Applied Research On TCM Clinical Pathway In Children With Community-acquired Pneumonia At Grass-roots Level

Objective:To observe the effect of TCM diagnosis and treatment scheme and clinical pathway in children with community acquired pneumonia(CAP)in base,and to provide reference for optimizing and standardizing the application of clinical pathway at grass-roots level.Methods:From December 2020 to November 2022,a total of 1106 hospitalized children with community-acquired pneumonia were selected from the hospital of Traditional Chinese medicine,Jiyang District,Jinan Province.They were divided into control group and clinical pathway group,560 cases in the clinical pathway group were studied retrospectively,the comprehensive data of sex,age,onset season,average days in hospital,average hospitalization cost,western medicine cost,Chinese patent medicine cost,Chinese herbal medicine cost,Chinese medicine syndrome type,Chinese medicine prescription,pathogenic examination,antibiotic use,clinical curative effect wer e analyzed.Results:1.The average days of hospitalization were 6.79±1.806 clays in control group and 5.97 ± 1.505 days in clinical pathway group.The average length of hospital stay in the clinical pathway group was significantly lower than that in the control group(P<0.05).2.The average total cost of hospitalization,the average cost of western medicine and the average cost of Chinese patent medicine in the clinical pathway group were lower than those in the control group,and the average cost of Chinese herbal medicine in the clinical pathway group was higher than that in the control group(P<0.05).3.TCM syndrome classification:The Path Group and the control group are mainly wind-heat syndrome,the control group the first three types of TCM syndrome:wind-heat syndrome,phlegm-heat syndrome,wind-cold syndrome.The first three TCM syndrome types in the clinical pathway group were wind-heat syndrome,phlegm-heat syndrome and damp-heat syndrome.4.Traditional Chinese medicine prescriptions:the top three prescriptions used in path group were MaxingShigan Decoction and Yinqiao powder plus or minus,Sangju drink plus or minus and Ganlu disinfection drink plus or minus.The top three prescriptions used in control group were Sangju Yin plus or minus,Maxingshigan decoction plus or minus,Dingchuan decoction plus or minus.5.The main pathogens were Mycoplasma pneumoniae,coxsackie virus,adenovirus,syncytial virus and Chlamydophila pneumoniae virus.Mycoplasma and adenovirus were the main pathogens in the control group and the pathway group.6.In the control group,the most common Azithromycin was cefminox,followed by ceftazidime,and the third was ceftazidime combined with antibiotics,accounting for 36.8%.In the pathway group,cefminox was the most frequently used drug,followed by Azithromycin,the third is oxacillin,combined use of antibiotics accounted for 29.1%.The combined use of antibiotics in the clinical pathway group was lower than that in the control group.7.Clinical efficacy:The cure rate and markedly effective rate were 92.68%in the clinical pathway group and 81.87%in the control group.8.Conclusion:There was no significant difference between the two groups in terms of sex,age and onset season.The average length of stay,the average total cost of hospitalization,the average cost of western medicine and the average cost of Chinese patent medicine in the clinical pathway group were lower than those in the control group,the results showed that Jiyang District Hospital of traditional Chinese medicine clinical pathway treatment of children with community-acquired pneumonia,the effect was better than the control group.However,due to the short research time,the limited cumulative observation sample size,the lack of satisfaction survey and analysis,the lack of rigorous syndrome differentiation and the mismatch between the prescription and syndrome type,etc.In view of the above problems,further revising the diagnosis and treatment plan of pneumonia and asthma suitable for grass-roots hospitals can better bring into play the advantages of the clinical pathway of traditional Chinese medicine,to provide reference for the clinical diagnosis and treatment of community-acquired pneumonia in children and the application of clinical pathway of traditional Chinese medicine at the grass-roots level.