The Real World Research On The Characteristics Of Jingxin Zhidong In The Treatment Of TD Based On The Constitution And The Influence Of Allergy Factors

Study 1:The real world research on the medication characteristics of Jingxin Zhidong prescription in the treatment of Tic Disorder based on the constitution of TCMObjective:This study analyzed Professor Han Fei’s medication characteristics of Jingxin Zhidong prescription for the treatment of Tic Disorder(TD)children with different constitutions using the method of data mining.In addition,summarized and refined her academic thought of treating TD from the heart and the characteristics of treating TD from body discrimination.Methods:This study collected children diagnosed with TD from November 1,2021 to July 30,2022,who were admitted to Professor Han Fei’s outpatient Department of Pediatrics,Guang’anmen Hospital,China Academy of Chinese Medical Sciences.Data were collected for cases meeting the inclusion and exclusion criteria,including demographic characteristics,disease characteristics,initial symptoms,comorbidities,TCM constitution and TCM syndrome types.Different constitutions were recorded into the Traditional Chinese Medicine Inheritance Support System(V2.5),frequency analysis,TCM flavor normalization analysis,association rule analysis,and cluster analysis and were used to find that Professor Han had different drug frequency,flavor,normalization and efficacy classification in the treatment of children with different constitutions of TD,so as to summarize Professor Han’s unique body regulation medication methods.Results:1.General information of TD cases:Among TD cases included in this study,there were 335 male children(74.28%)and 116 female children(25.72%);The mean age was 9.26±1.89 years old;There were 103 cases(22.84%)of PTD,161 cases(35.70%)of CTD and 187 cases(41.46%)of TS.The severity was mainly mild in 230 cases(51.00%)or moderate in 211 cases(46.78%).Average YGTSS total score 27.25±8.37;128 patients(28.38%)suffered from other neuropsychiatric diseases,of which 101 cases was ADHD(22.39%).177 cases(39.25%)suffered from allergic diseases,of which 150 cases(33.26%)were allergic rhinitis.The mean age of onset was 6.75±1.91 years.The most common first symptom was eye twitching in 261 cases(57.87%),followed by throat clearing in 64 cases(14.19%).The most common type of TCM constitution was balanced constitution in 148 cases(32.82%),followed by qi stagnation constitution in 124 cases(27.49%)and yin-deficiency constitution in 49 cases(10.86%).The most common constitution of TD children with allergic diseases was balanced constitution in 46 cases(25.99%),followed by qi stagnation constitution in 45 cases(25,42%)and inherited special constitution in 31 cases(17.51%).The most common constitution of TD children with allergic rhinitis was balanced constitution in 36 cases(24.00%),followed by qi stagnation constitution in 42 cases(28.00%)and inherited special constitution in 29 cases(19.33%).The most common type of TCM syndrome was liver and lung wind-heat syndrome in 219 cases(48.56%),followed by lung and spleen deficiency syndrome in 102 cases(22.62%).2.Analysis of drug frequency:The top 15 drugs in the initial prescription of TD children with nine different constitutions all included Suanzaoren,Jiangcan,Chaihu,Gaoben and Xinyi.Baiziren and Baiqian were used more often in balanced constitution children.Xiakucao and Muzei were used more often in qi stagnation constitution children.Baijili,Taizishen,Gouqi,Cangzhu,Shouwuteng,Hehuanpi and Baiziren were used more often in qi-deficiency constitution children.Shihu was used more often in yin-deficiency constitution children.Baiqian,Tianma,Xuanfuhua,Baiziren was used more often in phlegm-dampness constitution children.Dangshen was used more often in yang-deficiency constitution children.Xiakucao,Bohe were used more often in dampness-heat constitution children.Baiqian and Shihu were used more often in inherited special constitution children and the frequency of Xinyi and Baizhi were relatively high.The frequency of Chuanxiong was relatively high in blood stasis constitution children.3.Classification and analysis of efficacy of traditional Chinese medicine:The initial prescription of nine kinds of TD children with different constitutions mainly used sedative drugs,antipyretic drugs and peaceful liver drugs.There was a great difference in the frequency of heat-clearing drugs and deficient-reinforcing drugs in children with different constitutions.The frequency of heat-clearing drugs was lower in children with yang-deficiency constitution and qi-deficiency constitution,while the frequency of deficient-reinforcing drugs was lower in children with phlegm-dampness constitution and dampness-heat constitution.4.Regression analysis of TCM flavor and normalization:The initial prescription of nine kinds of TD children with different constitutions mainly used warm,cold and calm drugs.But the proportion of warm and cold drugs in children with different constitutions were different.The proportion of warm drugs in yang-deficiency constitution and qi-deficiency constitution were significantly higher than cold drugs,and the proportion of cold drugs in dampness-heat constitution was significantly higher than warm drugs.The primary prescription of nine kinds of TD children with different constitutions mainly used octyl,bitter and sweet drugs,among which the frequency of sweet drugs was higher than bitter drugs in yang-deficiency constitution and qi-deficiency constitution children.TD children with nine kinds of constitutions were mainly used drugs in liver,lung,stomach and heart normalization.5.Analysis of association rules of traditional Chinese medicine:Jiangcan had been used in the initial prescription of TD children with nine different constitutions.The most commonly used drug combination was Suanzaoren,Baizhi and Chaihu except Jiangcan.In balanced constitution,Jiangcan and Suanzaoren were used in all the children,the most commonly used drug combination was Baizhi and Chaihu except the two drugs.In qi stagnation constitution,Jiangcan was used in all the children,the most commonly used drug combination was Manjingzi and Chaihu except Jiangcan.In qi-deficiency constitution,Jiangcan,Suanzaoren and Chaihu were used in all the children,Gouqi and Xinyi was the most commonly used drug combination except the three drugs.In yin-deficiency constitution,Jiangcan and Suanzaoren were used in all patients,Muhudie and Chaihu was the most commonly used drug combination except the two drugs.In inherited special constitution,Jiangcan,Suanzaoren,Chaihu and Xinyi were used in all the children,and the most commonly used drug combinations was Chuanxiong and Gaoben were except the four drugs.6.Cluster analysis of high-frequency drugs:The high-frequency drugs used in the initial prescription of nine combinations TD children included three categories:relieving wind and relieving spasmodic,nourishing heart and calming the mind,dispelling wind and enhancing nasal orifice.Compared the children with other constitutions,balanced constitution children used more drugs to ease the liver and soft the liver,qi stagnation constitution children used more drugs to clearing away heat and detoxifying and nourishing yin and promoting fluid,qi-deficiency constitution used more drugs to tonify the qi and blood,yin-deficiency constitution children used more drugs to nourish the liver and kidney,inherited special constitution children used more drugs to dispel wind and relieve pain.Conclusion:1.Most children with TD have a tendency of constitution bias,qi stagnation constitution is the most common bias constitution in TD children,qi-deficiency constitution,yin-deficiency constitution,inherited special constitution are also important bias constitution in TD children.2.Professor Han has her own recommendations and abstentions in treating TD children with different constitutions.She pay attention to the balance of cold and heat,tonic and tonic drugs.She treated TD with the basic principles of calming the mind,calming the wind and promoting lung.Used drugs from heart,liver and lung which mainly include heart-nourishing and mind-calming,wind-relieving and spasmodic,wind-dispelling and nasal orifice.Suanzaoren,Jiangcan,Chaihu and Baizhi were the core drugs of Jingxin Zhidong prescription.3.Professor Han attaches great importance to the method of "treating diseases and regulating constitution".On the basis of calming the mind,calming the wind and promoting the lungs,qi stagnation constitution children were given drugs for clearing heat and detoxifying and nourishing Yin and promoting fluid,qi-deficiency constitution children were given drugs for invigorating qi and blood,yin-deficiency constitution children were given drugs for nourishing liver and kidney,and inherited special constitution children were given drugs for removing wind and relieving pain,formed a unique modality of drug use.Study 1:The real world research on allergy-related factors for Jingxin Zhidong prescription treatment of tic disordersObjective:In this study,we compared the expression levels of MBP,ECP,EPX and MMP-9 in peripheral blood of children in TD group and non-TD group,children in TD group before and after Jingxin Zhidong prescription treatment,children in TD group with and without allergic diseases and children with different TCM constitutions.Observed the differences of the four indexes in TD children and the changes of the indexes after Jingxin Zhidong prescription treatment.Analyzed the correlation between four indexes and the age,gender,constitutions and severity of YGTSS with TD children.Methods:Children with TD and without TD who met the inclusion and exclusion criteria were enrolled in the pediatric clinic of Guang ’anmen Hospital,China Academy of Chinese Medical Sciences from August 1,2021 to October 31,2022.The expression levels of MBP,ECP,EPX and MMP-9 in peripheral blood were detected.The YGTSS score of TD children was evaluated.Compared expression levels of four indicators among the children in TD group and non-TD group,children with and without allergic diseases in TD group and children with different constitutions with allergic diseases in TD group.Analyzed the correlation between four indexes and the age,gender,constitutions,severity of YGTSS and with or without allergic diseases of TD children.Results:1.There was no statistical difference in the gender and age composition of the two groups and they were comparable.2.The level of MBP,EPX and MMP-9 in the TD group was higher than that in the non-TD group.The MBP level of children with allergic diseases was higher than that of children without allergic diseases.The expression levels of MBP,ECP,EPX and MMP-9 had no significant correlation with gender,age,YGTSS scores and TCM constitutions.3.After 12 weeks of treatment with Jingxin Zhidong prescription,the total effective rate was 77.27%,among which the total effective rate was 69.23%in children with allergic diseases and 88.89%in children without allergic diseases.All the children showed no abnormal liver and kidney function and routine results of urine after treatment,and no obvious adverse reactions occurred during treatment.4.After 12 weeks of Jingxin Zhidong prescription treatment,the levels of MBP,EPX and MMP-9 in TD group were significantly lower than before,but still higher than those in non-TD group.The levels of MBP,EPX and MMP-9 in TD children with allergic diseases were significantly higher than those without allergic diseases.There was significant correlation between EPX level and TCM constitution classification after treatment.Conclusion:1.The results showed that the levels of MBP,EPX and MMP-9 in peripheral blood of children with TD were higher than those of children without TD.The level of MBP in peripheral blood of children with allergic diseases was higher than that of children without allergic diseases.It is speculated that there are immune dysfunction and inflammatory reactions related to EO in TD children,especially in children with co-allergic diseases.2.After Jingxin Zhidong prescription treatment,the levels of MBP,EPX and MMP-9 in peripheral blood of TD children were lower than before,but still higher than those of non-TD children;The changes of four indexes were more significant in TD children with allergic diseases.After treatment,EPX level of children with different constitutions showed statistical difference.It was confirmed that Jingxin Zhidong prescription could regulate EO-related immune dysfunction and inflammatory response in children,which may be one of the effective targets of Jingxin Zhidong prescription in the treatment of TD.The reduction of serum EPX level was greatly influenced by constitution factors which worth further study.3.In this study,the total effective rate of Jingxin Zhidong prescription treatment was 77.27%,among which the effect of Jingxin Zhidong prescription on children without allergic diseases was better than that of children with allergic diseases,and no abnormal safety indicators were found in all children after treatment,which confirmed the effectiveness and safety of Jingxin Zhidong prescription in the treatment of TD.The decrease of total effective rate in this study compared with previous studies may be due to the following reasons:(1)Children could not timely return to the clinic due to epidemic factors;(2)During the epidemic period,more children were treated online,and there was a lack of face-to-face diagnosis processes;(3)The drug varieties were not complete and other reasons caused by epidemic factors.