| Objective:Allergic rhinitis in children is a common chronic disease in childhood.At present,the prevalence of allergic rhinitis in children worldwide is still rising.Clinical treatment mainly uses methods such as avoiding allergens,using drugs,and immunotherapy,with unsatisfactory results.Traditional Chinese medicine treatment takes a holistic view and syndrome differentiation as the core,combining disease differentiation and syndrome differentiation,and emphasizing individual differences,with considerable therapeutic advantages.The purpose of this study is to evaluate the clinical efficacy and safety of magnolia flower powder combined with intradermal needling of children with allergic rhinitis(syndrome of lung meridian latent heat)through clinical observation and semi structured qualitative interview research,explore the factors that affect the compliance and satisfaction of magnolia flower powder combined with intradermal needling in the treatment of children with allergic rhinitis(syndrome of lung meridian latent heat)from the patients’ subjective perspective,broaden the clinical and extermal treatment approaches of this disease,and provide reference for the optimization and promotion of clinical treatment of traditional Chinese medicine.Methods:From June 2021 to October 2022,a total of 90 children with allergic rhinitis of syndrome of lung meridian heat were selected from the pediatric outpatient department of Dongzhimen Hospital of Beijing University of Chinese Medicine.They were randomly divided into three groups:the Chinese medicine combined with intradermal needling group,the Chinese medicine group,and the Western medicine group,with 30 cases each.The Chinese medicine combined with intradermal needling group was treated with magnolia flower powder pellet combined with intradermal needling,the Chinese medicine group was treated with magnolia flower powder pellet,and the Western medicine group was treated with loratadine syrup.Each of the three groups took 7 days as a course of treatment,and the total course of treatment was 2 courses.The observation time points were before treatment,1 course of treatment,2 courses of treatment,and 1 month after the end of all treatment.Relevant symptoms and signs were collected and statistically analyzed,and the clinical efficacies of the three groups of magnolia flower powder combined with intradermal needling,magnolia flower powder,and loratadine syrup were objectively compared and evaluated.The efficacies of the group before and after treatment were compared.After that,a semi structured qualitative interview was conducted with the children and parents who were previously enrolled to explore the factors that affect the compliance and satisfaction of children with allergic rhinitis(syndrome of lung meridian heat)treated with magnolia flower powder combined with intradermal needling to understand the expectations and views of the children and their parents on clinical treatment of traditional Chinese medicine and to promote the further development and optimization of clinical treatment of traditional Chinese medicine.Result:1 Case inclusion:In terms of efficacy evaluation of the scale,there were 30 cases in the Chinese medicine combined with intradermal needling group,of which 3 cases fell off,30 cases in the Chinese medicine group,of which 1 cases fell off,30 cases in the western medicine group,of which 2 cases fell off.The final effective cases were 84 cases,including 27 cases in the Chinese medicine combined with intradermal needling group,29 cases in the Chinese medicine group,and 28 cases in the western medicine group.In terms of interview,a total of 63 groups eventually participated in the interview through face-to-face or phone calls.2 General General data statistics:In the 84 effective cases,boys account for 65.5%,girls account for 34.5%.The proportion of men to women is uneven,and the ratio of men to women is 1.90:1.The age of children with cases is mainly concentrated in 4-5 years old.The total course of disease of children with cases is mainly concentrated in 2 years.Respiratory tract infection(infection)is the main inducing factor,accounting for 44.0%,and exposure to allergens(immunity)accounts for 22.7%.Cold air stimulation(environment)is also an important factor.Nearly half of the children have a history of allergies and family history.The main previously diagnosed allergic diseases include eczema(25.0%),allergic conjunctivitis(14.3%),bronchial asthma(6.0%),and urticaria(3.6%).3 Clinical effect:The total effective rate of children in the traditional Chinese medicine combined with intradermal needling group after 2 weeks of treatment is 96.3%,the total effective rate of children in the traditional Chinese medicine group after 2 weeks of treatment is 93.1%,and the total effective rate of children in the western medicine group after 2 weeks of treatment is 75.0%.There was no statistically significant difference in total effective rate among the three groups(P>0.05).There was a statistically significant difference in total points before and after treatment among the three groups(P<0.001).In terms of differences in total points among the three groups,there was a statistically significant difference between the traditional Chinese medicine combined with intradermal needling group and the traditional Chinese medicine group(P<0.05).There was a statistically significant difference between the traditional Chinese medicine combined with intradermal needling group and the western medicine group(P<0.05).There was a statistically significant difference between the traditional Chinese medicine group and the western medicine group(P<0.05).In terms of main symptoms such as nasal itching,sneezing,runny nose,and nasal congestion,the Chinese medicine combined with intradermal needling group had the best efficacy,followed by the Chinese medicine group,and then the Western medicine group,with the Western medicine group having a slightly poorer efficacy in treating nasal congestion.In terms of the secondary symptoms of cough,itching of the throat,itching of the eyes,and dry and irritated heat of the mouth,the curative effects of the traditional Chinese medicine combined with intradermal needling group and the traditional Chinese medicine group were significant and there was no significant difference,while the curative effects of the western medicine group took the second place.In terms of the physical signs of nasal concha,nasal mucosa and tongue pulse,the Chinese medicine combined with intradermal needling group and the Chinese medicine group had significant relief and there was no significant difference,followed by the Western medicine group.In terms of tongue and pulse,the Western medicine group had no significant improvement.Following up one month after the treatment,the recurrence rate in the traditional Chinese medicine combined with intradermal needling group was 31.8%,44.4%in the traditional Chinese medicine group,and 80%in the western medicine group.There was a statistically significant difference in the recurrence rate among the three groups(P<0.05).There was a statistically significant difference between the traditional Chinese medicine combined with intradermal needling group and the western medicine group(P<0.05).There was a statistically significant difference between the traditional Chinese medicine group and the western medicine group(P<0.05).There was no statistically significant difference between the traditional Chinese medicine combined with intradermal needling group and the traditional Chinese medicine group(P>0.05).In terms of quality of life,the improvement degree of the traditional Chinese medicine combined with intradermal needling group is the best,followed by the traditional Chinese medicine group,followed by the western medicine group.In terms of nasal symptoms and nose and eye related behaviors,the traditional Chinese medicine combined with intradermal needling group had the best improvement degree,followed by the traditional Chinese medicine group,followed by the western medicine group.In terms of eye symptoms,non nasal and eye symptoms,and emotional reactions,the improvement degree of the traditional Chinese medicine combined with intradermal needling group and the traditional Chinese medicine group is similar,both superior to the western medicine group.4 Interviews:This study used a semi structured qualitative interview method,involving 63 parents who participated in the preliminary clinical study.The main focus was on the factors affecting children’s compliance and satisfaction with the treatment of allergic rhinitis with traditional Chinese medicine combined with intradermal needling.The topic analysis method was used to analyze and summarize the interview content to obtain the results,and the patient,treatment and medical factors were reviewed and discussed.The influencing factors before treatment include the troubled life of the patient’s factors,daily stress,previous treatment experience,understanding of traditional Chinese and Western medicine,ways of understanding of the patient’s factors,and the reputation,age and medical skills of the medical factors.The influencing factors after treatment include the medical cost,and the impact of the epidemic situation of the patient’s factors,the treatment experience and feelings,actual efficacy,side effects of the treatment factors,and the attitude of the medical factors.Although there are many influencing factors,the actual efficacy is still the key factor affecting children’s compliance and satisfaction.However,it should be noted that the current efficacy evaluation still remains at the level of basic biomedical models,focusing only on the improvement of symptoms.In addition to the improvement of basic symptoms of rhinitis,the on-site efficacy evaluation of children and their parents should also include the improvement of their overall quality of life and their psychological state.When evaluating the therapeutic effect of traditional Chinese medicine in treating allergic rhinitis in children,it is necessary to strengthen the evaluation of the psychological and quality of life of children,combining the subjective feelings of children and their parents with objective indicators to conduct a comprehensive evaluation of multiple aspects,levels,and indicators.Conclusion:The efficacy of magnolia flower powder combined with intradermal needling in the treatment of allergic rhinitis in children is reliable.Its improvement of symptoms and signs,and quality of life are better than those of traditional Chinese medicine magnolia flower powder and loratadine syrup alone.Through interview,it found that the actual clinical efficacy is still a key factor affecting children’s compliance and satisfaction,but at the same time,the evaluation of children’s psychological and quality of life should be strengthened.By combining the subjective feelings of children and parents with objective indicators,a comprehensive evaluation of multiple aspects,levels,and indicators can be obtained. |
PDF Full Text Request