| Objective:To ex Plore the clinical characteristics and syndrome distribution of winter and s Pring influenza in children in Tianjin.Through collecting nose swabs of children with influenza-like illness from Pediatric out Patient de Partment and making ra Pid antigen detection,the Pathogenic characteristics of children with influenza in winter and s Pring in this area were clarified,and the clinical and syndrome distribution characteristics of children with influenza were discussed,this study will lay a foundation for further research on the standardization of TCM syndromes with large sam Ples and multi-centers,and Provide evidence-based evidence for TCM Prevention and treatment of childhood influenza.Methods:The clinical data of children with influenza-like illness were collected from October 2018 to April 2019 and from October 2019 to January 2020 in the pediatric Outpatient Department of the Second Affiliated Hospital of the Tianjin University of Traditional Chinese Medicine,on the basis of the positive results of rapid antigen detection in nasal swabs,120 cases meeting the research requirements were screened,the observation table of clinical cases of influenza in children was recorded,and the database was established by using Epidata software,SPSS22.0 software was used for statistical description,through descriptive analysis,chi-square test,non-parametric test and other statistical methods,to explore the winter and spring season influenza in Tianjin children with the clinical characteristics of traditional Chinese medicine and syndrome distribution characteristics.Results:1.General information: Among the 120 cases of influenza A(81/67.5%)was more than that of influenza B(39/32.5%).No mixed infection of influenza A and B was found.There were 120 cases of influenza in children,55(45.8%)boys and 65(54.1%)girls,and there was no significant difference in the distribution of influenza a and B between different sexes(P=0.107).The mean age of 120 children with influenza was 5.94～2.26 years old,the median was 6 years old,the most common was 3～6 years old group(73 cases/60.8%).There was no significant difference in the distribution of Influenza A and B in different age groups(P=0.773).Among the 120 cases of influenza in children,most of them had no obvious cause(71/59.2%),18.3%(22 cases)had contact history with confirmed influenza patients,and 5.8%(7 cases)had a history of influenza vaccination for nearly one year,there were 30 cases(25%)with pre-treatment history.2.Incidence of disease:120 children with influenza had fever at the time of visit,the mean body tem Perature was 38.64±0.49℃,the median was 38.6℃,and 91.7% of them had fever between 38.0℃and 39.5℃,it is suggested that the fever degree of influenza children is mainly middle and high fever.There was no significant difference in the com Position of influenza a and influenza B between different body tem Perature segments(P=0.713).Among120 children with influenza,42 cases(35%)had onset from October 2018 to APril 2019,78cases(65%)had onset from October 2019 to January 2020.There was no significant difference in distribution of influenza A and B between the two seasons(P=0.886).The Peak of influenza a in 2018-2019 season is January 2019,the Peak of influenza B is late March2019,the Peak of influenza a in 2019-2020 season is mid-late December 2019 to early January 2020,and the Peak of influenza B is mid-january 2020.3.TCM symptoms:120 cases of influenza in children,the most common symptoms are followed by fever,aversion to cold and evil wind,cough,fatigue,dry mouth,body pain,headache,mainly systemic symptoms.There was no significant difference in the distribution of systemic symptoms among different types of influenza(P>0.05).The most common respiratory system symptom in children with influenza is cough,mainly with light cough and less sputum,accompanied by more than respiratory system symptoms,the distribution of respiratory symptoms in children with influenza A and influenza B had no significant difference(P>0.05).The most common digestive symptoms in children with influenza were poor acceptance,abdominal distension,nausea and vomiting,abdominal pain,little urine and yellow urine had no significant difference(P>0.05).There were significant differences in the distribution of sodium deficiency and the nature of stool in children with influenza A and influenza B(P<0.05).The symptoms of sodium deficiency and loose stool in children with influenza B were more than those in children with influenza A.Red Tongue on the tongue,thin yellow coating on the tongue,yellow and greasy coating on the tongue,floating number of pulse on the pulse,pulse number.4.TCM syndrome type: In 120 children with influenza,the most common TCM syndromes were exterior-cold internal heat syndrome(61/50.8%),wind-heat invading wei syndrome(26/21.7%),wind-cold bundle exterior syndrome(18/15.0%)and heat-toxic obstructing lung syndrome(15/12.5%),no Syndrome of deficiency of both Qi and Yin was found.There was no significant difference in the distribution of TCM syndrome ty Pes between children with A and B(P=0.589).5.Laboratory tests: 120 children with influenza,106 tested for blood routine and CRP,87 with normal white blood cell count,63 with normal neutro Phil Percentage,55 with normal lym Phocyte Percentage,and 75 with normal hemoglobin,there were 101 normal Platelets and49 normal CRP.There was no significant difference in the distribution of white blood cell count and CRP(P>0.05),but there was significant difference in the distribution of neutro Phil Percentage and lym Phocyte Percentage(P<0.05),it is suggested that the Patients with neutro Phil and lym Phocyte were more than those with stream B.Conclusion:1.This study identified the etiological types of influenza A and B in children,from systemic symptoms,respiratory system symptoms,digestive symptoms,tongue and pulse,blood routine and CRP,at the same time,combined with the epidemiological characteristics of Etiology,five-transportation and six-qi,physical constitution and time-space characteristics of influenza season in children in Tianjin area,the TCM symptom characteristics and TCM syndrome distribution characteristics of early influenza children in Tianjin area were summarized.2.Most of the children in Tianjin were infected with influenza a,but more of them were infected with influenza B,and most of them were 3-6 years old(Preschool Age).Different years of influenza high incidence time can be different,and a single season of influenza a B two influenza epidemic can be alternating.3.In the early stage of influenza,exterior syndrome is the main manifestation,exterior-cold internal heat syndrome is the most common,wind-heat invading Wei Syndrome and wind-cold bundle exterior syndrome are the second most common,and heat-toxic Lung Syndrome is also common.There was no significant difference in the distribution of syndrome types between children with influenza a and those with influenza B.4.The most common symptoms of influenza in children are followed by fever,aversion to cold and aversion to wind,cough,fatigue,dry mouth,headache and body pain,the flu patient’s Asthenia symptom is more obvious.The most common respiratory system symptom is cough,and to light cough,expectoration mainly,mainly respiratory system symptoms to upper respiratory symptoms.The most common digestive symptoms are poor appetite,and the symptoms of poor appetite and loose stools are more common in children with stream B than in children with Stream A.Its tongue and pulse are unified with its clinical symptoms.5.Early changes in blood routine in children with influenza vary,mostly normal,but the Percentage of lym Phocyte decreases relative to the increase.There were more cases of neutro Phil than normal and more cases of lym Phocyte than normal.6.At Present,the confirmed rate of influenza in China is low,ignoring the infectivity of the missed cases and belittling the invisible source of infection.Moreover,at Present,the rate of children’s influenza vaccination in our country is relatively low.It is necessary for social and medical institutions to actively Play the role of Publicity and guidance,scientifically setting uP additional vaccination Points,and increasing the rate of influenza vaccination among children and close contacts,give full Play to the Preventive role of influenza vaccine.In addition,the next influenza season should be alert to the local outbreak of influenza B and the Possibility of multi Ple sub-ty Pes,vaccine research and develo Pment work.7.From the children’s clinical symptoms and Five-yun Six-qi,we can see the two seasons of influenza pathogenic factors in addition to the flu virus,there are wind,cold,heat,dryness,damp evil.To grasp the "prevention before disease,early detection,early isolation,as soon as possible treatment,active use of ’detoxification,cold,heat,dampness and Qi retention’methods," the prevention and treatment of early childhood influenza,to provide the train of thought for the treatment of children’s influenza based on syndrome differentiation of traditional Chinese medicine,so as to treat early and prevent and cure accurately. |
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