A Study On The Identification Of TCM Constitution And Its Correlation With Neurodevelopment In High-risk Children With Brain Injury In Kunming Area

Objective:This project aims to establish the "TCM physical classification and determination criteria for children at high risk of brain injury in Kunming",to determine the TCM physical quality of children at high risk of brain injury,to explore the correlation between the TCM physical classification and the results of the factors at high risk of brain injury and the Neurodevelopmental Diagnostic Scale(Gesell Neurodevelopmental Diagnostic Scale),and to provide scientific guidance and suggestions for early intervention and follow-up of children at high risk of brain injury.To provide scientific guidance and suggestions for the early intervention and follow-up of children at risk of brain injury.Methods: A cross-sectional survey was conducted to investigate children at risk of brain injury who first visited the high-risk pediatric specialist clinic and special needs clinic of Kunming Maternal and Child Health Hospital from October 1,2021 to October 1,2022.The survey included information related to the child’s general condition,high-risk factors,and pediatric physical condition.Case information was entered into the database using Excel and organized,and then the results were statistically analyzed using SPSS 26.0.General information,high-risk factors,information related to the GDS scale and physical information were analyzed using frequency analysis and composition ratio statistics;correlation analysis between groups of several groups of information was performed using Pearson chi-square test,Fisher’s exact probability method,and Wilcoxon rank sum test,with P < 0.05 indicating statistical significance.Results:1.This survey was proposed to initially set up the "TCM Physique Determination Table for Children at High Risk of Brain Injury in Kunming Area",which proposed to classify children at high risk of brain injury in Kunming area into eight types of physique,namely pinghe,qi deficiency,yin deficiency,yang deficiency,phlegm-damp,damp-heat,qi-yu,and special endowment.It fills the gap of physical determination of children at high risk of brain injury.2.A total of 184 questionnaires were filled out in this survey,12 questionnaires were excluded due to unclear and incomplete information,and 172 questionnaires were finally collected,with a valid recovery rate of 93.47%.3.The distribution of TCM constitution of brain injury high-risk children in this survey was as follows: the TCM constitution of brain injury high-risk children was mainly biased,with 120 cases of biased constitution(69.77%)> 52 cases of calm constitution(30.23%).The distribution of the biased constitution was as follows: Yin deficiency 48 cases(27.91%)> Qi deficiency 44 cases(25.58%)> Phlegm-damp 9 cases(5.23%)> Yang deficiency 8 cases(4.65%)> Special endowment 4 cases(2.33%)= Damp-heat 4 cases(2.33%)> Qi-yu 3 cases(1.74%).4.The distribution of high-risk factors for brain injury in high-risk infants in this survey was: 108 cases(62.79%)of preterm birth > 26 cases(15.11%)of pathological jaundice or suspected nuclear jaundice > 20 cases(11.62%)of neonatal hypoxic-ischemic encephalopathy > 13 cases(7.56%)of neonatal hypoglycemia > 12 cases(6.97%)of neonatal intracranial hemorrhage > congenital hypothyroidism(CH)3 cases(1.74%)>glucose-6-phosphate dehydrogenase(G6PD)deficiency in 2 cases(1.16%).5.Distribution of Gesell assessment results(total developmental quotient)in children at high risk of brain injury: 88 cases(51.16%)in the mild neurological delay group > 36cases(20.93%)in the moderate neurological delay group > 32 cases(18.60%)in the borderline state group > 11 cases(6.40%)in the severe neurological delay group > 5 cases(2.91%)in the very severe neurological delay group).6.The distribution of abnormalities in the Gesell assessment(five major functional areas)in children at risk of brain injury: 168 in gross motor functional area(97.67%)> 160 in fine motor functional area(93.0%)> 158 in adaptive functional area(91.86%)> 156 in personal-social functional area(90.70%)> 149 in language functional area(86.62%).7.TCM fitness of children at high risk of brain injury was not related to general factors(age,gender)(P > 0.05).The TCM fitness of children at high risk of brain injury was associated with high-risk factors(preterm birth,suspected nuclear jaundice,neonatal hypoxic-ischemic encephalopathy,neonatal hypoglycemia,neonatal intracranial hemorrhage)(P < 0.05).8.TCM fitness in children at high risk for brain injury was associated with Gesell assessment results(total developmental quotient)and Gesell assessment results(five major energy areas)in children at high risk for brain injury(P < 0.05).Conclusions:1.the practical utility of the scale "Chinese Medicine Physical Determination Scale for Children at High Risk of Brain Injury in Kunming Area" established in this preliminary study is feasible and operable.2.The TCM constitution of children at high risk of brain injury is dominated by the biased constitution,and the calm constitution is secondary,and the yin deficiency and qi deficiency constitutions are dominant among the biased constitutions.3.The physical constitution of children at risk of brain injury is related to the factors at risk of brain injury.Premature birth is related to qi deficiency and damp-heat,neonatal jaundice is related to damp-heat and phlegm-damp,neonatal hypoxic-ischemic encephalopathy is related to qi deficiency,and neonatal hypoglycemia is related to qi deficiency,yin deficiency and yang deficiency.4.The physical quality of children at risk of brain injury was related to the Gesell assessment results: there were significant correlations in the distribution of the Gesell assessment results(total developmental quotient)and the Gesell assessment results(five major energy areas)in children at risk of brain injury between biased and calm,qi deficiency and non-qi deficiency,and yin deficiency and non-yin deficiency.5.Children at high risk of brain injury were mostly at risk of preterm birth,suspected nuclear jaundice,neonatal hypoxic-ischemic encephalopathy,neonatal hypoglycemia,and neonatal intracranial hemorrhage,and children at high risk of brain injury had mild neurodevelopmental delay in the Gesell assessment(total developmental quotient)and gross motor delay in the Gesell assessment(five major energy areas).6.The identification of TCM physical classification of brain-injured high-risk children is expected to provide a reference and basis for early clinical assessment of the development of brain-injured high-risk children and optimization of early intervention programs for brain-injured high-risk children.