The Research Of Characteristic Of TCM Syndromes In Bronchiolitis Obliterans In Children

Bronchiolitis Obliterans(BO)is a respiratory disease caused by occlusion after bronchial injury,causing chronic airflow limitation.It occurs in children and post-transplant patients mostly.With the development of high-resolution CT,lung function and other examination techniques,more cases of BO have been reported.Now the coherent opinion of traditional Chinese medicine treatment of BO still stays at the level of trials of Qingfei Huatan anti-asthmatic Chinese medicine preparations.Literature reports are mostly empirical cases,lacking systematic and standardized evidences about mechanisation,principle,prescription,herbs and clinical efficacy analysis."Ling' nan Zhens Medical School of Miscellaneous Disease" has recently achieved curative effect on BO in children by TCM treatment.Based on the literature research,this study intends to use cross-sectional study to investigate the TCM characteristics of BO in children.A reference might be provided for further research.This paper is divided into two parts:literature research and clinical research.A.Literature researchObjectiveSort out the literatures on the TCM treatment of BO in recent years to extract relevant syndromes and treatment plans.MethodsBased on China National Knowledge Infrastructure Databases(CNKI),VIP Chinese Biomedical Journal Database and Wanfang Data,the research collects the TCM literatures about BO from January 2000 to January 2019.The extraction mainly involves TCM diagnosis,etiology,pathogenesis,syndrome differentiation,medication by methods according to TCM syndrome factor study and Chinese medicine diagnostics.Then the TCM literature database of BO would be established and analyzed to summarize the general knowledge of Chinese medicine treatment.Results(1)33 TCM literatures of BO are included in this study,involving 14 different TCM names.The most frequent disease names are wheezing disease(syndrome),cough,lung distension,Mapifeng and wheezing cough with pneumon ia.(2)In terms of basic pathogenesis factors,lung,spleen and kidney are the most frequent location factors,while blood stasis,phlegm and deficiency were the most frequent disease nature factors.(3)In terms of syndrome differentiation and classification,the syndrome types in literatures varies from 1 type to 12 types.After combining similar classification,it is found that syndrome of phlegm stasis trapping in lung appeared the most,followed by syndrome of phlegm-heat obstructing lung,syndrome of lung spleen kidney deficiency,syndrome of wind-heat invading lung,syndrome of lung and spleen deficiency.ConclusionNo TCM name for BO has been widely recognized.TCM mainly named BO by symptom or pathogenesis,most TCM names of BO are classified as wheezing disease(syndrome),cough and so on.Modern physicians have different views about the basic pathogenesis of BO,many think the disease attack lung mainly,relating to spleen and kidney.Blood stasis,phlegm and deficiency have the greatest influence in the disease development.We can deal with BO by syndrome differentiation,such as syndrome of phlegm stasis trapping in lung,syndrome of phlegm-heat obstructing lung,syndrome of lung spleen kidney deficiency,syndrome of lung and spleen deficiency,syndrome of wind-heat invading lung and so on.B.Clinical researchObjectiveThis study aims to analyze the clinical data of children with bronchiolitis obliterans by a cross-sectional study to summarize the distribution characteristics of TCM syndromes and provide a reference for "Ling' nan Zhens Medical School of Miscellaneous Disease",as well as for further studies.MethodsClinical data of children with BO admitted to Guangdong Provincial Hospital of TCM from February 2018 to February 2019 are collected to understand the general situation and the distribution characteristics of TCM syndromes.Results(1)In terms of basic data,46 cases were included in the study,including 35 males and 11 females,with a male-female ratio of 3.18:1.The average age is 30.52±30.31 months.(2)The main symptoms of bronchiolitis obliterans are cough,wheezing,sputum cough,nasal congestion and sneezing.The accompanying symptoms are poor sleep,loss of appetite and fecal change.The syndrome differentiation is divided into 20 cases for syndrome of lung spleen kidney deficiency,6 cases for syndrome of wind-cold attacking the lung,4 cases for syndrome of wind-heat invading lung,3 cases for syndrome of food stagnation and 13 cases for syndrome of spleen deficiency and liver hyperactivity.(3)In terms of auxiliary examination,pulmonary inflammatory changes and"mosaic-like" changes are the most frequently seen in high-resolution chest CT,other manifestations include bronchiectasis,fibrosis and pleural lesions.Etiology indicates that mycoplasma pneumoniae and adenovirus infection are the most.Lung function suggests obstructive or mixed,ventilationdysfunction.ConclusionBronchiolitis obliterans always occurs in infants and toddlers,more men than women.While the clinic is in remission,children still have different degrees of cough or wheezing,accompanying with poor sleep,loss of appetite and fecal change.The syndrome differentiation could be discussed from syndrome of lung spleen kidney deficiency,syndrome of wind-cold attacking the lung,syndrome of wind-heat invading lung,syndrome of food stagnation and syndrome of spleen deficiency and liver hyperactivity.