Clinical Research On Singapore's Pediatric Recurrent Respiratory Tract Infections With Syndrome Of Deficiency Of Qi In Lung And Spleen Accompanied By The Accumulation Of Excess Dampness And Heat

Objective and Significance:The objective of this research was to study and propose treatment method for Singapore children's recurrent respiratory tract infection(RRTI),so as to understand the characteristics of Singapore children's recurrent respiratory tract infection and arrive at the essential treatment methods,in line with the objective of establishing an evidence-based,standardized treatment plan for RRTI in children with syndrome of deficiency of qi in lung and spleen accompanied by the accumulation of excess dampness and heat.Its significance is to improve Singapore's healing efficacy rate for children with RRTI.Research methods:The method applied was for 105 cases of children with RRTI accompanied by the above-mentioned syndrome to be selected at Singapore ZhongHua TCM hospital and Jing Jing TCM clinic between September 2018 to November 2018.Computerised random assignment method had been applied to divide them into 3 groups with 35 patients in each group.A treating approach comprising enhancement to the lung and bodily overall functions together with improving spleen's qi to dissolve the excessive dampness was proposed.Consequently,Pingfengxiehuang granules and/or TCM pediatric massage were the formula applied for treatment.Of the 3 groups,Group A had been clinically treated with Pure Chinese medicine-Pingfengxiehuang granules,Group B had been treated with TCM pediatric massage,and Group C had been treated with a combination of both Pingfengxiehuang granules and TCM pediatric massage.A treatment period of 12 weeks and a total observation duration of 12 months including the treatment period were applied to this study.Treatment and observation of the above-mentioned patients ended in December 2019,followed by analysis of clinical data and arrived at a conclusion from the results.Results:(1)Treatments and observations conducted for the 12-month period,all three methods of treatment aimed to cure children suffering from RRTI with the syndrome of deficiency of qi in lung and spleen accompanied by the accumulation of excess dampness and heat,showed an overall positive healing effect.(2)The Illness Healing Efficacy results,based on 12 weeks of treatment and observation,showed that:Appling Kruskal-Wallis H test,the 3 methods all show statistical differences(P=0.023<0.05)in comparison of the overall healing effect.When comparing between groups,Group A(use of only Traditional Chinese medicine herbs in treatment)and Group B(use of only TCM message therapy in treatment)statistically had no significant in healing efficacy(P=0.119>0.05).Group A and Group C(combined use of TCM herbs and message therapy in treatment)too had no statistical significant in healing efficacy(P=0.216>0.05).Whereas when comparing Group C(combined use of TCM herbs and message therapy in treatment)and B(use of only TCM message therapy in treatment),Group C was statistically more healing effective than Group B(P=0.007<0.01).(3)The Illness Healing Efficacy results based on 12 months of continual observations and follow-up visits,showed that:The 3 methods all resulted in statistical differences(P=0.016<0.05)with the Kruskal-Wallis H test.Group A(use of only Traditional Chinese medicine herbs in treatment)and Group B(use of only TCM message therapy in treatment)statistically had no significant in illness healing efficacy(P=0.119>0.05).Group A and Group C(combined use of TCM herbs and message therapy in treatment)too had no statistical significant in illness healing efficacy(P=0.169>0.05).Whereas when comparing Group C(combined use of TCM herbs and message therapy in treatment)and B(use of only TCM message therapy in treatment),Group C was statistically more superior in healing efficacy compared to Group B(P=0.005<0.05).(4)The Syndrome Healing Efficacy results,upon the end of 12 weeks of treatment,showed in stages that:1)Week 2 and week 4:Group A and C had statistical significance in healing effect after treatment(P<0.05).In contrast,Group B had no statistical significance in healing effect after treatment(P>0.05).Variance analysis showed that Group A was statistically better than Group B(P<0.05);Group C was more superior to Group B(P<0.05);Whereas Group A and C had no statistical significance in healing effect(P>0.05).2)Week 6:Group A,B and C all resulted in healing efficacy statistically between the pre-treatment and post-treatment period(P=0.000<0.05).Variance analysis showed that Group A was statistically better than Group B(P=0.000<0.05);Group C was more superior to Group B(P=0.000<0.05);whereas Group A and C had no statistical significance in healing effect B(P=0.603<0.05).3)Week 8,10,12 and subsequent clinical follow-ups and observations till 12-month period:Group A,B and C all resulted in healing efficacy statistically(P<0.05)between the pre-treatment and post-treatment period.Variance analysis showed that Group A was statistically better than Group B(P<0.05);Group C was more superior to Group B(P<0.05);Group C was statistically better than Group A(P<0.05).(5)The Main Symptom healing efficacy results of these children with RRTI upon the expiration of the 12 weeks of treatment and 12-month follow-ups and observations,showed that:All three groups compared to pre-treatment conditions,have had obvious improvement in terms of Frequency of illness,Nature of illness,and Duration of illness(P<0.05).The healing efficacy of the Frequency of illness among Group A,B and C had no obvious difference statistically(P>0.05).The healing efficacy of the Nature of illness among Group A,B and C had significant difference statistically(P<0.05):Group A and Group B had no statistical significance on improvement(P>0.05);Group C had significant improvement statistically over Group A(P<0.05);Group C also had significant improvement statistically over Group B(P<0.05).The healing efficacy of the Duration of illness among Group A,B and C had no significant difference statistically(P=0.545>0.05).(6)The Secondary Symptom healing efficacy results of these children with RRTI upon 12 weeks of treatment and 12-month follow-ups and observations showed that:Within group analysis the symptoms that all the three groups have had obvious improvement statistically(P<0.05)between the pre-treatment and post-treatment period were:Perspiration,Aversion to wind-heat,Fever,Cough,Sputum,Auscultation of lung sound,Nasal congestion,Tongue coating,Spirit,Facial complexion,Lack of qi and no desire to speak,Stool,Sneezing with itchy nose and Sore throat.For the symptoms of Physical body shape,Aversion to hot food,Tongue quality and Sleeping quality,Group A showed healing efficacy statistically(P<0.05)after 12 weeks.Group B had no healing efficacy statistically(P>0.05)after 12 weeks;Group C had healing efficacy statistically(P<0.05)after 12 weeks.For the symptom of Appetite,Group A showed no healing efficacy statistically(P>0.05);Group B also showed no healing efficacy statistically(P>0.05);Group C showed healing efficacy statistically(P<0.05).For the symptoms of Nausea vomiting and Abdominal pain,all three groups had no significant healing efficacy statistically(P>0.05).Comparison between groups showed that symptom of Physical body shape,Aversion to wind-heat,Aversion to hot food,Auscultation of lung sound,Appetite,Nausea vomiting,Tongue quality and Sleeping quality have had significant healing efficacy statistically(P<0.05).The symptom of Physical body share among Group A,B and C had significant improvement statistically(P<0.05):Group A had no significant healing efficacy statistically over Group B(P>0.05);Group C had significant healing efficacy statistically over Group A(P<0.05);Group C had significant healing efficacy statistically over Group B(P=0.000<0.05).The symptom of Aversion to wind-heat among Group A,B and C had significant improvement statistically(P<0.05):Group A had significant healing efficacy statistically over Group B(P<0.05);Group C had significant healing efficacy statistically over Group A(P<0.05);Group C had significant healing efficacy statistically over Group B(P<0.05).The symptom of Aversion to hot food among Group A,B and C had significant improvement statistically(P<0.05):Group A had significant healing efficacy statistically over Group B(P<0.05);Group C had significant healing efficacy statistically over Group A(P<0.05);Group C had significant healing efficacy statistically over Group B(P<0.05).The symptom of Auscultation of lung sound among Group A,B and C had significant improvement statistically(P<0.05):Group A had significant healing efficacy statistically over Group B(P<0.05);Group C had significant healing efficacy statistically over Group A(P<0.05);Group C had significant healing efficacy statistically over Group B(P<0.05).The symptom of Appetite among Group A,B and C had significant improvement statistically(P<0.05):Group A had no significant healing efficacy statistically over Group B(P>0.05);Group C had significant healing efficacy statistically over Group A(P<0.05);Group C had significant healing efficacy statistically over Group B(P<0.05).The symptom of Nausea vomiting among Group A,B and C had significant improvement statistically(P<0.05):Group A had no significant healing efficacy statistically over Group B(P>0.05);Group C had significant healing efficacy statistically over Group A(P<0.05);Group C had significant healing efficacy statistically over Group B(P<0.05).The symptom of Tongue quality among Group A,B and C had significant improvement statistically(P<0.05):Group A had significant healing efficacy statistically over Group B(P<0.05);Group C had no significant healing efficacy statistically over Group A(P>0.05);Group C had significant healing efficacy statistically over Group B(P<0.05).The symptom of Sleeping quality among Group A,B and C had significant improvement statistically(P<0.05):Group A had significant healing efficacy statistically over Group B(P<0.05);Group C had no significant healing efficacy statistically over Group A(P>0.05);Group C had significant healing efficacy statistically over Group B(P<0.05).As for the symptom of Perspiration,Fever,Cough,Sputum,Nasal congestion,Tongue coating,Spirit,facial complexion,Lack of qi and no desire to speak,Abdominal pain,Stool,Sneezing with itchy nose and Sore throat,comparison between groups showed no significant healing efficacy statistically(P>0.05)upon 12 weeks of treatment and 12 months follow-up and observation.Conclusion and Importance:The research results concluded that the application of healing approach comprising enhancement to the lung and bodily overall functions together with improving spleen's qi to dissolve the excessive dampness,to treat children suffering from RRTI with syndrome of deficiency of qi in lung and spleen accompanied by the accumulation of excess dampness and heat,both the use of Pingfengxiehuang granules and TCM pediatric massage treatment methods respectively has proven its healing efficacy clinically and safe to use.Nevertheless,a combination of both methods resulted in better efficacious outcome for the patients.Hence,these treatment methods are recommended for clinical use.This study is innovative as there is no existing similar treatment method available in Singapore.