Meta-Analysis On Effectiveness Of Integrated Traditional Chinese And Western Medicine On Episode Of Acute Bronchial Asthma In Children And Data Mining Of Clinical Medication Rules

Objective:To evaluate the clinical effectiveness of TCM in the treatment of episode of acute bronchial asthma in children by literature collection and Meta-analysis method.Meanwhile,the effective prescriptions in the clinical treatment of episode of acute bronchial asthma in children were collected and sorted out,with the application of the TCM Inheritance Assistance Platform（V2.5）to analyze and summarize the medication rules,so as to provide objective basis and ideas for the clinical treatment of episode of acute bronchial asthma in children.Methods:1.The literature on randomized controlled trials of TCM for the treatment ofepisode of acute bronchial asthma in children was searched by a comprehensive and systematic computerized search on databases such as CNKI,CBM,Wanfang,and Vipop Pubmed.The eligible literature was screened among the retrieved literature on the basis of predetermined inclusion criteria,and Meta-analysis was performed on the data in the included literature,then the literature quality was comprehensively evaluated by a modified Jadad rating scale,finally,the results of literature studies were statistically analyzed by Review Manager 5.4.2.Cases of episode of acute bronchial asthma in children subject to the inclusion criteria were collected from November 2020 to November 2021 at the Guoyitang outpatient clinic of Hubei University of Chinese Medicine,and then the data of cases were screened and sorted out,and imported into the TCM Heritage Assistance Platform（V2.5）.Firstly,the included prescriptions were input into “Prescription Management” under “Platform Management”,and established the database;secondly,the data on“Data Analysis” and “Statistical Reports” sections were statistically analyzed,including the frequency of drug use,drug types,drug classification,four natures,five flavours,and the basic information of prescription rules;finally,cluster analysis of the drugs was performed by SPSS Statistics 26.0 software to derive the prescription combinations.Results:1.Meta-analysisTotally 21 studies were involved,including 2210 children,where 1112 children in the integrated Chinese and Western medicine treatment group and 1098 children in the Western medicine treatment group.Meta-analysis results revealed that the integrated Chinese and Western medicine treatment group had better overall efficiency[RR=1.19,95% CI [1.13,1.25],P<0.00001],greater wheezing improvement [SMD=-2.40,95% CI [-3.43,-1.37],P<0.00001],shorter elimination time of wheezing rale [SMD=-1.94,95% CI [-2.29,-1.59],P<0.00001],and greater improvement of pulmonary function FEV1%[SMD=0.69,95% CI [0.27,1.11],P=0.001<0.05] than those in the Western medicine treatment group.2.Medication rules（1）In the study,there were 112 herbal medicines,where 20 medicines are used frequently greater than or equal to 30 times including ephedra,almonds,asarum,liquorice,polygonatum,dark plum,pinellia ternata,poria cocos,atractylodes macrocephala,aster,allium macrostemon,schischk,cinnamon twig,pericarpium trichosanthis,astragalus membranaceus,tangerine peel,radix pseudostellariae,lepidium seed,stemona,centipede;（2）The main types of medicines are drugs for treating exterior syndromes,expectorant cough suppressant and anti-asthmatic drug,and tonic medicine;（3）The four nature are mainly warm and calm,while the five flavours are mainly bitter and pungent;（4）The main meridian drugs are the lung meridian,followed by the spleen meridian and stomach meridian;（5）Analysis of high-frequency drug combinations revealed 19 drug combinations,where the top ten groups were:（1）dark plum,ephedra;（2）dark plum,almonds;（3）pinellia ternata,ephedra;（4）polygonatum,ephedra;（5）polygonatum,asarum;（6）polygonatum,almonds;（7）ephedra,asarum;（8）liquorice,ephedra;（9）ephedra,almonds;（10）liquorice,asarum.（6）The prescription medications were subjected to cluster analysis and classified into 3 types as follows: Type 1 included allium macrostemon,pericarpium trichosanthis,lepidium seed,aster,stemona,fructus aurantii immaturus,polygonatum,asarum,and polygala root;type 2 included poria,tangerine peel,pinellia ternata,schisandra chinensis,dark plum,cassia twig,radix paeoniae alba,schischk,radix angelicae,atractylodes macrocephala,astragalus membranaceus,and rhodiola rosea;and type 3 included liquorice,centipede,almonds,and ephedra.Conclusion:1.Meta-analysis results revealed that the integrated Chinese and Western medicine treatment group had better overall efficiency,greater wheezing improvement,shorter elimination time of wheezing rale,and greater improvement of pulmonary function FEV1% than those in the Western medicine treatment group.2.Medication rule: The study reveals the characteristics of Chinese medicine treatment and medication in the clinical treatment of episode of acute bronchial asthma in children,it can be concluded by data mining that the high-frequency drugs are mainly used to disperse lung to release exterior,resolve phlegm and relieve asthma,relieve respiratory distress by guiding Qi downward,and warm the lung to reduce watery phlegm;and lung,spleen,kidney and heart are the major places for treatment,whose treatments are nourishing the lung,strengthening the spleen and stomach,tonifying the kidney and calming the mind,and the prescriptions use cold and warm,hard and combined,attacking and tonifying together to promote the lung and relieve the symptoms and calm asthma.In the prescription,co-therapy of cold and warm,bitter and pungent and attack supplementation method are used to ventilate the lung for diaphoresis,resolve phlegm and relieve asthma;the commonly used drug combinations reveal the prescription rule with the treatments of dispersing and astringing,dispersing lung and downwading Qi,and resolving phlegm and relieving asthma.