Analysis Of The Risk Factors Of Kawasaki Disease Complicated With Coronary Artery Damage And Study On The Medication Rule Of Treating Qi Ying Burn Syndrome

Objective:1.To explore the risk factors of Kawasaki disease with coronary artery lesion.2.Based on the traditional Chinese Medicine Inheritance platform v2.5,summarize the medication rules of traditional Chinese medicine for the treatment of KD with Qi and Ying Type.Methods:1.The clinical data of 92 children with KD admitted to the First Affiliated Hospital of Guangzhou University of traditional Chinese medicine from January 2010 to December2020 were retrospectively analyzed,including age,gender,clinical symptoms,laboratory indicators and echocardiographic results.The meaningful variables selected by univariate analysis were subjected to multivariate logistic regression analysis to determine the independent risk factors for CAL in KD,and ROC curve was used to evaluate the predictive ability of different risk factors for CAL in children with KD and the best diagnostic cut-off value.2.Association rules and hierarchical clustering data analysis method were used to analyze the 76 selected prescriptions of traditional Chinese medicine.Association rules and hierarchical clustering were used to analyze 76 selected prescriptions of traditional Chinese medicine to count the frequency of traditional Chinese medicine use,nature and flavour,channel entry,meridian and core herbs combination.Result:1.A total of 92 patients with KD were included in this study,including 56 males(60.9%)and 36 females(39.1%),And the ratio of male to female was 1.56:1.The age of onset ranged from 3 months to 10 years.2.Compared with CAL and NCAL,PLT and hs-CRP were significantly different between the two groups(P<0.05),while WBC,NEU%,HGB,PCT,ESR,AST,alt,ALB,CK,CK-MB,LDH,Ig A,Ig M and Ig G were not significantly different between the two groups(P>0.05).3.Univariate analysis showed that gender,hs-CRP and PLT were significantly correlated with KD complicated with cal(P<0.05),while the other indexes were not significantly correlated with KD complicated with cal(P>0.05).Multivariate logistic regression analysis showed that male gender,significantly increased PLT and hs-CRP were independent risk factors for KD complicated with cal(P<0.05).4.The AUC values of area under ROC curve of hs-CRP,PLT and their combined detection(prediction probability)were 0.65,0.66 and 0.71,respectively.The diagnostic threshold values were 99.155 mg/L,521×10~9/L and 0.526,respectively.The sensitivity of predicting CAL in KD was 40.5%,37.8%and 48.6%,and the specificity was 89.1%,90.9%and 90.9%,respectively.5.There are 29 herbs with frequency≥10 times,among which the top 10 medicines are Among them,the top 10 herbs were Forsythia suspensa(58),Glycyrrhiza uralensis(58),Lophatherum gracile(47),Radix rehmanniae recen(44),Buffalo Horn(42),Scutellaria baicalensis(38),Moutan bark(37),Radix Paeoniae Rubra(37),Gypsum(33)and Radix scrophulariae(32).Based on the association rules,40 commonly used Chinese medicine combinations were obtained.The top three Chinese medicine combinations used more than20 times were"Buffalo Horn,Radix rehmanniae recen,Moutan bark","Buffalo Horn,Forsythia suspensa,Radix rehmanniae recen","Buffalo Horn,Forsythia suspensa,Radix Paeoniae Rubra".30 high-frequency Chinese medicine combinations were obtained,among which the Chinese medicine combinations with a confidence level of more than 95%were"Radix scrophulariae,Moutan bark→Buffalo Horn","Rhizoma anemarrhenae,Moutan bark→Buffalo Horn","Moutan bark→Buffalo Horn","Scutellaria baicalensis,Radix Paeoniae Rubra→Forsythia suspensa".Based on complex system entropy clustering,14core TCM combinations were obtained,and 7 new TCM prescriptions were obtained by hierarchical clustering.Conclusion:1.Male children,significantly increased PLT and hs CRP can be used as independent risk factors for CAL in KD.2.The combination of hs CRP and PLT regression model can improve the prediction ability of CAL in KD children.3.Most of the traditional Chinese medicine for treating KD Qi and Ying Type are bitter cold in nature and return to lung and stomach meridian.The main treatment methods are heat-clearing and cooling blood and invigorating circulation,and nourishing yin and promoting body fluid.The high-frequency traditional Chinese medicines used are Forsythia suspensa,Glycyrrhiza uralensis,Lophatherum gracile,Radix rehmanniae recen,Buffalo Horn,Scutellaria baicalensis,Moutan bark,Radix Paeoniae Rubra,Gypsum and Radix scrophulariae,etc.the compatibility between them constitutes the core combination for the treatment of Qi and Ying Type.