| Objective:1.To explore the clinical characteristics and TCM syndrome elements distribution of children’s vocal tic disorder,and summarize its core pathogenesis,so as to provide reference for clinical syndrome differentiation;2.Summarize the medication rules of children’s encephalopathy clinic in our hospital for the treatment of children’s vocal tic disorder.Method:1.Research on syndrome elements of traditional Chinese medicine: a retrospective study was conducted to collect 175 cases of children who met the criteria of Na Pai(1)Clinical features: the general information,four diagnosis information,clinical classification,course of disease,severity of disease and other data were collected and entered into EXCEL form for frequency analysis.(2)Distribution characteristics of syndrome elements: according to the "syndrome elements scale" in Zhu Wenfeng’s "syndrome elements syndrome differentiation",we developed a clinical questionnaire,entered the four diagnostic information and extracted the syndrome elements to establish the syndrome elements distribution database,and used spss26.0software to summarize the distribution characteristics of TCM syndrome elements of children’s vocal tic disorder,and analyzed their relationship with age,clinical classification,course of disease,clinical symptoms and signs The relationship between the severity of the disease.2.Research on medication rules: 224 prescriptions of effective medical records in Study 1were selected,and the TCM inheritance platform(v2.5)was used to analyze the frequency of prescription category,drug frequency,drug flavor channel and drug type,and the data mining methods such as association rules and complex entropy clustering were used to summarize the medication rules of effective prescriptions for children with vocal tic disorder.Result:1.Clinical features(1)Gender and age:(1)133 cases(76%)were male and 42 cases(24%)were female.The ratio of male to female was 3.16∶1.(2)There were 89 cases(50.9%)aged 3-7 years old,73cases(41.7%)aged 8-12 years old,and 13 cases(7.4%)aged 13-16 years old.(2)Clinical classification: TTD 64 cases(36.6%),CTD 14 cases(8%),TS 97 cases(55.4%);TS accounted for the largest proportion.(3)Course of disease: 64 cases(36.6%)were less than 1 year,55 cases(31.4%)were 1-3years,56 cases(32%)were more than 3 years.(4)The severity of the disease: 29 cases(16.6%)were mild,137 cases(78.3%)were moderate,9 cases(5.1%)were severe.(5)Vocal symptoms: mainly clear throat;The second was hum,hum,snort,gasp and foul language;Voice,ah voice,dry cough,imitation,cackle,sigh and shout were less.(6)TCM physical examination: the majority of the tongue was light red tongue 165cases(94.2%),the majority of the tongue was white tongue 128 cases(73.1%),the majority of the normal cases 125cases(72.2%)in pharynx physical examination,followed by 47cases(26.2%)with slightly red pharynx.2.Distribution of syndrome elements(1)Results: 125 cases of liver > 66 cases of lung > 52 cases of Wei Biao > 30 cases of spleen > 24 cases of heart > 9 cases of kidney > 3 cases of chest diaphragm.The most common syndrome element was liver,followed by lung and Wei Biao.(2)Correlation between disease location and syndrome elements and other factors:(1)disease location and age: the proportion of health exterior syndrome elements in 3-7 age group was significantly higher than that in the other two age groups(P < 0.05).(2)Location and clinical classification: liver is the main syndrome element in different types of children with vocal tic disorder,followed by lung or Weibiao.(3)Location and severity of the disease: the main location of mild to moderate children was liver,followed by lung or health surface;The main location of severe cases was liver,followed by heart and spleen;There was a significant correlation between syndrome elements and the severity of the disease(P < 0.05).With the aggravation of the severity of the disease,the number of children with syndrome elements in the liver increased significantly.(4)Location and course of disease: in children with a course of less than 3 years,the main location of disease was liver,followed by lung or surface;The patients with more than 3 years of disease were mainly liver,followed by lung and spleen;The distribution frequency of Weibiao syndrome elements in children with disease course more than3 years was significantly lower than that in children with disease course less than 3 years(P <0.05).(3)Statistical results of disease syndrome elements frequency: 67 cases of yin deficiency >61 cases of qi stagnation > 57 cases of dynamic wind > 47 cases of phlegm > 46 cases of external wind = 46 cases of Yang Hyperactivity > 45 cases of blood deficiency > 40 cases of qi deficiency > 37 cases of cold > 20 cases of heat > 7 cases of Yang deficiency > 5 cases of dampness > 3 cases of dryness = 3 cases of Fugu.The most common disease syndrome elements were Yin deficiency,qi stagnation and dynamic wind,followed by phlegm,external wind,yang hyperactivity,blood deficiency and Qi deficiency.(4)Correlation between syndrome elements of disease nature and other factors:(1)disease nature and age: there was no statistical difference in the distribution of syndrome elements of disease nature in different age groups,P > 0.05.(2)Disease nature and clinical classification: Yin deficiency and qi stagnation syndrome elements were more distributed in the three clinical types;In addition,the distribution of external wind syndrome elements in TTD,phlegm syndrome elements in CTD and dynamic wind syndrome elements in TS was also more.(3)Disease nature and disease severity:The distribution of Qi stagnation syndrome was more in different disease severity;most of the mild cases were exogenous wind syndrome elements;Yin deficiency syndrome is the main factor in moderate and severe children;There was a significant correlation between the syndrome elements of yin deficiency and yang hyperactivity and the severity of the disease(P < 0.05).(4)Disease nature and course: Yin deficiency and qi stagnation syndrome elements were more distributed in children with different course of disease;The distribution of wind syndrome elements in children with disease course less than 1 year was also more;The distribution of dynamic wind and phlegm syndrome elements was also more in children with a course of more than one year.3.Analysis of medication rule(1)Statistics of nature,taste and meridian tropism: in 224 effective prescriptions,the four Qi were mainly cold,flat and warm,the five flavors were mainly bitter,sweet and pungent,and the meridian tropism was mainly lung and liver meridians.(2)Statistics of drug types: heat clearing drugs(27%),liver calming and wind calming drugs(17%)and exterior relieving drugs(14%)were in the majority,followed by phlegm resolving,cough relieving and asthma relieving drugs(11%),deficiency tonifying drugs(9%),Qi regulating drugs(7%)and sedative drugs(5%).(3)Meridian classification of antipyretic drugs: antipyretic drugs mainly focus on the heat of lung,stomach and liver channels.(4)Prescription usage: the most frequently used prescriptions were Xifeng Zhidong Decoction(72 times),Yinqiao Powder(57 times),Chaihu jialonggumuli Decoction(35 times),Ditan Decoction(32 times).It reflects the main treatment methods of calming the liver,calming the wind and stopping spasm,dispersing wind and clearing away heat,invigorating the spleen and eliminating phlegm,reconciling Shaoyang and calming the nerves in the treatment of children’s vocal tic disorder.(5)Through the analysis of association rules,the commonly used drug pairs with strong correlation and certain clinical significance are: Jinguolan Shegan Xuanshen pangdahai,Longgu oyster.(6)Through the analysis of new prescriptions,seven new prescriptions were obtained,which reflected the principles of regulating qi,dispersing wind and clearing lung,dispersing liver and purging heat,nourishing lung and stomach,strengthening spleen and replenishing qi.Conclusion:(1)TS was the most common clinical type in 175 children with vocal tic disorder,and the severity was mostly moderate.Clearing the throat was the most common symptom.(2)Through the study of syndrome elements,the location of the disease is mainly in the liver,often involving the lung and the surface of the body;The main syndrome elements are yin deficiency,qi stagnation and dynamic wind,often involving phlegm,external wind,yang hyperactivity,blood deficiency and Qi deficiency;Its pathogenesis can be summarized as follows: at the beginning of the disease,the external pathogens attack the lung and lead to liver wind;When the disease is serious,it is mainly liver depression and heat,Yin fluid consumption,yin deficiency and yang hyperactivity,and throat dystrophy.(3)The treatment of children’s encephalopathy in the outpatient department of our hospital is mainly based on the liver and lung.The methods of calming the liver,calming the wind and stopping spasm,dispersing the wind and clearing away heat,invigorating the spleen and expelling phlegm,reconciling Shaoyang,and calming the nerves are reasonably used.The addition and subtraction of drugs are often accompanied by the products of Liyan,Liqi and Jieyu,so good results are obtained. |
PDF Full Text Request