective feelings of the patient and can be comprehensive,reliable and effective.In recent years,studies on the quality of life of children with allergic rhinitis have been increasing.But,there is no systematic evaluation of these studies currently.Meanwhile,qualitative interviews were used to explore the prevention and treatment needs of parents of children with allergic rhinitis.MethodsStudy one:After searching China National Knowledge Infrastructure(CNKI),Chongqing VIP Chinese Science and Tech-Journal of Beijing University of TraditionalChinese Medicine nology Periodical Database(VIP),Wanfang Data,PubMed,and Embase,all clinical literature linked to Quality of life in children with allergic rhinitis were included.We searched these from their inception to July 25,2017.Two authors independently screened for inclusion and extra data,which inconsistent content debated with the third author.The methodological evaluation of the study was determined according to the type of research.Evaluate the case-control study and cohort study by Newcastle Ottawa quality scale(the Newcastle-Ottawa Scale,NOS);for the valuation of the cross-sectional study,depended on the advises from United States health research and quality management organization(Agency for Health care Research and Quality,AHRQ);for the randomized clinical trials,the Jadad scale was used as the standard for evaluation.The meta-analysis of cross-sectional studies was conducted using R version 3.2.2 software,and STATA14 software used for the data(mean±SD).The Meta-analysis of case-control studies was finished using software with rate or odds ratio(OR)and 95%confidence interval(CI)as effect size.The high heterogeneity outcome indicators were carried out by using qualitative analysis.Study two:semi structured qualitative interview was applied in outpatient department of Pediatrics,Beijing Huimin children's Hospital and the Third Affiliated Hospital of Beijing University of Chinese Medicine.Through interviews with children and parents diagnosed as allergic rhinitis during the process of following up with clinical doctors,a continuous sampling method was used to interview the end of information saturation.The interview time was in November-2017 July 2017.The interview results are transcribed into text manuscripts and read through repeated reading to familiarize the data.On this basis,the subject analysis method is used to encode,form and summarize the topics.ResultsA total of 32 studies involving quality of life in children with allergic rhinitis were included.The quality of research published in English is relatively high,and the overall methodological quality of Chinese research is not high.The survey tool used 9 scales,the higher frequency were nasal conjunctivitis,life quality questionnaire RQLQ,children allergic rhinitis,nasal symptom score TSS,visual analogue scale VAS.The results of Meta analysis showed that the effect value of the total quality of life score was 4.36[95%CI(4.24-4.48)and Z=70.76]with a score of 0-6.The scores to 1-7 points for the evaluation criteria of Meta analysis showed that the influence factors of allergic rhinitis children's quality of life before three are nasal symptoms,behavioral and emotional problems,effect values were 1.22[95%CI(1.06,1.38),Z=15.19],1.05[95%CI(0.88,1.21),and 0.86[95%CI(Z=12.35]0.69,1.03),Z=9.99].A cross-sectional survey of 14 primary school students in two surveys suggested that allergic rhinitis had a negative effect on children's academic performance,sleep and daytime mental state.This study was conducted at the pediatric outpatient clinics of two Chinese medical institutions in Beijing.A total of 22 children with allergic rhinitis were selected.Because the children were young and had insufficient expressive ability,interviews were mainly conducted with their parents.The analysis included 10 topics including symptom performance,a priori,impatience,confusion,delayed treatment,experience,doctor's level,efficacy,safety applicability,and compliance.In the early stages of the onset of allergic rhinitis,children suffer from symptoms that resemble a cold.They are often treated as colds by parents and cannot obtain professional medical treatment in time.Allergic rhinitis affects the children's physical and mental health.There are symptoms other than nasal symptoms,including loss of appetite,sleep disturbances,dizziness,and headaches.At the same time,emotional changes such as irritable temperament and inability to concentrate can occur.Parents interviewed agree that Chinese medicine can fundamentally enhance physical fitness and reconcile the advantages of the body,but believe that this relationship is very much related to the level of Chinese medicine doctors themselves.The prevention and treatment needs of Chinese parents of allergic rhinitis children from low to high in order of:safety first;The typical symptoms of allergic rhinitis can be quickly and effectively relieved;the comfort of the child(paste is the preferred);a good Chinese medicine doctor who can be trusted to confirm the efficacy can fundamentally enhance the children's constitution and reduce the incidence of disease.ConclusionsThis study systematically evaluated the quality of life of children with allergic rhinitis and found that the incidence of males was higher in females than in females with allergic rhinitis;the overall quality of life of children with allergic rhinitis was lower than that of healthy children;nasal symptoms,behavior problems,and emotional problems were important to the quality of life of children with allergic rhinitis.Factors;Disease also affects the children's academic performance and focus on memory.Qualitative Interview Analysis Children in the early stages of allergic rhinitis can not get timely professional medical treatment because symptoms are similar to colds.Allergic rhinitis affects the children's physical and mental health.There are symptoms other than nasal symptoms,including loss of appetite,sleep disturbances,dizziness,and headaches.At the same time,emotional changes such as irritable temperament and inability to concentrate can also occur.In the absence of certain efficacy,massage and ointments are treatments that parents are willing to accept.If you meet a good doctor who is worthy of the trust of your parents,the compliance of your parents will increase a lot.In the future,more large-scale,high-quality clinical studies are still needed to provide more reliable data sources for systematic evaluation,and at the same time,to combine the needs and wishes of patients to provide more valuable evidence-based evidence for clinical diagnosis and treatment,so that children with allergic rhinitis are More comprehensive attention and treatment to improve their quality of life.