Analysis And Study On The Correlation Between The Clinical Characteristics Of 137 Cases Of Infantile Pneumonia And The Pathogenesis Factors Of Traditional Chinese Medicine

Purpose：In2013,the incidence of pediatric respiratory system diseasesincrease, because Shenyang and the surrounding area’s climate was dry, withthe addition of air pollution and haze. Pneumonia children who with both lungslarge shadows or multiple patch shadows in X-ray or CT of the lung were morethan in previous years. The study selected137pneumonia children cases whichthe results of the chest X-ray or lung CT indicated large shadows or multiplepatch shadows(both lungs)on admission or the first three days after admission,from all pediatric pneumonia cases of Liaoning university of traditional Chinesemedicine hospital pediatric hospital treatment during January2013-December2013.Retrospective study of137selected cases, summarized clinicalcharacteristics of pediatric pneumonia，such as the sex, age, clinical mainsymptoms, physical signs, laboratory examination, the disappeared time of lungrales, course of disease and symptoms of recovery phase, analyzed therelationship between clinical characteristics of children whose chest X-ray orlung CT indicated large shadows or multiple patch shadows(both lungs)in2013and traditional Chinese medicine (TCM) pathogenesis factors,to deepen theunderstanding of the disease, had clinical guiding significance.Material and method: The study selected137pneumonia children cases whichthe results of the lung X-ray or CT indicate both lungs large shadows or bothlungs multiple patch shadows on admission or the first three days after admission.According to the results of the chest X-ray or lung CT, the137cases were dividedinto two groups: large shadows for group A, a total of67cases; multiple patchshadows(both lungs)for group B, a total of70cases.137children with pneumoniawere retrospectively investigated on clinical characteristics，such as sex, age,clinical main symptoms, mainly physical signs, laboratory examination, the disappeared time of lung rales, course of disease and symptoms of recovery phase,analyzed the relationship between clinical characteristics and traditionalChinese medicine (TCM) pathogenesis factors, analyzed the frequency,composition ratio, t value, X squared value by application of SPSS17.0statistics software.Results:1. Sex and Age:Sex: The gender composition was no significant difference between two groupsof children(X2=0.156,P=0.692).Age: Comparison in the group:①Group A was given priority to with4-7y ofpreschool children(X2=46.657,P=0.000).②Group B was given priority to with1-3yinfants(X2=70.914,P=0.000).Comparison between groups:①1y babies had noobvious difference between group A and group B(X2=0.132,P=0.717);②Group B with1-3y infants was obviously higher than group A with1-3y infants(X2=20.626,P=0.000);③Group A with4-7y of preschool children was obviously higherthan group B with4-7y of preschool children(X2=9.471,P=0.002);④Group A with8-13y of school-age children was obviously higher than group B with8-13y ofschool-age children(X2=5.647,P=0.017).2. Main and Cardinal Symptoms:Fever: Comparison in the group:①Group A was given priority to temperature morethan39degrees(X2=12.552,P=0.000),37.3%(25/67);②Group B was given priorityto temperature more than39degrees (X2=18.571,P=0.000),41.4%(29/70).Comparison between groups: The varioustemperature sections between the two groups compared with no significantdifference.Cough: Comparison in the group:①Group A was given priority to acute cough(X2=86.537,P=0.000),86.6%(58/67);②Group B was given priority to acute cough (X2=54.029,P=0.000),72.9%(51/70).Comparison between groups:①Group A acutecough higher than group B(X2=3.957,P=0.047)；②There were no significant differences on paroxysmal cough and sound cough between the two groups.Sputum:①Group A was given priority to have sputum,92.5%(62/67);②Group B wasgiven priority to have sputum,84.3%(59/70);③There was no significantdifference between the two groups(X2=2.260,P=0.133).Shortness:①Group A was given priority to shortness,85.1%(57/67);②Group B wasgiven priority to shortness,91.4%(64/70);③There was no significant differencebetween the two groups(X2=1.340,P=0.247).3. Main and Physical Signs:the Properties of Rales: Comparison in the group:①Group A was given priorityto widespread rales(X2=105.881,P=0.000),92.5%(62/67);②Group B was givenpriority to widespread rales(X2=96.886,P=0.000),88.6%(62/70). Comparisonbetween groups: There were no significant differences on widespread rales,widespread rales with wheezing rales and sputum sound between the two groups.the Tongue Boby: By looking for changes in this case, group A and group B allwere red tongues.the Tongue Fur: Comparison in the group:①Group A was given priority to yellowand thick moss(X2=115.313,P=0.000),68.7%(46/67);②Group B was given priorityto yellow and thick moss(X2=82.571,P=0.000),68.6%(48/70). Comparison betweengroups: There were no significant differences on yellow moss and yellow and thickmoss between the group A and B.4. Laboratory Examination:the Pathogenic Bacteria Types: About cases of Mycoplasma pneumoniae infectiongroup A was higher than group B(X2=6.368,P=0.012); About cases of on bacterialand virus infection there were no significant differences.the Infection Types:①Group A was given priority to mixedinfection,52.2%(35/67).②Group B was given priority to simpleinfection,70.0%(49/70).③Group B with simple infection was obviously higherthan group A,and group A with the mixed infection was obviously higher than groupB(X2=7.006,P=0.008).the Pathogenic Bacteria: Comparison in the group:①Group A was given priority to Mycoplasma pneumoniae infection(X2=16.269,P=0.012),25.4%(17/67).②Group Bwas given priority to bacterial infection(X2=31.400,P=0.000),34.3%(24/70).Comparison between groups: the Simple Infection:①Group B with simple bacterial infection was obviously higher than group A(X2=6.877,P=0.009);②The simple Mycoplasma pneumoniae infection was nosignificant difference between group A and B(X2=0.926,P=0.336);③The simplevirus infection was no significant difference between group A and B(X2=2.951,P=0.086). the Mixed Infection:①Group A mixed bacterial and Mycoplasmapneumoniae infection was higher than group B(X2=5.035,P=0.025);②Group A mixedbacterial, Mycoplasma pneumoniae and virus infection was higher than group B(X2=4.820,P=0.028);③There were no significant differences on bacterial and virusinfection(X2=0.835,P=0.361), Mycoplasma pneumoniae and virus infection(X2=0.140,P=0.708) between the group A and B.C reactive protein (CRP): Group A and group B had part of children’s elevatedCRP, respectively accounted for52.2%(35/67),27.1%(19/70).Group A elevated CRPwas significantly higher than group B(X2=9.029,P=0.003).5. Symptoms of Recovery Period:①Part of children had bronchialhyperresponsive(BHR) in group A and B at recovery period.，and there was nosignificant difference on BHR between the group A and B(X2=0.026,P=0.871). Thepathogenic bacteria of18case was given priority to Mycoplasma pneumoniaeinfection,33.3%(6/18),followed by viral infection,22.2%(4/18).②Group A’srales persistence cases were significantly higher than group B(X2=16.03,P=0.000).③Review blood routine cases were no significant differencesbetween the group A and B before hospital discharge(X2=1.892,P=0.000). GroupA’s elevated platelet cases were significantly higher than group B(X2=20.727,P=0.000).6.Course of Treatment:①Group A of average rales disappear time wassignificantly longer than group B(t=4.278,P=0.000).②Group A of averagehospital stays was significantly longer than group B(t=3.170,P=0.002).7. TCM syndrome type: Comparison in the group:①Group A was given priority to phlegm heat closed lungs card(X2=85.463,P=0.000),86.6%(58/67);②Group B wasgiven priority to phlegm heat closed lungs card(X2=71.686,P=0.000),80.0%(56/70).Comparison between groups: Phlegm heat closed lungs card and wind hot closedlungs card were no significant differences between the group A and B.Conclusion:1. In2003, gender composition of pneumonia children cases which the resultsof the chest X-ray or lung CT indicated large shadows or multiple patch shadows(both lungs) changes were no significant difference, but the age of them haddifference: Pneumonia children tipped large shadows changes were given priorityto preschool children with4-7y.2. Acute cough of pneumonia children cases which the results of large shadowswas obviously, and its cases of Mycoplasma pneumoniae infection and mixedinfection were obviously higher than pneumonia children cases which the resultsof multiple patch shadows (both lungs) changes, what is more its CRP and plateletwere also higher.The rales of pneumonia children tipped large shadows changeswere easy to persist, and its course of treatment were obviously higher.3.“Heat evil, toxic pathogen and the visible phlegm evil” were the mainpathogenesis factors of pneumonia children tipped large shadows or multiplepatch shadows (both lungs) changes during the acute phase, and the main TCMsyndrome type of pneumonia children was phlegm heat closed lungs card.“Dampand invisible phlegm evil” were the main pathogenesis factors during therecovery period.“Blood stasis” throughed the acute and recovery period, andthe degree about “blood stasis” of children tipped large shadows was heavier.