| Research BackgroundThe infection problem of patients with blood diseases is related to the therapeutic effect and quality of life of chemotherapy or transplantation.Therefore,prevention,control and treatment of infection is a vital part of improving patient survival,but acute leukemia patients have a higher incidence of infection than other types of blood diseases.At present,there is still a lack of literature on the treatment of perianal diseases in children with acute leukemia.However,once an anal infection occurs,such as hemorrhoids and anal fissures,the child needs immediate treatment.Especially in the chemotherapy or inhibition period,granulocyte deficiency,immunity is extremely low,mild skin ulceration is easy to induce systemic infection,which puts certain requirements on the healing time and healing degree of the child's rupture.In the clinic,the types of drugs available for Western medicine are limited.The use of disinfectant preparations and antibiotics has the defects of slow wound healing and drug resistance,and the curative effect is not clear.The healing time is valuable for children with hematological diseases.Local problems are not well resolved in the early stage of the disease,the condition is not controlled,and the extension of the hospitalization period will bring more risk of nosocomial infection,and the child can not afford it.so,alleviating symptoms,controlling infection,and accelerating healing are the common aspirations of many hematologists and their families.In the follow-up observation of outpatient cases in 2 years,we found that the current anal maintenance program based on Quhuangtang is gradually replacing the iodophor and potassium permanganate used by western medicine.It has penetrated the anal protection and symptoms of patients with blood diseases before and after chemotherapy transplantation.The whole process of treatment and infection control has received satisfactory results in the treatment of localized injuries such as severe perianal infection and skin ulceration in children with leukemia.Therefore,this study focuses on clinical features,treatment methods,and efficacy comparisons.It aims to explore the safety and benefit of integrated Chinese and Western medicine treatment in the treatment of anal fissures in special populations,and provide more possibilities for the choice of clinical treatment methods.This study is the first attempt in the field of pediatrics in terms of disease population,disease types,and treatment options.It is expected to bring practical solutions to children and their families with acute leukemia.ObjectiveThe study used the method of bibliometrics to sort out and explore the research trends,research status and research hotspots in the field of acute leukemia with perianal infection,and analyze the current research situation.Through clinical exploratory research,the acute anal fissure in children with acute leukemia is taken as the entry point to understand the relevant clinical features,and to observe the differences in wound healing time and total effective rate between children with acute leukemia under the different treatment modes,aiming to highlight the therapeutic effect of traditional Chinese medicine in acute illness in high-risk population.We also want to form a standardized,clinically operable,easy to promote clinical treatment program.MethodUsing China Knowledge Network,Wanfang Database and Weipu Database as data sources,the literature is filtered according to the standard of nano-discharge.Then use NoteExpress to calculate the distribution of literature years,journals and high frequency keywords.Finally,the Excel table is used to calculate the patient's gender,age,research purposes and methods,observation indicators,and drug use.Through retrospective cohort study,we are in the anorectal clinic of Xiyuan Hospital from July 1,2017 to January 31,2019,and the Yanda Daopei Hematology Hospital of Hebei,Beijing Bayi Children's Hospital,Beijing jingdu Children's Hospital,Screening of cases of acute leukemia diagnosed as acute anal fissure in hospital.According to the exposure factor(receiving the treatment of phlegm)divided into two groups.The treatment method of the exposed group is the combination of scorpion venom soup and western medicine.The treatment method of the exposed group is the traditional treatment of scorpion venom soup combined with western medicine,while the non-exposed group treatment method is only the conventional treatment of western medicine.Then we collect the general information,the characteristics of the relevant clinical symptoms,and follow up the medication and the therapeutic effect.Taking the treatment time of the first medication as the starting point,the time of administration of this cohort was stopped as the end point,and the total effective rate was evaluated as the efficacy evaluation index,and the clinical efficacy evaluation was performed.Result(1)Using bibliometrics to sort out the problem of perianal infection in acute leukemia,we have a preliminary understanding of the research trends and research profiles in this field in the past 30 years.Research trend:After deduplication and screening,a total of 65 articles were retrieved,including 38 clinical observations,19 nursing foundations,and 8 case reports.From 1990 to 2018,the research trend showed an overall upward trend,especially after 2011.The publication of the literature is mainly journals,accounting for 95%,but the core journals contain less text.Through the statistics of research content and high-frequency keywords,the focus of attention on acute leukemia perianal infection is mainly focused on nursing and prevention.Research Overview:A total of 4095 patients were included in 38 clinical observation articles.Except for the unspecified gender grouping,1906(56%)males and 1481 females(44%),male:female=1.28:1.The age distribution spans 1-87 years old,and this disease can occur in all age groups,but most people over 20 years old.The research method is mainly grouped,accounting for 92%,The study focused on treatment(57%)and prevention(42%),while the observations were related to the purpose of the study.The top 3 were followed by effective(48%),infection(37%),and symptom improvement(5%).Statistics on the trends of drug use in different years can be seen in the literature on the lack of drug use during the period 1990-2006,but since 2007,the types of drugs and treatment methods have gradually increased,among which sterilization and disinfection agents and antibiotics are the most frequently used.The use of Chinese medicines is also high,but the use of traditional Chinese medicine decoctions is relatively low.(2)In the clinical research section,we have a general understanding of the clinical features of 48 patients with acute anal fissure in acute leukemia,and a positive evaluation of the efficacy of the two ways.Clinical features:Among the children with acute anal fissure,31 patients with school age(over 7 years old)are mostly.While there are 30 males,and 18 females,males:females 1.66:1.Anal fissure is 71%caused by constipation,21%of normal stool,8%of diarrhea.The location of the gap is mostly in the medianl(6 and 12 o'clock),and is also scattered in the oblique position(5,7 and 9 o'clock).Pain is the main manifestation of anal fissure in children,with a small amount of bleeding,or a combined infection.Efficacy evaluation:In terms of total efficiency,the Chinese and Western medicine group was effective in 26 cases and ineffective in 1 case,with a total effective rate of 96.3%;While the Western medicine group was effective in 12 cases,ineffective in 9 cases,and the total effective rate was 57.1%.The difference between the two groups was statistically significant(P=0.000).In the comparison of cure rates in different time periods,the Chinese and Western medicine group recovered 9 cases within 7 days,18 cases recovered within 14 days,and 25 cases recovered within 14 days.The Western Medicine Group recovered 2 cases within 7 days,4 cases recovered within 14 days,and 5 cases recovered within 14 days.There was no significant difference in the cure rate between the two groups at different time points(P>0.05).There was significant statistical difference between the two groups at 14 days and 14 days(P<0.05).The time of pain disappearance was 4.00±2.29 days in the Chinese and Western medicine group and 6.20±2.85 days in the western medicine group.The difference was statistically significant(P<0.05).ConclusionCompared with western medicine alone,the total effective rate of the integrated Chinese and Western medicine group and the wound healing rate at different time points are higher,and the curative effect is more remarkable,which highlights the role of traditional Chinese medicine in the treatment of acute diseases.In the western medicine group,16 patients were converted to traditional Chinese medicine treatment due to healing problems,while only one patient in the Chinese and Western medicine group was converted to western medicine alone,which shows that the curative effect of the Chinese and Western medicine treatment group is more accurate,the patient's medication tolerance is higher,and the acceptance is better. |
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