| Objective:According to the otolaryngology and oral science of Traditional Chinese Medicine which is edited by Wang Yongqin, observe the performance of the adenoid through the nasal endoscopic as comprehensive as possible. At the same time,we will select part of the children and make a comprehensive review of the clinical symptoms, signs, tongue condition, pulse condition, nocturnal oxygen saturation and the quality of life for children with obstructive sleep apnea18items survey (OSA-18). And comparing with traditional syndrome differentiation. We hope it will make the syndrome differentiation of Traditional Chinese Medicine on adenoid hypertrophy classification more objective, accurate and comprehensive. And it will provide information and basis for the syndrome differentiation and treatment and its outcomes of adenoid hypertrophy.Methods:The subjects included204cases between the age1～12years old, who all diagnosed as adenoid hypertrophy by the nasal endoscopic examination. Observe the performance of the adeniod through the nasal endoscopic as comprehensive as possible. We classified it according to the otolaryngology and oral science of Traditional Chinese Medicine which is edited by Wang Yongqin. Among all the cases,88of them filled in questionnaires and the quality of life for children with obstructive sleep apnea18items survey (OSA-18). We selected75of them to accept the nocturnal oxygen saturation check. According to the performance of adenoid, combined with clinical symptoms, signs, tongue condition, pulse condition, and the quality of life for children with obstructive sleep apnea18items survey (OSA-18). We compared and analysed them with traditional syndrome differentiation.Results:The subjects included204cases between the age1-12years old, who all diagnosed as adenoid hypertrophy by the nasal endoscopic examination.88of them filled in questionnaires and the quality of life for children with obstructive sleep apnea18items survey (OSA-18). We selected75of them to accept the nocturnal oxygen saturation check.1The subjects included204cases, the maximum age is12years old and the minimum age is1years old, the mean age is4.99±1.963years old. Among all the cases,139were male and65were female. By the χ2test, P=0.000<0.05, there is significant difference between male and female. 2Common symptoms in88cases were arranged in the order:nasal congestion, snoring, mouth breathing, running nose, cough, cough up phlegm, hawk, sore throat, bed-wetting and ear symptoms. Related pathogenic factors were arranged in the order: easy cold, like eating meat, like eating sweet, allergy, father/mother smoking, father/mother allergy, like eating cold drink, contact with pets, like eating spicy.3There were75cases accept the nocturnal oxygen saturation check,4cases were among the normal range,56cases were among the mild hypoxia range and15cases were among the moderate hypoxia range. Eliminate the3degree tonsil, the Ⅱ and Ⅳ degree of adenoid. There were61cases of children with III degree of adenoid, including20cases of pulmonary spleen-deficiency type,15cases of lung and kidney Yin deficiency type,14cases of resistance of qi and blood stasis, and12cases above cannot be classified as the three kinds of syndrome types. By the rank and inspection, P<0.05, the minimum values of blood oxygen between pulmonary spleen-deficiency, lung and kidney Yin deficiency, qi and blood stasis and the rest of the group have significant differences. The minimum oxygen value between the three groups had no significant difference.488cases filled in the quality of life for children with obstructive sleep apnea18items survey (OSA-18). By the rank and inspection, there was no significant difference in the OSA-18rating scale in different syndrome types.5According to the performance of the adenoid under the nasal endoscopic. In204cases, there were70cases belong to the pulmonary spleen-deficiency type,67cases belong to the lung and kidney Yin deficiency type,34cases belong to the qi and blood stasis blocking type. There were another33cases whose performance can not classified as the above3syndrome types. We observed and analysed the performance of the adenoid through the nasal endoscopic and found that they have the same characteristics:the surface of the adenoid was uneven, lobulated obviously, the color was reddish or red, there maybe secretions on the surface of the adenoid.6The tongue was red or reddish, the tongue coating was thin white or greasy white. The pulse condition was slide or astringent.Conclusion:We observed the performance of the adenoid through the nasal endoscopic as comprehensive as possible. At the same time, we selected part of the children and make a comprehensive review of the clinical symptoms, signs, tongue condition, pulse condition, nocturnal oxygen saturation and the quality of life for children with obstructive sleep apnea18items survey (OSA-18).1The main symptoms of adenoid hypertrophy include:nasal congestion, snoring, mouth breathing, running nose, cough. The accompanying symptoms include:cough up phlegm, hawk, sore throat, bed-wetting and ear symptoms. All children have all the main symptoms and some of the accompanying symptoms.2According to the otolaryngology and oral science of Traditional Chinese Medicine which is edited by Wang Yongqin, the disease can be divided into3types. There were33cases of the204whose performance can not classified as the above3syndrome types. We found that the performance of the adenoid through the nasal endoscopic had the same characteristics. We made a comprehensive review of the clinical symptoms, signs, tongue condition, pulse condition, nocturnal oxygen saturation and the quality of life for children with obstructive sleep apnea18items survey (OSA-18) and thought that they should be classified as a new type, this type was tend to be TanNing blood stasis which was common in clinical.3Under the guidance of the classification, we put forward the following opinions of the treatment of adenoid hypertrophy:all the children of different syndrome types may have nocturnal oxygen saturation decline, there was no significant difference on the severity of clinical symptoms in the3types. The3types recorded in the the otolaryngology and oral science of Traditional Chinese Medicine which is edited by Wang Yongqin play a certain guidance function in the clinical treatment. But we found that some children’ adenoid can not be classed as the above3types, we put forward the new syndrome differentiation type. The new type proposed in this topic may be was the main type which lead to the obstructive sleep apnea hypopnea syndrome. Such as the traditional Chinese medicine treatment can alleviate clinical symptoms, improve the oxygen at night, it can be used continuously. If the clinical symptoms and the oxygen at night can not be improved significantly, it is better to accept surgical treatment as soon as possible. Different syndrome differentiation type should be taken to different treatment methods. The3types could accept treatment of traditional Chinese medicine. Such as the traditional Chinese medicine treatment is invalid in the new type, it is better to take surgery treatment. |
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