| PurposeTo observe the clinical efficacy of selective spinal tuina in the treatment of adenoid hypertrophy in children with lung and spleen qi deficiency,and to explore the possible immune mechanism of selective spinal tuina in the treatment of adenoid hypertrophy in children by detecting the changes of serum lymphocyte subsets CD3+,CD4+,CD8+,CD4+/CD8+,CD19+ and CD56+ before and after treatment.MethodSixty-six children who met the inclusion criteria were collected and divided into experimental group(n = 33)and control group(n = 33)according to the random number table,and there was one sample shedding in each group,and the actual number of samples included was 64 cases,including 32 cases in the experimental group and 32 cases in the control group.The experimental group was treated with selective spinal tuina with 20 min once every other day,3 times a week for 12 weeks,while the control group was treated with momethasone furoate nasal spray combined with oral montelukast sodium chewable tablets for 12 weeks.Before entering the group and on the first day after the course of treatment,professional evaluation doctors used TCM syndrome score scale and quality of life score scale to evaluate the two groups of children.At the same time,the serum lymphocyte subsets were detected,and the size of adenoid under fiberoptic nasopharyngoscope was examined.Excel software was used to record the data and IBM SPSS26.0 software for statistical analysis.The measurement data are expressed by mean plus and minus standard deviation((?) ±s),t-test is used for those who conform to normal distribution,rank sum test is used for those who do not conform to normal distribution,and counting data are described by frequency and percentage,and tested by chi-square test.The data of the two groups were compared within and between groups,P < 0.05 means that there is statistical difference,P > 0.05 means there is no statistical difference.Result1.Before entering the group,there was no significant difference in sex,age,course of disease,height and weight between the test group and the control group(P > 0.05).2.Before treatment,there were 15 cases of Ⅲ degree and 17 cases of Ⅳ degree in the experimental group,14 cases of Ⅲ degree and 18 cases of Ⅳ degree in the control group.There was no significant difference in the distribution of adenoid size between the two groups.After treatment,the adenoid size of the experimental group decreased from IV degree to Ⅱ degree in 6 cases,Ⅳ degree to Ⅲ degree in 3 cases,and Ⅲ degree to Ⅱ degree in 7 cases.In the control group,the size of adenoid decreased from IV degree to Ⅱ degree in 5 cases,from Ⅳ degree to Ⅲ degree in 6 cases,and from Ⅲ degree to Ⅱ degree in 6cases,which was statistically different from that before treatment.After treatment,there were 13 cases of Ⅱ degree,11 cases of Ⅲ degree and 8 cases of Ⅳ degree of adenoid size in the experimental group,while in the control group,there were 11 cases of Ⅱ degree,14 cases of Ⅲ degree and 7 cases of Ⅳ degree.3.Before treatment,there was no significant difference in the integral value of TCM syndrome between the two groups(P > 0.05),but after treatment,the score of TCM syndrome in the experimental group(21.90 ±8.47)was significantly lower than that before treatment(39.49 ±9.80),and the difference was statistically significant(P < 0.05).The integral value of TCM syndrome in the control group(26.80 ±9.73)was significantly lower than that before treatment(39.63 ±9.84),and the integral value of TCM syndrome in the test group(21.90 ±8.47)was significantly lower than that in the control group(26.80 ±9.73)(P < 0.05).Both the experimental group and the control group showed significant improvement of TCM clinical syndromes,and the curative effect of the experimental group was significantly better than that of the control group.4.Before treatment,there was no significant difference in the score of quality of life between the two groups(P > 0.05).After treatment,the scores of quality of life in both the test group and the control group were significantly lower than those before treatment,and the differences before and after treatment were statistically significant(P < 0.05),indicating that the quality of life in the test group and the control group had been improved.The data of the two groups were compared between the two groups(P < 0.05),which showed that the improvement of quality of life in the test group was better than that in the control group after treatment.5.Before treatment,there was no significant difference in the distribution of lymphocyte subsets between the two groups(P > 0.05).After treatment,the proportion of CD3+,CD4+ and CD4/CD8 in the experimental group decreased,while the proportion of CD19+ increased,these results showed statistical difference(P < 0.05).Although the proportion of CD56+ and CD8+ also increased,there was no significant difference.Compared with those before treatment,the proportion of CD3+,CD4+ and CD4/CD8 in the control group decreased,while the proportion of CD19+,CD56+ and CD8+ increased,but there was no significant difference before and after treatment.After treatment,the distribution level of CD3+,CD4+ and CD4/CD8 in the test group was lower than that in the control group,while the distribution level of CD19+ in the test group was higher than that in the control group,and the levels of CD56+ and CD8+ in the test group were higher than those in the control group,but there was no significant difference.The results showed that after treatment,the expression levels of CD3+,CD4+ and CD4/CD8 in the two groups were down-regulated,while the expression levels of CD19+,CD56+ and CD8+ were up-regulated,in which CD3+,CD4+ and CD4/CD8 in the test group were down-regulated and CD19+ was significantly higher than that in the control group.Conclusion1.Selective spinal tuina can effectively improve the TCM clinical syndrome of children with adenoid hypertrophy and improve their quality of life.2.The mechanism of selective spinal tuina in the treatment of adenoid hypertrophy in children may be achieved by down-regulating CD3+,CD4+ and CD4/CD8,up-regulating the expression of CD19+ and regulating immune function. |
