A Real World Study Of Integrated Traditional Chinese And Western Medicine In The Treatment Of Phlegm-heat Closed Lung Syndrome In Children With Community Acquired Pneumonia

Objective: To observe the diagnosis and treatment rules of children with phlegm-heat closed lung syndrome of community acquired pneumonia(CAP)in the real world.Methods: Based on the real-world research concept,the real situation of children with CAP syndrome of phlegm heat and closed lung was observed in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Shandong Provincial Hospital,Qilu Hospital of Shandong University,Qilu Children’s Hospital of Shandong University,Jinan Maternal and Child Health Care Hospital,and Jining First People’s Hospital from November 2020 to October 2021,and statistical analysis.Results:1.In this study,the incidence of phlegm-heat closed lung syndrome was mainly concentrated in early childhood(59.52%)and early school age(31.29%),with more males than females(1.55:1),and more in autumn and winter(55.14%).The proportion of height and weight below the standard w as 10.58% and 18.30%,respectively.2.38.73% of the children had a previous history of recurrent pneumo nia,eczema and asthma.3.Fever,cough,expectoration,abnormal sweating,runny nose,wheez ing,shortness of breath,nasal congestion,pharyngeal discomfort and po or sleep were the main clinical manifestations.The most common positivesigns were pharyngeal congestion,tonsil enlargement and cervical lymphnode enlargement,and the most common pulmonary rale was phlegm.4.Pathogenic bacteria were detected in 64.11% of the children,whic h 32.76% of them were mixed infections.Mycoplasma pneumonia(51.54%),in fluenza B virus(20.82%),Epstein-Barr virus(11.95%)and Haemophilus in fluenza(9.90%)were the most common pathogenic bacteria.5.In this study,bronchopneumonia was the most common symptom of phl egm-heat closed lung,followed by lobar pneumonia.Occasionally occur atel ectasis,pleural effusion and other complications,may appear gastrointest inal diseases and other complications.6.The main abnormal manifestations of laboratory examination in thechildren were rapid erythrocyte turnover(58.87%),increased absolute v alue of lymphocytes(41.40%),increased white blood cell(35.00%),decre ased percentage of neutrophils(28.61%),and increased D-dimer(26.02%).Medical imaging examination results showed double lung pneumonia.7.The pre-admission treatment was mainly western medicine treatment,60.18% of the children were treated with antibiotics,The main oral anti biotics were cephalosporins(42.06%)and macrolides(36.98%).After admis sion,traditional Chinese medicines such as resolving phlegm,relieving cough and relieving asthma have the highest frequency of use.Traditiona l Chinese medicines include Wuhu and tinglidazaoxiefei soup,Wendan soup.Proprietary Chinese medicine to Xiyanping,children xiaoji cough granul es/oral liquid,jinzhen oral liquid is the most commonly used Chinese me dicine.Western medicine treatment is based on antibiotics(92.55%)Macroli de antibiotics(70.65%),third-generation cephalosporins(44.47%)are themost common western treatment,31.60% of children had treatments with mu ltiple antibiotics.28.22% of the children were treated with hormone the rapy,87.36% were treated with atomization therapy.Other drugs mainly pl ayed antiviral,expectorant,antipyretic,antiasthmatic and antiallergicfunctions.8.In 443 undetached cases,the number of children treated with bothChinese and Western medicine(64.56%)were more than the number of thos e treated with western medicine alone(35.44%).There was no statistical difference in hospitalization cost and incidence of complications betwee n the two groups(P>0.05).The length of hospitalization in the western m edicine group was significantly shorter than that in the integrated Chin ese and Western medicine group(P < 0.05).However,the frequency of antib iotic combination and the probability of complications were significantl y higher than those of the integrated Chinese and Western medicine group s(P < 0.05).Conclusion:1.Children’s CAP syndrome of phlegm-heat clung closure is more comm on play childhood and early school age,and more common in autumn and wi nter.Clinical symptoms are fever,cough,nasal congestion,runny nose,w heezing,shortness of breath and other respiratory symptoms,which is co mmon influent throat,lungs,lymph nodes.2.Mycoplasma pneumonia was the main pathogenic bacteria in the year ly survey year,followed by mixed and viral infection.Nearly half of thechildren could not identify the pathogenic bacteria.3.Abnormal erythrocyte sedimentation rate and the level of lymphocy te and leukocyte are typical in laboratory examination4.Lesions often involve both lungs.5.Western medicine treatment is mainly based on the treatment of in tra-ring lipid,third-generation cephalosporins and penicillin antibioti cs,which is according to the condition of children.The main Chinese me dical treatments are relieving cough,reducing phlegm and relieving asth ma,followed by relieving the surface,clearing heat,dryness and dampne ss,eliminating fire,detoxifying and regulating qi.6.The hospitalization days of simple western medicine treatment arerelatively short,but the rates of antibiotic combination and complicat ion are high.