| Objective:This topic retrospectively analyzes the basic information,TCM patterns,clinical symptoms and signs,treatment methods and curative effects of children with MPP.To explore the effect of Tongluo method and related factors on the prognosis of MPP,furthermore summarize the clinical application and effectiveness of Tongluo method in treating MPP,in order to provide a reference for the clinical diagnosis and standardized treatment of MPP.Method:This is a retrospective analysis,children with MPP admitted to the pediatrics department of Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine from January 1,2017 to December 31,2017 were selected,and there is a total of 250 cases.Using Excel to record and organize the information,SPSS21.0for data statistics.The distribution characteristics of age,gender,disease season,main symptoms and signs,TCM patterns,hospitalization days,etc were observed by statistical methods such as Chi-squared test and nonparametric test.The factors affecting the prognosis of MPP were analyzed by Ordinal Logistic regression.Results:1.Basic situation:Among the 250 children with MPP,there were 122 cases of males and 128 cases of females,the ratio of male to female was 0.953:1;the age group consisted of 27 cases(10.8%)in early childhood 1 to 3 years old,152 cases(60.8%)in preschool age 3~+to 7 years old,and 71 cases(28.4%)of school age 7~+to 14 years old,3~+to 7 years old preschool children are more common group of MPP.The prevalence of MPP was mainly in the autumn(78 cases,31.2%)and winter(82 cases,32.8%).A total of 190 children with MPP had a history of pulmonary disease,most of them had pneumonia(158 cases,including 71 cases of MPP history).2.TCM pattern:Clinically,TCM pattern of MPP are mainly wind-heated pattern(176 cases,70.4%).Age has an effect on TCM pattern(?~2=16.975,P<0.05).Wind-heated pattern is more common in children aged above 3 years,and phlegm-heated pattern is more common in children aged 1 to 3 years.The onset season has an impact on TCM pattern(?~2=9.565,P=0.023).Wind-heated pattern is more common in spring and summer,and phlegm-heated pattern is more common in autumn and winter.3.Clinical symptoms and signs:The first symptoms of children with MPP were cough(133 cases,53.2%),and the main symptoms of MPP were also cough(242 cases,96.8%),followed by phlegm obstruction(164 cases,65.6%).There were 82 children(32.8%)with fever at admission,mostly low fever(35 cases)and moderate fever(37 cases).The signs of lungs in children with MPP were mainly moderately moist voices(116 cases,46.4%)and fine moist voices(89 cases,35.6%).When the children with MPP were admitted to the hospital,their tonsils were mostly enlarged by?°(169 cases,67.6%).4.Laboratory indicators:In 250 children with MPP,there were 65 cases with MP antibody titer of 1:160,68 cases with a titer of 1:320,and 117 cases with a titer of1:640;WBC abnormalities(83 cases,22.4%),increased percentage of monocytes(109 cases,43.6%),elevated PLT(87 cases,34.8%),elevated CRP(61 cases,24.4%);abnormal myocardial enzymes(147 cases,58.8%)included 23 cases(85.2%)of 1 to 3 years old,91 cases(59.9%)of 3~+to 7 years old and 33 cases(46.5%)of 7~+to 14 years old.The younger the age,the more cases of abnormal myocardial enzymes(?~2=12.280,P=0.002).5.Treatment plan and curative effect:Among 250 children with MPP,139 cases(55.6%)of integrated Chinese and Western medicine with external treatment,58 cases(23.2%)of integrated Chinese and Western medicine,37 cases(14.8%)of Western medicine and external treatment,and 16 cases(6.4%)of Western medicine treatment.The age distribution of the four groups of treatments was different(?~2=15.739,P=0.001).The children in the western medicine treatment group were more to children from 1 to 3 years old,while the other three groups were mostly 3~+to 7 years old and 7~+to 14 years old.The gender composition of the four groups of treatments was different(?~2=8.120,P=0.044).There were more male patients in the Western medicine treatment group,and the other three groups were the opposite.The TCM patterns of the four groups of treatments were different(?~2=9.625,P=0.022).The Western medicine treatment group had more phlegm-heated pattern,while the other three groups were mostly wind-heated pattern.The therapeutic effects of the four groups of treatments were different(?~2=98.864,P=0.001).There was statistically significant difference(P<0.05)between the other groups except the Western medicine treatment combined with the external treatment group and the integrated Chinese and Western medicine treatment group.The curative effect of the treatment of children with integrated Chinese and Western medicine combined with external treatment(137 cases,98.6%)was significantly more than the other three groups.The hospitalization days of the four groups of treatments were different(?~2=42.701,P=0.001),and the number of hospitalization days with less than 7 days for children with integrated Chinese and Western medicine combined with external treatment(127 cases,91.4%)was more than the other three groups.6.Factors affecting prognosis of MPP:Treatment plan(all?smaller than 0,all OR smaller than 1)and pre-hospital use of traditional Chinese medicine(?=-1.038<0,OR=0.354<1)are protective factors affecting prognosis.Exceptional CRP index(?=0.977>0,OR=2.656>1)and elevated PLT index(all?larger than 0,all OR larger than 1)are risk factors for prognosis.Using the Western medicine treatment group as comparison,the curative effect of the integrated Chinese and Western medicine with external treatment group is 6.425 times better,the curative effect of the integrated Chinese and Western medicine treatment group is 2.319 times better,the curative effect of the Western medicine treatment combined with the external treatment group is 2.218 times better.Conclusion:There is a certain rule in the pathogenesis of MPP.The combination of TCM and Western medicine is the best.The treatment plan,pre-hospital use of traditional Chinese medicine,CRP and PLT are all factors influencing the prognosis of MPP. |
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