| Objective:A common disease of adenoidal hypertrophy,hypertrophic adenoids cause mechanical compression of the eustachian tube,adenoids act as a "saving pool" for bacteria and release inflammatory mediators.Through the tympanic pressure curve,adenoids can be observed to cause middle ear function.influences.If the middle ear is in a negative pressure state,the leakage of fluid may cause the development of secretory otitis media.Adenoid hypertrophy is also the most common complication of secretory otitis media.Secretory Otitis Media(SOM)is a high-risk disease in children.Prolonged unhealed disease can affect children's hearing,and can also lead to children's growth retardation.Surgical treatment is often used in the treatment of children with adenoid hypertrophy and SOM.However,there is no reliable evidence-based medical evidence for surgical treatment,and there is a risk of postoperative complications.Because of the taste of traditional Chinese medicine,it is difficult for children to adhere to treatment for a long time,which brings difficulties for treatment.Leading Professor Sun Shuchen,under the guidance of many years of clinical experience,combined with modern medicine,created the "Sun's Sequential Therapy"(SST)in the TCM external treatment method,which can avoid surgery without oral Chinese medicine.To make the child and parents acceptable during the treatment.Purpose:To study the effect of adenoid hypertrophy on middle ear function and the observation of whether or not to accompany SOM.An analysis of the TCM syndrome type was performed on the collected children.For children with a tympanic pressure curve of type B,the "SST" method was used to observe the curative effect.Method:A sonographic examination was performed on children diagnosed with adenoid hypertrophy and with ear discomfort.According to the "Consensus of Traditional Chinese Medicine Diagnosis and Treatment of Children with Adenoid Hypertrophy",the children with adenoid hypertrophy and SOM were divided into four syndromes.According to the syndrome differentiation,the obtained prescription was treated by fumigation + nose.The tympanic pressure curve was reviewed twice a week for a maximum observation period of 12 weeks.Result:In 57 children with adenoid hypertrophy,47 patients were 2-6 years old,accounting for 82.46%of all children.Among them,the trend is rising from 2 to 4 years old,reaching the highest peak at 4 years old,and then showing a downward trend.Of the 57 children with adenoid hypertrophy,30(52.63%)had moderate hypertrophy and 27(47.37%)had severe hypertrophy.There was no difference in the distribution of A,C,and B tympanic pressure curves between the moderate and severe adenoids(P>0.05),while the adenoid moderate and severe hypertrophy did not differ in the incidence of SOM(P).>0.05).Among the 57 children observed,the morphology of the adenoids under nasal endoscopy can be divided into bergamot type,mulberry type,and swollen type.Among them,16 cases(28.07%)were bergamot type,28 cases(49.12%)were mulberry type,and 13 cases(23.81%)were swollen type.There was no difference in the distribution of four adenoids in type A,type C and type B(P>0.05).The four adenoid morphology were not distributed in the tympanic pressure curve for the distribution of B-type and non-B-type tympanic pressure curves.Difference(P>0.05).Among the 57 types of syndromes of adenoid hypertrophy,the number of syndromes of lung spleen qi deficiency was the highest,23 cases(40.34%),and 22 cases of lung and kidney yin deficiency(38.60%).Six cases(10.53%)of phlegm and blood stasis syndrome were found in 6 cases(10.53%).There were differences in the incidence of SOM among the four TCM syndromes(P<0.05),the incidence of qi and blood stasis syndrome was 83.33%,the incidence of phlegm and blood stasis syndrome was 66.67%,the lung and kidney yin deficiency was 31.80%,and the lung spleen qi deficiency was 26.10%..57 children with adenoid hypertrophy were found to have deficiency of lung spleen qi deficiency syndrome and lung yin deficiency syndrome,qi and blood stasis syndrome and phlegm and blood stasis syndrome.The deficiency syndrome and evidence showed significant difference in SOM incidence rate(P=0.01),the incidence of deficiency syndrome was 28.89%,and the empirical incidence rate was 83.33%.The tympanic pressure curve of 57 patients with adenoid hypertrophy was 23(35 ears)with type B,and the age ranged from 2 to 9 years old with an average age of 4.43 years.The efficacy of SST external treatment was observed in this group of patients.The observation period was 2 weeks,and the longest observation period was 12 weeks.The cure rate was 17.14%in 2 weeks,22.86%in 4 weeks,28.57%in 6 weeks,34.29%in 8 weeks,37.14%in 10 weeks,and 40%in 12 weeks.The total effective rate of treatment was 31.43%in 2 weeks,54.29%in 4 weeks.65.71%in 6 weeks,65.71%in 8 weeks,74.29%in 10 weeks,and 77.14%in 12 weeks.There was no difference in the cure rate between adenoid and moderate hypertrophy(P>0.05),and there was no difference in total effective rate(P>0.05).There was no difference in the cure rate between the four adenoids(P>0.05),and there was no difference in the total effective rate(P>0.05).There was no difference between the deficiency rate and the actual cure rate(P>0.05),the total effective rate was different(P<0.05),the total effective rate of deficiency syndrome was 90%,and the total effective rate was 60%.Of the 23 patients,19(82.61%)were children who had been treated with Western medicine for more than two weeks without adenoid hypertrophy with SOM.A total of 31 ears were found in 19 patients.The type B was 31 ears before treatment.After treatment,B type 7 and type A 2 ears,AS type 11 ears,and C type 11 ears.The cure rate increased with the treatment time.The cure rate was 19.35%in 2 weeks,the cure rate was 22.58%in 4 weeks,the cure rate was 29.03%in 6 weeks,the cure rate was 35.48%in 8 weeks,and the cure rate was 38.71%in 10 weeks.The cure rate during the week was 41.94.The total effective rate was 25.81%in 2 weeks,54.84%in 4 weeks,64.52%in 6 weeks,64.52%in 8 weeks,74.19%in 10 weeks,and 77.42%in 12 weeks.Conclusion:1.Adenoids are greater than 1/2 and above,and there is no difference in the effect of adenoid size on the tympanic pressure curve.2.Adenoids were greater than 1/2 and above,and there was no difference in the effect of adenoid morphology on the tympanic pressure curve.3.The proportion of deficiency syndrome(78.95%)in children with adenoid hypertrophy was higher than that of the evidence(21.05%).4.60%of children with adenoid hypertrophy have SOM associated with SOM.In the evidence,90%of children are associated with SOM.The proportion of SOM associated with evidence is higher than that of deficiency syndrome.5.SST external treatment for adenoid hypertrophy with SOM children with cure rate and total effective rate and adenoid size and morphology.6.The SST external treatment method has a cure rate of 40%for adenoid hypertrophy with SOM,and the total effective rate is 77.14%,which is consistent with the reported therapeutic effect of western medicine.Among the collected cases,88.57%of the children had not healed by western medicine intervention(more than two weeks),and this method still had good curative effect.7.SST external treatment for adenoid hypertrophy with SOM children with deficiency syndrome is better than empirical treatment. |
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